BOOK
Psychiatric Aspects of Critical Care Medicine, An Issue of Critical Care Clinics, E-Book
(2017)
Additional Information
Book Details
Abstract
This issue of Critical Care Clinics focuses on Psychiatric Aspects of Critical Care Medicine. Editor Jose Maldonado has assembled an expert team of authors on topics such as: Psychiatric Aspects of Organ Transplantation in Critical Care; Medical Complications of Psychiatric Treatment; Psychiatric and Palliative Care in the ICU; Psychiatric Aspects of Heart and Lung Disease in Critical Care; Alcohol Withdrawal Syndromes: Assessment and Management; Substance Abuse and Withdrawal in the Critical Care Setting; Mood Disorders and The Outcome of Suicidal Thoughts and Attempts; Anxiety Disorders and the Outcomes of Trauma; Assessment and Management of Toxidromes in the Critical Care Unit; Neuropsychiatric Consequences of Trauma and Head Injury; Detection and Management of Pre-Existing Cognitive Impairment in the Critical Care Unit; Delirium: Pathophysiology, Diagnosis and Treatment; Neuropsychiatric Aspects of Infectious Processes.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Psychiatric Aspects of Critical Care Medicine:Update\r | i | ||
Copyright\r | ii | ||
Contributors | iii | ||
CONSULTING EDITOR | iii | ||
EDITOR | iii | ||
AUTHORS | iii | ||
Contents | vii | ||
Preface: Psychiatric Aspects of Critical Care Medicine: Update | vii | ||
Neurobehavioral Management of Traumatic Brain Injury in the Critical Care Setting: An Update | vii | ||
Detection and Management of Preexisting Cognitive Impairment in the Critical Care Unit | vii | ||
Acute Brain Failure: Pathophysiology, Diagnosis, Management, and Sequelae of Delirium | vii | ||
Assessment and Management of Toxidromes in the Critical Care Unit | viii | ||
Substance Use, Intoxication, and Withdrawal in the Critical Care Setting | viii | ||
Novel Algorithms for the Prophylaxis and Management of Alcohol Withdrawal Syndromes–Beyond Benzodiazepines | viii | ||
Psychiatric Aspects of Lung Disease in Critical Care | viii | ||
Psychiatric Aspects of Heart Disease (and Cardiac Aspects of Psychiatric Disease) in Critical Care | ix | ||
Psychiatric Disorders and Suicidality in the Intensive Care Unit | ix | ||
Posttraumatic Stress Disorder Phenomena After Critical Illness | ix | ||
Psychiatric Aspects of Organ Transplantation in Critical Care: An Update | ix | ||
Neuropsychiatric Aspects of Infectious Diseases: An Update | x | ||
Medical Complications of Psychiatric Treatment: An Update | x | ||
Psychiatric and Palliative Care in the Intensive Care Unit | x | ||
CRITICAL CARE CLINICS\r | xi | ||
FORTHCOMING ISSUES | xi | ||
October 2017 | xi | ||
January 2018 | xi | ||
April 2018 | xi | ||
RECENT ISSUES | xi | ||
April 2017 | xi | ||
January 2017 | xi | ||
October 2016 | xi | ||
