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Small animal critical care medicine
SILVERSTEIN-HOPPER
Small animal critical care medicine
3° ed., 1258 pagg., 800 ill., Elsevier, gennaio 2023
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The 3rd edition of your #1 go-to resource for veterinary critical care, Small Animal Critical Care Medicine, has been significantly updated to focus specifically on diagnostic and management strategies for the sickest veterinary patients. It covers critical care medical therapy, monitoring, and prognosis — from assessment and stabilization through the entire course of intensive care treatment. To make therapeutic decisions easier, clear and practical guidelines address underlying clinical findings, pathophysiology, outpatient follow-up, and long-term care. Editors Deborah Silverstein and Kate Hopper, along with leading experts from the veterinary emergency and critical care profession, have created this indispensable resource to help you and your team provide the highest standard of care for your critically ill patients.
 
Key Features
  • Over 200 concise, thoroughly updated chapters cover all the clinical areas needed for evaluating, diagnosing, managing, and monitoring a critical veterinary patient.
  • More than 150 recognized experts and many new authors offer in-depth, authoritative guidance on emergency and critical care clinical situations from a variety of perspectives.
  • A problem-based approach focuses on clinically relevant details.
  • Hundreds of full-color illustrations with updated photos and videos depict various emergency procedures, such as chest tube placement.
  • Handy appendices offer quick access to the most often needed calculations, conversion tables, continuous rate infusion determinations, reference ranges, and more.
  • Practical, user-friendly format makes reference quick and easy with summary tables, boxes highlighting key points, illustrations, and algorithmic approaches to diagnosis and management.

Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Foreword
Video TOC
    List of Tables
    List of Illustrations
Part I. Key Critical Care Concepts
1.  Evaluation and triage of the critically ill patient
    Introduction
    Primary survey
    Supporting diagnostics
    Summary
    Selected references
    References
2.  Physical examination and daily assessment of the critically ill patient
    Physical examination
    Point-of-care ultrasound
    Monitoring and laboratory data
    Drug dosages and metabolism
    Nutrition
    Nursing care
    References
3.  Hemostasis
    Overview of platelet structure and function
    Primary hemostasis and the three-stage model of platelet activation
    Secondary hemostasis
    Overview of fibrinolysis
    Immunothrombosis
    Summary
    References
4.  Cardiopulmonary resuscitation
    Preparedness and prevention
    Basic life support
    Monitoring
    Advanced life support
    Open-chest CPR
    Prognosis
    References
5.  Postcardiac arrest care
    Propagating sustained ROSC
    Systemic response to ischemia and reperfusion: Sepsis-like syndrome
    Post-cardiac arrest brain injury
    Neurologic assessment and prognostication
    Myocardial dysfunction
    Persistent precipitating pathology
    References
6.  Classification and initial management of shock states
    Pathophysiology
    Clinical presentation of circulatory shock
    Diagnostics and monitoring
    Treatment
    References
7.  SIRS, MODS, and sepsis
    Background
    Evolution of definitions
    Assessment of MODS severity
    The apple score
    Assessment of animals with SIRS or MODS
    Summary
    References
8.  Oxygen toxicity
    Pathophysiology
    Cellular effect of oxidative injury
    Ischemia-reperfusion injury
    Clinical effects of hyperoxia
    Hyperoxia in the critically ill
    Hyperbaric oxygen therapy
    Antioxidants
