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Adrenal insufficiency is a deficiency of glucocorticoid production, which can result from adrenal gland failure (primary adrenal insufficiency) or failure of hypothalamic–pituitary secretion of corticotropin-releasing hormone (CRH) or adrenocorticotropic hormone (ACTH) (secondary adrenal insufficiency).
History. Obtain as accurate a history as possible, including the substance ingested or inhaled and the amount and time of ingestion. Always consider possible ingestion or inhalation of multiple substances.
It is estimated that 2 million people are burned annually in the United States. Of them, over 130,000 are children under the age of 15. Although most of these burns are minor, approximately 3–5% of burn injuries are life threatening.
Cardiovascular disease is the number one cause of death in the United States, killing more than 1,000 patients every day. Recent advances in our understanding of the pathogenesis of some of these disorders, as well as new therapeutic techniques, have greatly improved our ability to treat these patients.
The number of infectious complications encountered in the intensive care unit (ICU) continues to increase. Patients who otherwise would have not survived in the past are now improving due to new technical advancements. However, the length of stay, as well as the large number of devices employed for this purpose, predisposes patients to difficult and often fatal infections. Clinical characteristics...
Critical and intensive care medicine is an integrated discipline that requires the clinician to examine a number of important basic interactions. These include the interactions among organ systems, between the patient and his or her environment, and between the patient and life-support equipment. Gas exchange within the lung, for example, is dependent on the matching of ventilation and perfusion—in...
An intensive care unit (ICU) is an area of a hospital that provides aggressive therapy, using state-of-the-art technology and both invasive and noninvasive monitoring for critically ill and high-risk patients. In these units the patient’s physiological variables are reported to the practitioner on a continuous basis, so that titrated care can be provided.
Cancer is becoming the leading cause of death in the United States. Enhanced critical care capabilities have contributed substantially to improved survival. Critical care may be needed on a short-term basis for the complications of the underlying malignancy or of aggressive antineoplastic therapy. Postoperative critical care has greatly facilitated major extirpative cancer surgery and is an implicit...
A. The first technique in the management of patients with airway problems is manual opening of the airway (i.e., head-tilt, chin-lift). See Chapter 2, “The Basics of Critical Care.”
Many patients presenting to an intensive care facility will be pregnant. Many patients will have diseases peculiar to pregnancy and will need critical care support. Others, however, will have underlying medical diseases (Table 12.1). Some of those diseases will require consideration of the passenger (fetus) who has created many changes in maternal physiology. The hormonal milieu created by the placenta—progesterone...
The Handbook of Critical and Intensive Care Medicine, second edition, is a comprehensive, user-friendly guide for students, residents, fellows, and attending physicians who cover the ICU. The book's concise and up-to-date information includes frequently performed procedures and therapeutic guidelines that have great efficacy and relevance in everyday ICU rotations. For ease of reference, the chapters...
Background Rhabdomyolysis is a clinical syndrome that comprises destruction of skeletal muscle with outflow of intracellular muscle content into the bloodstream. There is a great heterogeneity in the literature regarding definition, epidemiology, and treatment. The aim of this systematic literature review was to summarize the current state of knowledge regarding the epidemiologic data, definition,...
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