Preface:\rPsychiatric Aspects of Critical Care Medicine: Update | xiii | ||
Neurobehavioral Management of Traumatic Brain Injury in the Critical Care Setting | 423 | ||
Key points | 423 | ||
INTRODUCTION | 423 | ||
Epidemiology | 424 | ||
DEFINITION | 424 | ||
CLASSIFICATION | 424 | ||
PATHOPHYSIOLOGY | 425 | ||
NEUROANATOMICAL CIRCUITRY | 427 | ||
NEUROBEHAVIORAL SYMPTOMS | 427 | ||
Acute Phase | 428 | ||
POST-TRAUMATIC BRAIN INJURY SYNDROMES | 429 | ||
Cognitive Deficits in Traumatic Brain Injury | 429 | ||
Psychosis | 430 | ||
Post-traumatic Stress Disorder | 430 | ||
Post-traumatic Brain Injury Depression | 430 | ||
Post-traumatic Brain Injury Mania | 430 | ||
Post-traumatic Brain Injury Aggression | 430 | ||
Behavioral Dyscontrol Disorder | 431 | ||
TREATMENT | 431 | ||
Introductory Remarks | 431 | ||
Treatment of Post-traumatic Brain Injury Delirium | 431 | ||
Antipsychotics | 432 | ||
Anticonvulsants | 432 | ||
Alpha-2 Antagonists | 432 | ||
Treatment of Post-traumatic Brain Injury Cognitive Deficits | 432 | ||
Dopaminergic Agents | 432 | ||
Psychostimulants | 433 | ||
SUMMARY | 433 | ||
REFERENCES | 434 | ||
Detection and Management of Preexisting Cognitive Impairment in the Critical Care Unit | 441 | ||
Key points | 441 | ||
IMPORTANCE OF PREEXISTING COGNITIVE IMPAIRMENT IN THE INTENSIVE CARE UNIT | 441 | ||
DEFINITIONS | 442 | ||
ROLE OF PREEXISTING COGNITIVE IMPAIRMENT IN INTENSIVE CARE UNIT UTILIZATION AND CARE DECISIONS | 444 | ||
DETECTION OF PREEXISTING COGNITIVE IMPAIRMENT IN THE INTENSIVE CARE UNIT | 445 | ||
PREVALENCE OF PREEXISTING COGNITIVE IMPAIRMENT IN THE INTENSIVE CARE UNIT | 446 | ||
RELATIONSHIP BETWEEN PREEXISTING COGNITIVE IMPAIRMENT AND DELIRIUM | 447 | ||
DELIRIUM SUPERIMPOSED ON DEMENTIA | 447 | ||
MANAGEMENT OF NEUROPSYCHIATRIC SYMPTOMS ASSOCIATED WITH PREEXISTING COGNITIVE IMPAIRMENT | 448 | ||
NONPHARMACOLOGIC MANAGEMENT | 448 | ||
IMPULSE DYSCONTROL AND AGITATION | 449 | ||
COMPORTMENT/PERSONALITY CHANGE | 449 | ||
AFFECTIVE DYSREGULATION | 452 | ||
MOTIVATIONAL DEFICIT | 452 | ||
PERCEPTUAL CHANGE AND PSYCHOTIC SYMPTOMS | 454 | ||
SUNDOWNING BEHAVIOR | 454 | ||
SUMMARY | 454 | ||
REFERENCES | 455 | ||
Acute Brain Failure | 461 | ||
Key points | 461 | ||
EPIDEMIOLOGY OF DELIRIUM | 461 | ||
Risk Factors for Delirium | 461 | ||
Neuropathogenesis of Delirium | 462 | ||
Clinical Presentation of Delirium | 467 | ||
Delirium Phenotypes | 467 | ||
Diagnosing Delirium | 468 | ||
MANAGEMENT OF DELIRIUM | 468 | ||
DELIRIUM PREVENTION STRATEGIES | 470 | ||
Nonpharmacologic Management Strategies | 470 | ||
Environmental Manipulations | 473 | ||
Physical and Occupational Therapy | 473 | ||
Light Therapy | 483 | ||
PHARMACOLOGIC MANAGEMENT STRATEGIES | 483 | ||
Pharmacologic Prevention Options | 483 | ||
Dopamine-antagonist agents | 483 | ||