    Prevention and treatment of oxygen toxicity
    References
9.  The endothelial surface layer
    Introduction
    The importance of the ESL in critical illness
    Structure and function
    Fluid movement across the endothelium
    Shedding of the ESL
    Methods for detection of ESL shedding
    ESL shedding in dogs and cats
    Protection of the ESL in disease
    Conclusion
    References
10.  Hyperthermia and fever
    Thermoregulation
    Hyperthermia
    True fever
    Inadequate heat dissipation
    Benefits and detriments of fever
    Clinical approach to the hyperthermic patient
    Nonspecific therapy for febrile patients
    The febrile intensive care patient
    References
11.  Interstitial edema
    Microvascular filtration
    Lymphatic drainage
    Serosal transudation
    Antiedema mechanisms
    Mechanisms of edema formation
    Chronic edemagenic conditions
    Conclusion
    References
12.  Patient suffering in the intensive care unit
    Maslow’s hierarchy of needs and primal alert signals
    References
13.  Predictive scoring systems in veterinary medicine
    Definition
    Outcome probability vs. clinical decision aid tools
    Applications in clinical practice
    Applications in hospital management
    Applications in research
    Demonstration of effective or ineffective randomization in randomized controlled trials
    Reduction of required sample sizes
    Construction of scoring systems
    Critical appraisal
    Conclusion
    References
Part II. Respiratory Disorders
14.  Control of breathing
    Central control of breathing
    Descending pathways
    Chemoreceptors and response to blood gases
    Other sensory receptors
    Abnormalities in the control of breathing
    References
15.  Oxygen therapy
    Arterial oxygen content
    Indications for oxygen therapy
    Methods of oxygen administration
    Complications of oxygen therapy
    References
16.  Hypoxemia
    Collection of blood samples for in vitro measurement
    Recognition of hypoxemia
    Mechanisms of hypoxemia
    Estimating the magnitude of the venous admixture
    References
17.  Hypoventilation
    Definitions and measurement
    Mechanisms and etiologies of hypercapnia
    Clinical signs
    Diagnosis
    Treatment
    References
18.  Upper airway disease
    History and clinical signs
    Patient evaluation
    Stabilization of patients with upper airway obstruction
    Diagnostics
    Diseases of the upper airway
    References
19.  Tracheal collapse: Management & indications for tracheal stents
    Etiology
    Clinical signs
    Diagnostic evaluation
    Medical management
    Tracheal rings
    Tracheal stenting
    Post-stenting management considerations
    Tracheal stent complications
    Stenting for tracheal neoplasia
    References
20.  Feline bronchopulmonary disease
    History and physical examination
    Laboratory testing
    Lung function testing
    Airway sampling
    Treatment
    Prognosis
    References
21.  Lower airway disease in dogs
    Introduction
    Diagnosis of underlying conditions
    Standard treatment
    Disease exacerbation
    Conclusion
    References
22.  Pulmonary hypertension
    Definitions and terminology
    Pathophysiology
    Assessment of PH
    Classification of PH
    Clinical findings
    Diagnostic evaluation
    Clinical management
    Prognosis and monitoring
    References
23.  Pulmonary edema
    Pathophysiology
    Clinical presentation
    Diagnostic tests
    Treatment
    Prognosis
    References
24.  Pneumonia
    Pathology
    Pathophysiology
    Specific types of pneumonia
    Clinical features
    Diagnostic approach
    Therapeutic approach
    Prevention
    Prognosis and outcome
    References
25.  Acute respiratory distress syndrome
    Introduction
    Pathophysiology
    Causes/risk factors
    Diagnostic criteria
    Management
    Prognosis
    References
26.  Pulmonary contusions and hemorrhage
