bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consequences of Anoxia and Ischemia to the Brain
Authors: Fugate Jennifer E. 
Published: August 2019

Abstract
Systemic illness can have an abrupt and sometimes profound effect on the central nervous system. Organ failure and acute electrolyte disturbances may cause neurologic manifestations that are often accompanied by a decline in consciousness. Secondary injury is characterized by demyelination, cerebral edema, and anoxic-ischemic brain injury.
Neurogenic Cardiac Manifestations
Authors: Braksick Sherri A. , Wijdicks Eelco F. M. 
Published: August 2019

Abstract
Paroxysmal sympathetic hyperactivity (PSH) is a form of acute dysautonomia that can occur after several types of acute (usually severe) structural brain injury. PSH typically occurs after traumatic brain injury (TBI) with diffuse axonal injury, yet it can also occur after aneurysmal subarachnoid hemorrhage, encephalitis, massive fat or air embolism, or profound anoxic-ischemic brain injury, often with each condition leading to prolonged unconsciousness. The development of PSH is associated with longer hospital stays, and it may be associated with increased mortality and worse outcomes.
Paroxysmal Sympathetic Hyperactivity
Authors: Gobeske Kevin T. 
Published: August 2019

Abstract
Neurologic examination of critically ill neurologic patients must be the uncompromised gold standard in any evaluation. Without it or when confounded, the attending physician is prone to make errors in diagnosis and prognosis. Even in intensive care units (ICUs), where abnormal laboratory test results and imaging findings are common, knowledge of the neurology of neurocritical care includes understanding the clinical course after initial presentation. Despite surprises delivered by magnetic resonance imaging, the clinical practice of lesion localization must be a component of the practice of neurocritical care and be based on a full knowledge of neurologic tests, an approach typically lacking in clinical trial–devised scales or scores.
Pulmonary Embolism: An Overview
Authors: Nokes Brandon T. , Cartin-Ceba Rodrigo 
Published: August 2019

Abstract
Venous thromboembolism (VTE) is a major public health concern with an annual incidence of 1 per 1,000 patients in the United States. VTE encompasses a spectrum of diseases including deep vein thrombosis (DVT) and pulmonary embolism (PE). DVT is a precursor to PE, and approximately 80% of patients have DVT when PE is diagnosed. The risk factors for PE are the same as those for DVT; consequently, diagnosis and management of VTE are contingent on the underlying risk factors and the extent of disease. A suspected VTE diagnosis should be pursued with risk stratification tools such as the Wells DVT and PE criteria and the Revised Geneva Score for PE. This chapter reviews PE diagnosis, risk stratification, and management.
Asthma in the Critically Ill Patient
Authors: Danaraj Jonathan J. , Lee Augustine S. 
Published: August 2019

Abstract
Asthma is a common condition that affects an estimated 24 million children and adults in the United States (prevalence, 8%-10%). Globally, over 300 million people are affected and the number is expected to increase. The age distribution is bimodal, but in most patients, asthma is diagnosed before age 18 years (male to female ratio, 2:1 in children; 1:1 in adults). Susceptibility to asthma is multifactorial with both genetic and environmental factors. The strongest risk factor is atopy, a sensitivity to the development of immunoglobulin E (IgE) to specific allergens. A person with atopy is 3- to 4-fold more likely to have asthma than a person without atopy. Other risk factors include birth weight, prematurity, tobacco use (including secondary exposure), and obesity.
Chronic Obstructive Pulmonary Disease Exacerbation
Authors: Mira-Avendano Isabel , Kwon Minkyung 
Published: August 2019

Abstract
Patients with chronic obstructive pulmonary disease (COPD) have recurring or continuous obstruction of bronchial airflow. The disease is usually characterized by progressive chronic airway inflammation that results from smooth muscle hypertrophy, airway ciliary dysfunction, and excessive mucous production, which ultimately increases airway resistance and hyperactivity. Parenchymal destruction associated with emphysema increases lung compliance, which further decreases expiratory airflow. COPD exacerbation can be precipitated by several factors, but the most common causes are respiratory tract infections (viral or bacterial).
Pleural Diseases in Critical Care Medicine
Authors: Linga Karthika R. , Patel Neal M. 
Published: August 2019