Alpha-2 agonists | 483 | ||
Glutamate antagonists and calcium channel modulators | 483 | ||
Ketamine | 486 | ||
Melatonin and melatonin-agonists | 486 | ||
Statins | 486 | ||
Acetylcholinesterase inhibitors | 486 | ||
Pharmacologic Treatment Options | 486 | ||
Dopamine antagonists | 486 | ||
Safety concerns | 486 | ||
Antipsychotic alternatives to haloperidol | 487 | ||
Dopamine antagonist agents: treatment recommendations | 491 | ||
Alpha-2 agonists | 491 | ||
Glutamate antagonists and calcium channel modulators | 500 | ||
Acetylcholinesterase inhibitors | 500 | ||
Serotonin antagonists | 501 | ||
Melatonin and melatonin agonists | 501 | ||
MANAGEMENT OF HYPOACTIVE DELIRIUM | 501 | ||
DELIRIUM MANAGEMENT: WHAT DOES AND WHAT DOES NOT WORK | 501 | ||
THE IMPACT OF DELIRIUM | 503 | ||
Morbidity and Mortality Related to Delirium | 503 | ||
Cognitive Sequelae | 503 | ||
Behavioral Sequelae | 504 | ||
Fiscal Impact | 505 | ||
SUMMARY | 505 | ||
REFERENCES | 505 | ||
Assessment and Management of Toxidromes in the Critical Care Unit | 521 | ||
Key points | 521 | ||
INTRODUCTION | 521 | ||
GENERAL APPROACH | 522 | ||
TOXIDROMES | 523 | ||
Anticholinergics | 526 | ||
Cholinergics | 528 | ||
Sedative/Hypnotics | 529 | ||
Opioids | 530 | ||
Sympathomimetics | 531 | ||
Serotonergics | 532 | ||
Neuroleptics | 534 | ||
SUMMARY | 536 | ||
REFERENCES | 537 | ||
Substance Use, Intoxication, and Withdrawal in the Critical Care Setting | 543 | ||
Key points | 543 | ||
INTRODUCTION | 543 | ||
GENERAL CRITICAL CARE ISSUES RELATED TO SUBSTANCE USE | 544 | ||
Overdose | 544 | ||
Agitation | 544 | ||
Withdrawal | 544 | ||
Iatrogenic Dependence | 545 | ||
CRITICAL CARE ISSUES RELATED TO SPECIFIC SUBSTANCES | 545 | ||
Opioids | 545 | ||
Intoxication and overdose | 545 | ||
Withdrawal | 546 | ||
Pain management in patients with opioid use disorder, including patients receiving opioid agonist therapy | 547 | ||
Benzodiazepines | 547 | ||
Intoxication and overdose | 548 | ||
Withdrawal | 548 | ||
Stimulants: Cocaine and Methamphetamine | 548 | ||
Intoxication and overdose | 549 | ||
Withdrawal | 550 | ||
3,4-Methylenedioxymethamphetamine | 550 | ||
Intoxication and overdose | 550 | ||
Withdrawal | 551 | ||
Synthetic Cannabinoids | 551 | ||
Intoxication and overdose | 552 | ||
Withdrawal | 552 | ||
Synthetic Cathinones | 552 | ||
Intoxication and overdose | 553 | ||
Withdrawal | 553 | ||
TRANSITIONS OF CARE FOR PATIENTS WITH SUBSTANCE USE DISORDERS | 553 | ||
SUMMARY | 553 | ||
REFERENCES | 554 | ||
Novel Algorithms for the Prophylaxis and Management of Alcohol Withdrawal Syndromes–Beyond Benzodiazepines | 559 | ||
Key points | 559 | ||
BACKGROUND | 559 | ||
NEUROBIOLOGICAL EFFECTS OF ALCOHOL | 560 | ||
OVERVIEW OF ALCOHOL WITHDRAWAL SYNDROMES | 560 | ||
CLINICAL DILEMMA | 563 | ||