    Pathophysiology and pathology
    Diagnosis
    Management
    Prognosis and outcome
    Atraumatic pulmonary hemorrhage
    Diagnostic evaluation
    Treatment
    Prognosis and outcome
    References
27.  Pulmonary thromboembolism
    Pathophysiology
    History and clinical signs
    Physical examination
    Diagnostic testing
    Classification of acute pulmonary thromboembolism
    Treatment and prophylaxis
    References
28.  Chest wall disease
    Chest wall anatomy and function
    Diagnosis of chest wall disease
    Causes of chest wall disease
    Spinal cord and neuromuscular disease
    Obesity
    References
29.  Pleural space disease
    Pleural space
    Physical examination
    Imaging
    Thoracocentesis
    Pleural effusion
    Pneumothorax
    Diaphragmatic hernia
    Reexpansion pulmonary edema
    Acknowledgment
    References
30.  Respiratory distress look-alikes
    Introduction
    Control of respiration
    Extrapulmonary causes of decreased oxygen delivery
    Metabolic derangements
    Hyperthermia
    Behavioral
    Brain disease
    Drugs
    Summary
    References
Part III. Advanced Respiratory Support
31.  High flow nasal oxygen
    Introduction
    Physiological benefits of high flow nasal oxygen (see Box 31.1)
    High flow nasal oxygen in small animal critical care
    Practical guidance for using high flow nasal oxygen
    References
32.  Mechanical ventilation—core concepts
    Physiology
    The ventilator breath
    Ventilator settings
    Ventilator alarms
    Indications for mechanical ventilation
    Initiation of mechanical ventilation
    Goals
    Complications
    Troubleshooting
    Prognosis
    References
33.  Mechanical ventilation—advanced concepts
    Introduction
    Patient–ventilator asynchrony
    Lung protective ventilation
    Refractory hypoxemia
    Pressure modes of advanced mechanical ventilation
    References
34.  Jet ventilation
    Physics and physiology
    Equipment
    Indications
    Disadvantages
    Monitoring of gas exchange during jet ventilation
    Ventilator settings
    References
35.  Ventilator waveforms
    Waveform types
    Patient–ventilator dyssynchrony
    Summary
    References
36.  Anesthesia and monitoring of the ventilator patient
    Injectable anesthetics
    Adjunct agents
    Making an anesthesia plan for the ventilator patient
    Withdrawal of anesthesia for ventilator weaning
    Monitoring of the mechanically ventilated patient
    References
37.  Nursing care of the ventilator patient
    General monitoring
    Airway management
    Oral care
    Eye care
    Urinary care
    Gastrointestinal tract care
    Recumbent patient care
    Apparatus care
    References
38.  Discontinuing mechanical ventilation
    When to wean
    Anesthetic considerations
    Approaches to weaning
    Weaning prediction
    Tracheostomy and weaning
    Extubation
    References
39.  Ventilator-induced lung injury
    Definitions
    Mechanisms of ventilator-induced lung injury
    Histopathology
    Clinical relevance
    Prevention
    References
40.  Ventilator-associated pneumonia
    Pathogenesis
    Diagnosis
    Prevention
    Treatment
    References
Part IV. Cardiovascular Disorders
41.  Mechanisms of heart failure
    Neurohormonal aspects of heart failure
    Myocardial remodeling
    Abnormal calcium ion handling
    Abnormal myocardial energy production
    Global cardiac function
    Clinical staging and assessment of heart failure
    References
42.  Ventricular failure and myocardial infarction
    Diagnosis
    Treatment
    References
43.  Feline cardiomyopathy
    Classification and etiology of feline cardiomyopathy
    Pathophysiology
    Clinical presentation and findings
    Diagnostic approach
    Treatment
    References
44.  Canine cardiomyopathy
    Dilated cardiomyopathy
    Arrhythmogenic right ventricular cardiomyopathy