Abstract
Pleural disease often affects critically ill patients and is usually related to trauma (including accidental perforation) or infection. Pneumothorax, a potentially life-threatening condition, requires early clinical recognition and sometimes urgent treatment. General intensivists often encounter pneumothorax after a procedure such as catheter placement. Neurointensivists often encounter pneumothorax after polytrauma or recent tunneling of a ventriculoperitoneal catheter.
Pulmonary Hypertension and Right-Sided Heart Failure in the Critically Ill
Authors: Burger Charles D. 
Published: August 2019

Abstract
Pulmonary hypertension (PH) was defined hemodynamically at the Fifth World Symposium on Pulmonary Hypertension (WSPH) as a mean pulmonary artery (PA) pressure (mPAP) of 25 mm Hg or more. Five diagnostic groups represent the various causes of PH. Group 1 pulmonary arterial hypertension (PAH) requires both an elevated mPAP and a pulmonary vascular resistance (PVR) of at least 3 Wood units; therefore, the left-sided heart filling pressures are not elevated (pulmonary arterial wedge pressure [PAWP] ≤15 mm Hg). Conversely, in group 2 PH, left-sided heart disease causes an elevation in PAWP. Group 3 PH is due to chronic hypoxemia typically from lung disease, group 4 PH is chronic thromboembolic PH, and group 5 PH is a miscellaneous category.
Cardiac Rhythm and Conduction Disturbances
Authors: Gonzalez Yahaira Ortiz , Kusumoto Fred 
Published: August 2019

Abstract
Patients in the intensive care unit (ICU) are exposed to several physiologic stressors that may trigger cardiac arrhythmias and lead to hemodynamic instability. Prompt recognition and initiation of appropriate therapies for arrhythmias is important because critically ill patients with arrhythmias (compared to patients without arrhythmias) have longer hospitalizations and higher mortality (30.8% vs 21.2%). Arrhythmias are classified as tachyarrhythmias or bradyarrhythmias. The most common sustained arrhythmias are supraventricular; atrial fibrillation is the most prevalent. Among the ventricular arrhythmias, up to 50% are monomorphic ventricular tachycardias.
Hypertensive Emergencies
Authors: Hill Denzil R. , Onigkeit James A. 
Published: August 2019

Abstract
Hypertension is a global problem. According to the World Heart Federation, nearly 1 billion people worldwide have hypertension, and nearly two-thirds of them live in developing countries. By the year 2025, hypertension may affect more than 1.5 billion people. Uncontrolled hypertension is 1 of the main causes of premature death worldwide and the most common risk factor for heart disease, stroke, and renal diseases.
Cardiopulmonary Resuscitation
Authors: Patch Richard K. 
Published: August 2019

Abstract
Cardiac arrest is a complex dynamic process that may occur as an end point of multiple disease states. The field of cardiopulmonary resuscitation (CPR) for cardiac arrest continues to evolve, and guidelines are updated in accordance with evidence-based evaluation of current medical literature. The guidelines are the cornerstone for the management of cardiac arrest in out-of-hospital, in-hospital, and intraoperative settings. Furthermore, the implementation of comprehensive postarrest care is vital for improving patient outcomes.
Diabetes Insipidus
Authors: Erickson Dana 
Published: August 2019

Abstract
Diabetes insipidus (DI) results from the impaired secretion or action of antidiuretic hormone (ADH). Central DI occurs with partial or complete ADH deficiency; nephrogenic DI occurs with impaired action of ADH in the kidneys. These defects result in the production of large volumes of inappropriately dilute urine, which increases plasma osmolality and eventually stimulates thirst.
Glycemic Control in Neurocritically Ill Patients
Authors: Venegas-Borsellino Carla P. , Pizzi Michael A. , Naranjo-Sierra Santiago 
Published: August 2019

Abstract
Hyperglycemia, hypoglycemia, and variable blood glucose levels are associated with poor outcomes in critically ill patients. Patients with acute brain injury are sensitive to changes in glycemic levels because brain metabolism depends on a continuous, reliable supply of glucose. Numerous studies have shown that even moderate hypoglycemia may cause pronounced neuroglycopenia. Conversely hyperglycemia, which is prevalent in neurocritically ill patients, has been related to adverse outcomes after traumatic brain injury, ischemic stroke, intracranial hemorrhage, and subarachnoid hemorrhage.
Acute Gastrointestinal Hemorrhage
Authors: Franco Pablo Moreno , Lowman Philip E. 
Published: August 2019

