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25 - Critical care medicine

Published online by Cambridge University Press:  05 September 2009

Harald Herkner
Affiliation:
Editor Cochrane Anaesthesia Review Group, Specialist Internal Medicine, Intensive Care Medicine, Cochrane Anaesthesia Group; Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria
Christof Havel
Affiliation:
Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria
Ann Møller
Affiliation:
KAS Herlev, Copenhagen
Tom Pedersen
Affiliation:
Rigshospitalet, Copenhagen
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Summary

This chapter will deal with a selection of topics, which are currently of practical and scientific importance. We discuss respiratory support including indication and conditions requiring respiratory support, examine the choice of artificial airway (tracheal tube, mask, tracheostoma). We present practical examples of ventilation strategies: lung-protective ventilation for acute respiratory distress syndrome (ARDS) and non-invasive ventilation for obstructive lung disease (OLD). Weaning from respiratory support will end this part.

Antibiotic therapy can be used as prophylactic therapy or to treat manifest sepsis. The current concept of initial empirical antimicrobial therapy and de-escalating strategy will be described. The part dealing with nutrition contains the steps necessary in practice: estimating the required energy, deciding kind of nutrient and route of administration, and management of problems. We will demonstrate that evidence regarding Vasopressors is sparse and give some practical information for treating cardiac arrest and septic shock.

Antithrombotic therapy goes beyond heparin alone. We exemplify this for deep vein thrombosis and sepsis.

Respiratory support

Indication for respiratory support

Some vague guidance is available to decide whether respiratory support should be provided to the individual patient. Nonetheless it is important to mention here that – on top of the available evidence – patient centredness, ethical considerations, and critical assessment of the actual situation are necessary to appropriately supply this core element of intensive care medicine.

Type
Chapter
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Publisher: Cambridge University Press
Print publication year: 2006

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  • Critical care medicine
    • By Harald Herkner, Editor Cochrane Anaesthesia Review Group, Specialist Internal Medicine, Intensive Care Medicine, Cochrane Anaesthesia Group; Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria, Christof Havel, Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book: Evidence-based Anaesthesia and Intensive Care
  • Online publication: 05 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544613.026
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  • Critical care medicine
    • By Harald Herkner, Editor Cochrane Anaesthesia Review Group, Specialist Internal Medicine, Intensive Care Medicine, Cochrane Anaesthesia Group; Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria, Christof Havel, Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book: Evidence-based Anaesthesia and Intensive Care
  • Online publication: 05 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544613.026
Available formats
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Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Critical care medicine
    • By Harald Herkner, Editor Cochrane Anaesthesia Review Group, Specialist Internal Medicine, Intensive Care Medicine, Cochrane Anaesthesia Group; Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria, Christof Havel, Department of Emergency Medicine, Vienna General Hospital/Medical University of Vienna, Austria
  • Edited by Ann Møller, KAS Herlev, Copenhagen, Tom Pedersen, Rigshospitalet, Copenhagen
  • Book: Evidence-based Anaesthesia and Intensive Care
  • Online publication: 05 September 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544613.026
Available formats
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