    Hypertrophic cardiomyopathy
    Atrioventricular myopathy
    References
45.  Canine myxomatous mitral valve disease
    Introduction
    Pathology and pathophysiology
    Historical and physical examination findings
    Clinicopathologic findings and cardiac biomarkers
    Thoracic radiographic findings
    Cardiac and thoracic ultrasound findings
    Emergency management
    Management of complicating factors
    Monitoring
    Long-term management
    Prognosis
    References
46.  Blunt cardiac injury
    Definitions and pathogenesis
    Diagnosis and clinical assessment
    Treatment
    Summary
    References
47.  Pericardial diseases
    Pericardial effusion
    Cardiac tamponade
    Clinical presentation
    Diagnosis
    Management of cardiac tamponade
    Constrictive pericardial disease
    Congenital pericardial disease
    References
48.  Bradyarrhythmias and conduction disturbances
    Definition
    Differential diagnosis
    Treatment
    References
49.  Supraventricular tachyarrhythmias
    Introduction
    Electrocardiographic diagnosis
    Treatment
    References
50.  Ventricular tachyarrhythmias
    Introduction
    Definitions
    Electrocardiographic diagnosis
    Causes of ventricular tachycardia
    Practical approach to ventricular tachycardia treatment
    References
51.  Myocarditis
    Infectious myocarditis
    Noninfectious myocarditis
    Diagnosis
    Treatment
    References
52.  Cardiac biomarkers
    Blood-based cardiac biomarkers
    Clinical use of NT-proBNP and BNP testing in the emergency setting
    Clinical use of cardiac troponin in the emergency setting
    Important limitations and considerations involving cardiac biomarker testing
    References
53.  Systemic hypertension
    Normal determinants of blood pressure
    Pathogenesis of systemic hypertension
    Definitions and causes of systemic hypertension
    Adverse effects associated with systemic hypertension
    Diagnosis of systemic hypertension
    Treatment of systemic hypertension
    References
54.  Cardiopulmonary bypass
    Introduction
    Fundamentals of cardiopulmonary bypass
    Postoperative management and complications
    Summary
    Acknowledgments
    References
Part V. Electrolyte and Acid-Base Disturbances
55.  Sodium disorders
    Distribution of body water
    Osmolality and osmotic pressure
    Regulation of plasma osmolality
    Total body sodium content versus plasma sodium concentration
    Hypernatremia
    Hyponatremia
    Clinical signs of hyponatremia
    A rapid drop in plasma sodium concentration and cerebral edema
    Volume expansion in the hypovolemic patient that is hyponatremic or hypernatremic
    References
56.  Potassium disorders
    Normal distribution of potassium in the body and its steady state regulation
    Hypokalemia: Definition and causes
    Management of hypokalemia
    Anticipated complications
    Hyperkalemia: Definition and causes
    Pseudohyperkalemia
    Consequences
    Treatment of hyperkalemia
    Acknowledgements
    References
57.  Calcium disorders
    Calcium homeostasis
    Calcium measurement
    Hypercalcemia
    Hypocalcemia
    References
58.  Magnesium and phosphate disorders
    Magnesium
    Phosphate
    References
59.  Traditional acid-base analysis
    Introduction
    Sample collection and handling
    Traditional approach
    Acid-base analysis
    Causes of acid-base abnormalities
    Bicarbonate therapy
    References
60.  Nontraditional acid-base analysis
    The strong ion difference approach
    Semiquantitative approach
    Conclusion
    Clinical examples
    References
61.  Hyperlactatemia
    Biochemistry
    Physiology
    Etiology of hyperlactatemia
    d-lactate
    Clinical use
    Prognostic use
    Diagnostic use
    Lactate as a therapeutic endpoint
    References
62.  Urine osmolality and electrolytes
    Introduction
    Urine osmolality
    Urinary sodium