Abstract
Gastrointestinal hemorrhage (GIH) is a common medical problem that is associated with considerable morbidity, mortality, and medical costs. The initial approach when GIH is suspected depends on a patient’s clinical stability, which will vary depending on the amount and speed of blood loss. Therefore, if time allows, the initial evaluation should include history, physical examination, laboratory tests, and, possibly, nasogastric tube placement.
Paralytic and Obstructive Ileus
Authors: Canabal Juan M. 
Published: August 2019

Abstract
Ileus is the most common manifestation of acute gastrointestinal injury which exhibits grades of severity in the critically ill. Appropriate characterization of ileus as adynamic or mechanical in origin determines its management. This chapter discusses the most important causes, clinical and radiologic findings, and appropriate management of ileus that develops in patients in the intensive care unit.
Acute Vascular Disorders of the Intestine
Authors: Mousa Omar Y. , Pungpapong Surakit 
Published: August 2019

Abstract
Mesenteric ischemia is caused by insufficient blood supply to the foregut and intestines. When the blood supply does not meet the metabolic requirements of these organs, catastrophic complications may result. Death is imminent in the setting of acute mesenteric ischemia if diagnosis is delayed; associated mortality rates are as high as 60% to 80%. The severity and extent of this disease depend on the nature of the vascular obstruction and the type of occluded vessel.
Abdominal Compartment Syndrome
Authors: Johnson Daniel J. 
Published: August 2019

Abstract
In abdominal compartment syndrome (ACS), a fixed compartment (the abdomen with defined myofascial elements) is subjected to increased pressure. The result is decreased organ perfusion and subsequent dysfunction inside the abdominal cavity and the respiratory and cardiovascular systems. Given the affect of treatment for organ dysfunction, an accurate characterization of primary illness progression and ACS is crucial for diagnostic assessment.
Acute Kidney Injury
Authors: Sakhuja Ankit , Kashani Kianoush B. 
Published: August 2019

Abstract
Acute kidney injury (AKI) is a complex disorder that encompasses a broad spectrum of clinical presentations ranging from subclinical injury to complete loss of kidney function. AKI is fairly common in critically ill patients. Among patients who have similar conditions, those who have development of AKI have worse outcomes than those who do not. There have been significant strides in understanding the pathophysiology of AKI in recent years, but management is mostly supportive, and prevention remains critical for improving outcomes.
Anemia and Blood Transfusion
Authors: Hughes Joy D. , Rivera Mariela , Park Myung S. 
Published: August 2019

Abstract
Critically ill patients commonly present with anemia, defined as a hemoglobin level less than 13.0 g/dL in men and less than 11.6 g/dL in women or as clinical signs of bleeding, including tachycardia and low urine output with active hemorrhage. Anemia is common, occurring in up to a third of critically ill patients, and is associated with high morbidity and mortality rates, particularly in patients with central nervous system injuries and disease. The causes of anemia can vary from chronic conditions such as kidney disease or malnutrition to acute conditions such as bleeding or consumptive coagulopathy.
Hematologic and Oncologic Complications in the Intensive Care Unit
Authors: Ruthman Carl A. , Yataco Jose C. 
Published: August 2019

Abstract
Patients with cancer can present to the ICU with the complications and conditions of the general population, but a few are particular to their type of cancer or treatment. Some of the most common of cancer-related ICU complications are reviewed in this chapter, particularly those that need complex and urgent management.
Thrombocytopenia and Thrombocytopathy
Authors: Johns Gretchen 
Published: August 2019

Abstract
Platelet disorders are quantitative or qualitative, or both. Either markedly increased or decreased numbers of platelets can cause harmful sequelae. Platelet disorders can be divided into acquired or hereditary; acquired disorders are much more common than congenital disorders. Platelet disorders can be due to increased platelet destruction or decreased platelet production. Pseudothrombocytopenia, dilutional effects, or possible splenic sequestration should be considered when the platelet count is low for the first time. The recent addition of a drug, commonly used in intensive care units, is also an important consideration for patients with newly acquired thrombocytopenia.
Diagnosis and Management of Acquired Bleeding Disorders
Authors: Pruthi Rajiv K. 
Published: August 2019

