Critical Care

Download Anaesthesia, Pain, Intensive Care and Emergency Medicine - by A. Gullo PDF

By A. Gullo

In sleek medication the main useful methodologies are taking an expanding significance in spreading informations, rendering it credible whereas whilst utilizing trustworthy information to concentration interplay among uncomplicated technology and scientific drugs. serious care drugs embraces those wishes and greater than the other self-discipline thrives and develops because of interdisciplinary touch. APICE 2004 has been organised to supply special solutions to those matters. particularly, massive emphasis has been given to the experiences in regards to the most crucial facets - or the main major medical advancements - within the sectors related to number of services: neurological, breathing and cardiovascular, gastrointestinal, metabolism and perfusion; trauma infections, sepsis and organ failure; perioperative medication and lifestyles aid options; info know-how devoted to scientific medication, but additionally as a method of data and schooling. The contributing authors are all a part of major study teams on the foreign point within the quite a few sectors provided within the quantity.

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Extra resources for Anaesthesia, Pain, Intensive Care and Emergency Medicine - A.P.I.C.E.: Proceedings of the 19 th Postgraduate Course in Critical Care Medicine. Trieste, Italy - November 12-15, 2004

Example text

Am J Respir Crit Care Med 161:1660-1665 31. Broccard AF (2003) Prone position in ARDS: are we looking at a half-empty or half-full glass? Chest 123:1334-1336 Effect of body position on ventilation/perfusion matching 15 32. Gattinoni L, Pelosi P, Vitale G et al (1991) Body position changes redistribute lung computed-tomographic density in patients with acute respiratory failure. Anesthesiology 74:15-23 33. Langer M, Mascheroni D, Marcolin R et al (1988) The prone position in ARDS patients. A clinical study.

But an initial recognition of the different waves of depolarisation/repolarisation allows a quick understanding of many cardiac conditions that are potentially dangerous, so that anybody approaching a patient in the ED should be familiar with these. Moreover, new insights into ECG interpretation are under investigation, as the molecular and biophysical bases of the cardiac action potential have just been discovered [3]. The P wave is the first depolarisation wave to be examined: it usually comes from the sinoatrial (SA) node and spreads throughout the atrial myocardium.

10 G. Hedenstierna Table 1. Improved oxygenation in prone position Condition Adult ALI Cardiac surgery Paediatric ALI ALI = acute lung injury Reference [19–23] [23] [24] Table 2. Potential mechanisms of improved oxygenation in the prone position Proposed mechanism 1 More even vertical distribution of perfusion 2 Improved V/Q match 3 More even ventilation distribution a) Smaller vertical pleural pressure gradient b) Increased FRC and more even gas volume distribution c) Less lung compression by the heart 4 Less lung consolidation/atelectasis Reference [25] [26, 27] [28] [29] [30, 31] [33, 34] The distribution of ventilation will be affected by the collapse and consolidation, and a major feature is redistribution away from the dependent to the higher lung regions that are still aerated.

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