    Urine potassium
    Urine chloride
    Free water clearance
    References
Part VI. Fluid Therapy
63.  Assessment of hydration
    Variability in assessing hydration
    Distribution and control of total body water
    Measuring total body water
    Clinical assessment of hydration status
    Hypotonic fluid loss
    Isotonic fluid loss
    Special challenges
    Conclusion
    References
64.  Assessment of intravascular volume
    Introduction
    Defining a fluid bolus
    Mini-bolus and passive leg raising
    Conclusions
    References
65.  Crystalloids and hemoglobin-based oxygen-carrying solutions
    Crystalloids
    Hypotonic fluids
    Hypertonic fluids
    Acid-base effects of crystalloids
    Hemoglobin-based oxygen-carrying solutions
    Conclusion
    Acknowledgement
    References
66.  Colloid solutions
    Synthetic starch colloids
    Natural colloids
    Conclusion
    References
67.  Daily intravenous fluid therapy
    Total body water
    Movement of fluids within the body
    Fluid therapy plan
    Fluid type
    Monitoring
    Discontinuation of fluid therapy
    Acknowledgements
    References
68.  Shock fluids and fluid challenge
    Administration of shock fluids
    Resuscitation endpoints and monitoring
    Shock fluids
    Hypotensive resuscitation
    Fluid challenge
    References
69.  Transfusion medicine
    Introduction
    Anemia and RBC transfusions
    Platelet transfusions
    Plasma transfusions
    Albumin transfusions
    Blood sources and donor management
    Blood donation
    Blood banking
    References
70.  Blood types, pretransfusion compatibility, and transfusion reactions
    Blood types
    Precompatibility testing
    Transfusion reactions
    Storage lesion
    Leukoreduction
    Transfusion administration and monitoring
    References
71.  Hemorrhagic shock
    Assessment of the hemorrhagic shock patient
    Management of controlled hemorrhage
    Management of uncontrolled hemorrhage
    Special considerations
    References
Part VII. Endocrine Disorders
72.  The diabetic patient in the ICU
    Insulin
    Nutritional support
    References
73.  Diabetic ketoacidosis
    Pathophysiology
    Signalment
    History and clinical manifestation
    Diagnosis
    Additional diagnostic evaluation
    Therapy
    Outcome
    References
74.  Hyperglycemic hyperosmolar syndrome
    Pathogenesis
    History and clinical signs
    Physical examination
    Diagnostic criteria
    Treatment
    Monitoring
    Postcrisis therapy
    Prognosis
    References
75.  Hypoglycemia
    Normal glucose homeostasis
    Clinical signs and consequences of hypoglycemia
    Diagnosis of hypoglycemia
    Causes of hypoglycemia
    Treatment of hypoglycemic crisis
    References
76.  Diabetes insipidus
    Osmotic regulation and pathophysiology of diabetes insipidus
    Implications of diabetes insipidus in the critically ill patient
    References
77.  Syndrome of inappropriate antidiuretic hormone secretion
    Normal physiology
    Syndrome of inappropriate antidiuretic hormone
    Etiology
    Diagnosis
    Management
    References
78.  Thyroid storm
    Pathogenesis
    Precipitating events
    Clinical signs
    Diagnosis
    Laboratory abnormalities
    Treatment
    Outcome
    References
79.  Hypothyroid crisis in the dog
    Pathophysiology
    Risk factors
    Clinical signs and physical examination findings
    Clinical pathology
    Differential diagnosis
    Treatment
    Outcome
    References
80.  Pheochromocytoma
    Clinical signs
    Diagnosis
    Treatment
    Prognosis
    References
81.  Critical illness-related corticosteroid insufficiency
    Background
    Pathophysiology
    Clinical manifestations
    Diagnosing CIRCI in people
    Diagnosing CIRCI in dogs and cats
    Treating CIRCI in people
    Treating CIRCI in dogs and cats
    Prognosis
    References
82.  Hypoadrenocorticism
    Who is affected?