Abstract
The hemostatic response to vascular injury consists of vascular constriction, platelet activation resulting in platelet adhesion (mediated by von Willebrand factor), and platelet aggregation resulting in an initial platelet plug formation at the site of vascular injury. This platelet plug is stabilized by formation of fibrin, which results from activation of the procoagulant coagulation factors. Congenital or acquired abnormalities of the procoagulant factors result in a bleeding and thrombotic tendency of variable severity. Acquired abnormalities of the procoagulant system are typically associated underlying systemic disorders; however, they may also be idiopathic. Recognition, laboratory diagnosis, and principles of management of acquired coagulopathy are reviewed in this chapter.
Anticoagulation Monitoring and Reversal
Authors: Kinard Theresa N. 
Published: August 2019

Abstract
The balance of natural procoagulant and anticoagulant activity within the body is delicate, and a minor disruption may lead to bleeding or clotting complications. Anticoagulation in critical illness is often necessary for a host of reasons, either prophylactic or therapeutic. This chapter reviews common anticoagulation management issues in the critically ill patient, such as optimal laboratory monitoring of anticoagulation therapy and urgent reversal options, focusing on the most common anticoagulants used in current practice.
Therapeutic Plasma Exchange for Acute Hematologic Disorders
Authors: Adamski Jill 
Published: August 2019

Abstract
Therapeutic plasma exchange (TPE) is a process by which whole blood is removed from a patient and separated into 3 components: red blood cells, white blood cells (buffy coat), and plasma. After separation, the plasma is discarded, and the other blood components are returned to the patient along with exogenous fluid to replace the removed plasma. TPE is an important tool to remove pathogenic substances (eg, antibodies) from plasma, and this technique is considered first-line therapy for numerous conditions that affect patients in the critical care unit. This chapter describes the role of TPE in management of hematologic disorders, some of which have neurologic manifestations.
Infectious Diseases Complicating Critical Care
Authors: Aviles David A. Sotello , Hellinger Walter C. 
Published: August 2019

Abstract
Infection is a common complication in the intensive care unit (ICU). Furthermore, infection more than doubles the mortality rate in the ICU. Antibiotic resistance in Staphylococcus aureus, Enterococcus, Enterobacteriaceae, and fungal infection is among the most challenging issues in the ICU. In addition, critical illness affects antibiotic pharmacokinetics. Thus, implementation of strategies to prevent infection is of utmost importance to improve patient outcome.
Initial Approach to the Management of Multisystem Trauma
Authors: Morris David S. 
Published: August 2019

Abstract
Nearly 200,000 people die of injury-related causes in the United States each year, and injury is the leading cause of death for all patients aged 1 to 44 years. Approximately 30 million people sustain nonfatal injuries each year, which results in about 29 million emergency department visits and 3 million hospital admissions. Management of severely injured patients, typically defined as having an Injury Severity Score greater than 15 is best managed in a level I or level II trauma center. Any physician who provides care for critically ill patients should have a basic familiarity with the fundamentals of trauma care.
Chest and Abdominal Trauma
Authors: Hughes Joy D. , Morris David S. 
Published: August 2019

Abstract
Injuries to the chest or abdomen frequently affect management of traumatic brain injury (TBI). Neurocritical care clinicians must be familiar with management principles for these injuries. This chapter reviews common injuries to the torso, with particular attention to problems affecting neurologic management, but it cannot provide an exhaustive list of injuries and management principles for this broad topic. Close interaction with clinicians familiar with the management of nonneurologic traumatic injury is recommended.
Burns and Electrical Injuries
Authors: Nokes Brandon T. , Sen Ayan 
Published: August 2019

Abstract
Burn injuries may cause morbidity and death, and patients may have widely variable presentations and outcomes. This chapter focuses on the critical care aspects of burn injury and management issues of burn and electrical injuries. Burns are classified according to the amount of total body surface area (TBSA) affected, the depth of burn, and the type of exposure associated with the burn. More specifically, burns can be chemical, electrical, or thermal. Burn severity is determined by the depth of involvement.
Cardiothoracic Surgery and Postoperative Intensive Care
Authors: Sanz Juan G. Ripoll , Ratzlaff Robert A. 
Published: August 2019

Abstract
Cardiothoracic surgical (CTS) critical care responsibilities have progressively shifted away from surgeons and toward intensivists in the past several decades. CTS patients present unique challenges, and optimal patient care in the intensive care unit is a main factor for the prevention of deaths after any type of open heart surgery.
Mechanical Circulatory Assist Devices
Authors: Sen Ayan , Patel Bhavesh M. 
Published: August 2019