ALCOHOL WITHDRAWAL TREATMENT | 564 | ||
BENZODIAZEPINE-SPARING ALTERNATIVE FOR THE TREATMENT OF ALCOHOL WITHDRAWAL | 564 | ||
Other γ-Aminobutyric Acid-ergic Agents | 565 | ||
Antiepileptic Drugs | 565 | ||
Carbamazepine | 565 | ||
Oxcarbazepine | 567 | ||
Valproic acid | 567 | ||
Gabapentin | 571 | ||
Other antiepileptic agents | 571 | ||
Alpha-2 Adrenergic Receptor Agonist | 571 | ||
Clonidine | 577 | ||
Dexmedetomidine | 577 | ||
Guanfacine | 581 | ||
DEVELOPMENT OF A NOVEL ALGORITHM FOR THE PROPHYLAXIS AND TREATMENT OF ALCOHOL WITHDRAWAL | 581 | ||
SUMMARY | 587 | ||
REFERENCES | 587 | ||
Psychiatric Aspects of Lung Disease in Critical Care | 601 | ||
Key points | 601 | ||
INTRODUCTION | 601 | ||
EPIDEMIOLOGY OF PSYCHIATRIC ILLNESS IN CHRONIC LUNG DISEASE | 602 | ||
Substance Use Disorders and Pulmonary Disease | 602 | ||
ANXIETY IN CRITICALLY ILL PATIENTS WITH LUNG DISEASE | 603 | ||
Comorbid Anxiety Disorders and Pathophysiology of Comorbidity | 603 | ||
Acute Anxiety Disorders Emerging in Pulmonary Patients in the Intensive Care Unit | 605 | ||
Medical Conditions Manifesting as Anxiety in Pulmonary Patients in the Intensive Care Unit | 605 | ||
MOOD DISORDERS IN CRITICALLY ILL PATIENTS WITH LUNG DISEASE | 606 | ||
DELIRIUM IN CRITICALLY ILL PATIENTS WITH LUNG DISEASE | 607 | ||
PULMONARY MEDICATIONS LEADING TO NEUROPSYCHIATRIC SYMPTOMS | 608 | ||
ASSISTIVE RESPIRATORY TREATMENTS IN THE INTENSIVE CARE UNIT AND PSYCHOLOGICAL SYMPTOMS | 610 | ||
PSYCHIATRIC CONDITIONS AFTER THE INTENSIVE CARE UNIT | 611 | ||
USE OF PSYCHOTROPIC MEDICATIONS AMONG LUNG DISEASE PATIENTS IN THE CRITICAL CARE SETTING | 611 | ||
Sedative Infusions | 611 | ||
Antipsychotics | 611 | ||
Antidepressants | 612 | ||
Antianxiety Medications | 612 | ||
Drug–Drug Interactions | 613 | ||
SUMMARY | 613 | ||
REFERENCES | 614 | ||
Psychiatric Aspects of Heart Disease (and Cardiac Aspects of Psychiatric Disease) in Critical Care | 619 | ||
Key points | 619 | ||
PSYCHOLOGICAL RESPONSES TO CRITICAL CARE | 619 | ||
PSYCHIATRIC DISORDERS AND HEART DISEASE | 621 | ||
Differential Diagnosis | 621 | ||
Anger, Hostility, and Stress | 622 | ||
Takutsubo Cardiomyopathy | 623 | ||
Anxiety | 623 | ||
Depression | 623 | ||
Bipolar Affective Disorder | 624 | ||
Posttraumatic Stress Disorder | 625 | ||
Psychosis | 625 | ||
Delirium and Cognitive Impairment | 627 | ||
Alcohol Withdrawal | 627 | ||
CARDIOVASCULAR EFFECTS OF PSYCHOTROPIC DRUGS | 628 | ||
SPECIAL SITUATIONS | 629 | ||
Left Ventricular Assist Devices | 629 | ||
Atrial Fibrillation | 629 | ||
SUMMARY | 630 | ||
REFERENCES | 630 | ||
Psychiatric Disorders and Suicidality in the Intensive Care Unit | 635 | ||
Key points | 635 | ||
INTRODUCTION | 635 | ||
Psychiatric Disorders | 636 | ||
Mood Disorders | 636 | ||
Psychotic/Thought Disorders | 636 | ||