    Etiology
    Clinical presentation
    Diagnosis
    Treatment
    Associated disorders
    Prognosis
    References
Part VIII. Neurologic Disorders
83.  Neurological evaluation of the ICU patient
    Mentation
    Gait and posture
    Cranial nerves
    Proprioceptive positioning
    Segmental reflexes
    Sensation/nociception
    Neurologically abnormal
    Clinical challenges in the critical patient with neurological disease
    Next steps
    References
84.  Seizures and status epilepticus
    Definitions
    Classification
    Pathophysiology
    Etiology
    Diagnostic plan
    Treatment plan
    References
85.  Intracranial hypertension
    Normal physiology of the brain
    Clinical assessment of intracranial hypertension
    Treatment of ICH
    Prognosis
    References
86.  Tetanus
    Etiology
    Pathogenesis
    Clinical presentation
    Diagnosis
    Treatment
    Prognosis
    References
87.  Hepatic encephalopathy
    Causes of hepatic encephalopathy
    Diagnosing hepatic encephalopathy
    Managing hepatic encephalopathy
    References
Part IX. Infectious Disorders
88.  Hospital-associated infections and zoonoses
    HAI in dogs and cats
    Risk factors
    Antimicrobial-resistant nosocomial pathogens
    Zoonoses, anthropozoonoses and HAI’s in the ICU
    Conclusions
    References
89.  Febrile neutropenia
    Neutrophil physiology
    Pathophysiology of neutropenia
    Clinical presentation and diagnostic tests
    Treatment and supportive care
    References
90.  Sepsis and septic shock
    Introduction
    Current sepsis definitions
    Pathobiology of sepsis
    Diagnosis
    Resuscitation and treatment of sepsis and septic shock
    Prognosis
    References
91.  Bacterial infections
    Introduction
    Bacterial structure and taxonomy
    Diagnosis of bacterial infections
    Gram-positive bacteria of clinical importance
    Gram-negative bacteria of clinical importance
    Mycoplasma and intracellular bacteria of clinical importance
    Treatment and prevention of bacterial infections
    Conclusion
    References
92.  Fungal infections
    Fungal organisms
    Diagnosis
    Treatment and outcome
    References
93.  Viral infections
    Canine distemper virus infection
    Influenza virus infections
    Other emerging respiratory viral infections of dogs
    Feline panleukopenia
    Feline respiratory viral disease
    Feline infectious peritonitis
    Severe acute respiratory syndrome coronavirus-2
    References
94.  Canine parvovirus infection
    Parvoviridae
    Epidemiology
    Risk factors for infection
    Transmission and pathogenesis
    Clinical signs
    Clinical pathology
    Sepsis, systemic inflammatory response syndrome, and coagulation
    Diagnostic investigations
    Diagnostic imaging
    Treatment
    Nutrition
    Antiviral drugs
    Outpatient protocol
    Controversial therapies
    Prevention of transmission
    Prognosis
    References
95.  Infective endocarditis
    Pathophysiology
    Incidence, signalment, and presenting complaint
    Predisposing factors
    Etiologic agents
    Clinical abnormalities
    Clinicopathologic abnormalities
    Diagnosis
    Treatment
    Prognosis
    References
96.  Urosepsis
    Introduction
    Pathogenesis
    Causes of urosepsis
    Conclusion
    References
97.  Necrotizing soft tissue infections
    Diagnosis
    Treatment
    Extracorporeal plasma treatment
    Conclusion
    References
98.  Catheter-related bloodstream infections
    Pathophysiology
    Definitions
    Risk factors
    Incidence
    Diagnosis
    Treatment
    Prevention
    Acknowledgements
    References
99.  Multidrug-resistant infections
    Definitions
    Risk factors for multidrug-resistant organisms
    Escalation versus deescalation therapy
    Specific multidrug-resistant organisms
    References
100.  Infectious disease control in the ICU
    Health care-associated infections and biosafety
    HCAIs in intensive care settings
    HCAI prevention and control
    Surveillance
    Active infection control
    Feedback to stakeholders
    Dedicated biosafety team
    References
Part X. Hematologic Disorders
101.  Hypercoagulable states
    Mechanisms of thrombophilia
    Diagnostics
    Common conditions in veterinary medicine
    Management of hypercoagulable conditions
    Conclusion
    References
102.  Feline aortic thromboembolism
    Introduction
    Pathophysiology
    Clinical presentation
    Diagnosis
    Prognosis
    Thrombolysis in fate
    Antiplatelet therapy in fate
    Anti-coagulant therapy in fate