Abstract
Mechanical circulatory assist devices (MCADs) are used in patients with decompensated heart failure refractory to medical therapy. The devices are used as a bridge to transplant, as a bridge to recovery for reversible conditions, as a bridge to decision while a patient’s eligibility for transplant is determined, and as destination therapy to support left-sided heart function when a patient is not eligible for transplant. MCADs restore tissue circulation by increasing blood flow and, thereby, improving organ function.
Critical Care of Heart-Lung and Lung Transplant Recipients
Authors: Sista Ramachandra R. 
Published: August 2019

Abstract
Lung transplant is a complex procedure that has been a successful therapy for various end-stage lung diseases since the 1980s. Combined heart-lung transplant, however, is performed much less frequently than in the past. Survival rates after lung transplant have been stable over the past several years (90% survival at 3 months, 80% at 1 year, 60% at 3 years, and 45% at 5 years). The types of transplant procedures available and the general indications for lung transplant are listed in this chapter.
Clinical Management of Liver Transplant Recipients
Authors: Gali Bhargavi 
Published: August 2019

Abstract
Improvements in surgical, anesthetic, and critical care management since the 1990s have led to better outcomes for liver transplant (LT) recipients. Estimated 1-year survival after LT increased from 64% in 1989 to 89% in 2014. Of all transplants performed in the United States, 23% are LTs, and more than 7,000 LTs were performed in 2015. In most medical centers, LT recipients are initially cared for in an intensive care unit (ICU). With changes in the intraoperative surgical and anesthetic management, the typical time and resources required for immediate postoperative care have decreased, allowing for rapid recovery protocols to be instituted in some centers for patients without clinical complications.
Neuroleptic Malignant Syndrome and Hyperthermia
Authors: Renew J. Ross , Mordecai Monica 
Published: August 2019

Abstract
Neuroleptic malignant syndrome (NMS) is an uncommon, potentially fatal reaction to antipsychotic medications. Most cases occur in men between the ages of 20 and 50 because they have the highest proportion of antipsychotic consumption. The prevalence of NMS has been reported as 0.07% to 2.2%, but the published diagnostic criteria for NMS varied widely until the Diagnostic and Statistical Manual of Mental Disorders addressed the issue in 2013. NMS is characterized by a constellation of clinical symptoms and laboratory abnormalities, including hyperthermia, muscle rigidity, and increased serum creatine kinase levels. Patients may also present with tremor, altered mental status, autonomic dysfunction, and leukocytosis.
Clinical Toxicology: Selected Drugs of Abuse and Chemical and Biological Warfare Agents
Authors: Sztajnkrycer Matthew D. 
Published: August 2019

Abstract
Approximately 10% of the US population 12 years or older uses illicit drugs. Although illicit drug use is typically considered a disease of the young, substance misuse is also a serious risk for older persons. Chemical and biological agents have been used in warfare for millennia. Chemical weapons are regulated under the 1993 Chemical Weapons Convention. Classic chemical weapons include nerve agents, vesicants, blood agents (cellular asphyxiants [eg, cyanide]), choking agents (pulmonary toxicity [eg, phosgene and chlorine]), and incapacitating agents (nonlethal [eg, 3-quinuclidinyl benzilate]). The Centers for Disease Control and Prevention (CDC) classifies biological warfare agents into Category A, B, or C. Category A agents are of greatest concern.
Diagnosis and Management of Hemispheric Infarction
Authors: Grewal Sanjeet S. , Brown Benjamin L. 
Published: August 2019

Abstract
Hemispheric infarction is a major cause of morbidity and death among patients with acute stroke. These patients must receive a timely diagnosis and treatment for the best outcomes. Treatment is often multimodal and requires close and meaningful communication with the patient and family about management options and the risks and benefits of each.
Adult Primary Central Nervous System Vasculitis
Authors: Salvarani Carlo , Brown Robert D. , Hunder Gene G. 
Published: August 2019

Abstract
Primary central nervous system vasculitis (PCNSV) is an infrequent and not well understood form of vasculitis that is limited to the brain and spinal cord. However, PCNSV is the most frequent vasculitis involving the central nervous system. Men and women are similarly affected, and the median age at diagnosis is approximately 50 years.