Substance Use Disorders | 636 | ||
Personality Disorders | 638 | ||
NEUROBIOLOGY OF SUICIDE | 638 | ||
SUICIDE SAFETY ASSESSMENT IN THE INTENSIVE CARE UNIT | 639 | ||
Current State of Suicidality | 639 | ||
Risk Factors | 639 | ||
Protective Factors | 639 | ||
Precipitating and Perpetuating Factors | 639 | ||
Environmental Safety Assessment | 641 | ||
Staff Attitudes Toward Patients Who Self-Harm | 642 | ||
The Patient’s Perspective | 642 | ||
Suicide Attempts and Completions in General Hospitals | 642 | ||
INVOLUNTARY PSYCHIATRIC HOLDS IN THE INTENSIVE CARE UNIT | 643 | ||
LIMITATIONS OF SUICIDE ASSESSMENTS | 644 | ||
OUTCOMES OF SUICIDE ATTEMPTS | 644 | ||
SUMMARY | 644 | ||
REFERENCES | 645 | ||
Posttraumatic Stress Disorder Phenomena After Critical Illness | 649 | ||
Key points | 649 | ||
INTRODUCTION | 649 | ||
WHAT IS STRESSFUL ABOUT CRITICAL ILLNESS? | 650 | ||
ARE POSTTRAUMATIC STRESS PHENOMENA REALLY A PROBLEM AFTER CRITICAL ILLNESS? | 651 | ||
SO PSYCHIATRIC ILLNESS IS A “RISK MARKER” FOR PSYCHIATRIC ILLNESS? | 652 | ||
WHAT ARE INTENSIVE CARE UNIT DIARIES? | 653 | ||
REFERENCES | 654 | ||
Psychiatric Aspects of Organ Transplantation in Critical Care | 659 | ||
Key points | 659 | ||
INTRODUCTION | 659 | ||
EPIDEMIOLOGY OF TRANSPLANTATION | 660 | ||
PRETRANSPLANT PERIOD | 660 | ||
Psychosocial Transplant Evaluation | 660 | ||
Waiting Period | 660 | ||
Psychological Considerations in Assistive Devices in Intensive Care Unit | 661 | ||
Ventricular assist devices for heart transplant candidates | 661 | ||
Extracorporeal membrane oxygenation in lung transplant patients | 662 | ||
PSYCHIATRIC DISORDERS IN TRANSPLANT PATIENTS | 662 | ||
Depression and Anxiety | 662 | ||
Suicidality | 663 | ||
Severe Mental Illness | 664 | ||
Cognitive Impairment and Delirium | 664 | ||
Substance Use Disorders | 665 | ||
Acute alcohol hepatitis | 666 | ||
Methadone maintenance therapy | 666 | ||
PSYCHOPHARMACOLOGY IN TRANSPLANT PATIENTS | 667 | ||
Effects of Immunosuppressant Medications | 667 | ||
Steroids | 667 | ||
Calcineurin-inhibiting immunosuppressants | 667 | ||
Treatment of Psychiatric Conditions in Transplant Patients | 668 | ||
Sedative drips | 668 | ||
Antidepressants | 669 | ||
Antipsychotics | 669 | ||
Mood stabilizers | 670 | ||
Antianxiety medications | 670 | ||
LIVE DONORS | 670 | ||
CAREGIVERS | 672 | ||
Patient Caregivers | 672 | ||
Health Care Provider Caregivers | 672 | ||
SUMMARY | 673 | ||
REFERENCES | 673 | ||
Neuropsychiatric Aspects of Infectious Diseases | 681 | ||
Key points | 681 | ||
INTRODUCTION | 681 | ||
MEDICAL HOSPITALIZATION IN HUMAN IMMUNODEFICIENCY VIRUS–AIDS | 682 | ||
EPIDEMIOLOGY OF PSYCHIATRIC DISORDERS IN MEDICAL INPATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS–AIDS | 682 | ||
HUMAN IMMUNODEFICIENCY VIRUS AND THE BRAIN | 682 | ||
DIFFERENTIAL DIAGNOSIS | 685 | ||
DIAGNOSTIC EVALUATION | 687 | ||
PSYCHIATRIC DISORDERS IN HUMAN IMMUNODEFICIENCY VIRUS–AIDS AND THEIR TREATMENT | 688 | ||
Depression | 688 | ||
Delirium | 689 | ||
Mania | 690 | ||
Psychosis | 691 | ||
Anxiety | 692 | ||
Herpes Simplex Encephalitis | 692 | ||
PEDIATRIC AUTOIMMUNE NEUROPSYCHIATRIC DISORDERS ASSOCIATED WITH STREPTOCOCCAL INFECTIONS | 693 | ||
NEUROCYSTICERCOSIS | 698 | ||
NEUROSYPHILIS | 699 | ||
CREUTZFELDT-JAKOB DISEASE | 700 | ||
LYME DISEASE ENCEPHALOPATHY (NEUROBORRELIOSIS) | 703 | ||
SUMMARY | 704 | ||
REFERENCES | 704 | ||
Medical Complications of Psychiatric Treatment | 713 | ||
Key points | 713 | ||
CENTRAL NERVOUS SYSTEM | 714 | ||
Neuroleptic Malignant Syndrome | 714 | ||
Serotonin Syndrome | 715 | ||
Delirium | 716 | ||
Seizures | 717 | ||
Cerebrovascular Events | 718 | ||
Reversible Cerebral Vasoconstriction Syndrome | 718 | ||
Extrapyramidal Syndromes | 718 | ||
Discontinuation Syndromes | 719 | ||
Sedation | 719 | ||
Myoclonus | 719 | ||
Thermoregulation | 719 | ||
CARDIOVASCULAR SYSTEM | 720 | ||
Arrhythmia | 720 | ||
Tricyclic antidepressants | 720 | ||
QT prolongation | 720 | ||
Orthostatic hypotension | 720 | ||
Hypertension | 722 | ||
Cardiotoxicity | 722 | ||
GASTROINTESTINAL | 722 | ||
Gastrointestinal Symptoms | 722 | ||
Pancreatitis | 723 | ||
Hepatic Dysfunction | 723 | ||
IMMUNOLOGIC | 723 | ||
RENAL | 723 | ||
Lithium | 724 | ||
Hyponatremia | 724 | ||
Urinary Symptoms | 724 | ||
ENDOCRINOLOGIC | 725 | ||
Weight Gain and Diabetic Ketoacidosis | 725 | ||
Thyroid Disorders | 725 | ||
HEMATOLOGIC | 726 | ||
Blood Dyscrasias | 726 | ||
Bleeding | 727 | ||
RESPIRATORY | 727 | ||
Respiratory Depression | 727 | ||
Respiratory Dyskinesia | 727 | ||
Pulmonary Embolism | 727 | ||
DERMATOLOGIC | 728 | ||
REPRODUCTIVE | 728 | ||
Sexual Dysfunction | 728 | ||
Priapism | 729 | ||
Pregnancy | 729 | ||
SUMMARY | 729 | ||
REFERENCES | 729 | ||
Psychiatric and Palliative Care in the Intensive Care Unit | 735 | ||
Key points | 735 | ||
INTRODUCTION | 735 | ||
PALLIATIVE CARE EVALUATION OF INTENSIVE CARE UNIT PATIENTS AND FAMILIES | 736 | ||
Evaluation and Management of Patients with Preexisting Chronic Mental Illness | 737 | ||
Spiritual Care Needs | 737 | ||
MODELS OF PALLIATIVE CARE IN THE INTENSIVE CARE UNIT | 737 | ||
The Consultative Model | 737 | ||
The Integrative Model | 738 | ||
The Combined Consultative-Integrative Model | 738 | ||
COMMUNICATION AND PALLIATIVE CARE IN THE INTENSIVE CARE UNIT | 738 | ||
PALLIATIVE PSYCHIATRY IN THE INTENSIVE CARE UNIT | 739 | ||
PSYCHIATRIC AND PALLIATIVE CARE IN THE POST–INTENSIVE CARE UNIT SETTING | 740 | ||
The Patient Experience | 740 | ||
The Family Experience | 741 | ||
SUMMARY/DISCUSSION | 741 | ||
REFERENCES | 742 | ||
Index | 745 |