    Nursing and supportive care in fate
    Prevention of fate
    References
103.  Platelet disorders
    Acquired thrombocytopenia
    Acquired platelet disorders
    Congenital platelet disorders
    General diagnostic approach to platelet disorders
    Treatment of platelet disorders
    References
104.  Coagulopathy in the ICU
    Normal hemostasis
    Abnormal bleeding tendency
    Clinical signs associated with hemostatic dysfunction
    Laboratory tests for hemostasis
    Hemostatic disorders in critically ill animals
    Therapeutic management of coagulopathy
    References
105.  Management of the bleeding patient in the ICU
    Diagnostic approach to a bleeding patient
    Treatment of the bleeding patient
    Suggested reading
    References
106.  Anemia in the ICU
    Introduction
    Oxygen transport by erythrocytes
    Erythropoiesis
    Physiological adaptation to anemia
    Characterization of anemia
    Clinical approach to anemia in the ICU
    Therapeutic approach to anemia
    References
107.  Dyshemoglobinemias
    Introduction
    Causes of dyshemoglobinemia
    Diagnosis of dyshemoglobinemias
    References
108.  Acute hemolytic disorders
    Evaluation of the patient with hemolysis
    Fragmentation hemolysis
    Toxicant-induced hemolysis
    Heritable hemolysis
    Infection-related hemolysis
    Immune-mediated hemolysis
    References
Part XI. Intraabdominal Disorders
109.  Acute abdominal pain
    Diagnostic evaluation
    Surgical versus medical management
    References
110.  Acute pancreatitis
    Pathophysiology
    Clinical presentation
    Diagnosis
    Determining severity
    Treatment
    Outcome
    Conclusion
    References
111.  Acute cholecystitis
    Clinical findings
    Common causes of cholecystitis in dogs and cats
    Conclusion
    References
112.  Hepatitis and cholangiohepatitis
    Introduction
    Historical findings
    Physical examination findings
    Causes of hepatitis and cholangiohepatitis in dogs and cats
    References
113.  Hepatic failure
    Pathophysiology
    Clinical signs
    Diagnosis
    Therapy
    Prognosis
    Future therapies
    References
114.  Portal hypertension
    Pathogenesis of PH
    Classification of PH
    Diagnosis of PH
    Clinical consequences of PH
    Treatment of PH
    References
115.  Portosystemic shunt management
    Preoperative stabilization
    Medical management
    Surgical options
    Postoperative monitoring
    Postoperative complications
    Prognosis
    References
116.  Acute gastroenteritis
    Gastroenteritis
    History and physical examination
    Diagnostic testing
    Therapeutic approach
    Prognosis
    References
117.  Gastrointestinal hemorrhage
    Etiology
    History and physical examination
    Diagnostic tests
    Treatment
    Prognosis
    References
118.  Regurgitation and vomiting
    Differentiation of vomiting and regurgitation
    Regurgitation
    Vomiting
    Conclusion
    References
119.  Diarrhea
    Pathophysiologic mechanisms of diarrhea
    Iatrogenic causes of diarrhea
    Primary gastrointestinal causes of diarrhea
    Extra-gastrointestinal diseases causing diarrhea
    Diagnostic evaluation
    Treatment
    Conclusions
    References
120.  Peritonitis
    Etiology
    Diagnostics
    Treatment
    Postoperative therapy and monitoring
    Conclusion
    References
Part XII. Urogenital Disorders
121.  Acute kidney injury
    Etiology
    Pathophysiology
    Clinical presentation
    Diagnosis
    Treatment
    Prognosis
    References
122.  Chronic kidney disease
    Etiology
    Pathophysiology
    Clinical presentation
    Diagnosis
    Treatment
    Long-term management
    Advanced therapeutic modalities
    Prognosis
    References
123.  Kidney transplantation
    Indications
    Case selection
    Donor selection
    Preoperative management
    Anesthetic management
    Surgery
    Postoperative management and perioperative complications
    Long-term management and complications
    Canine transplantation
    Conclusion
    References
Part XIII. Nutrition
124.  Nutritional assessment
    Impacts of nutritional support during critical illness
    Screening systems used for nutritional assessments
    Conclusion
    References
125.  Nutritional modulation of critical illness
    Omega-3 fatty acids
    Antioxidants
    Immune-modulating nutrients
    Nucleotides
    Probiotics
    Conclusion
    References
126.  Enteral nutrition
    Introduction
    Importance of nutritional support
    Pathophysiology of malnutrition
    Nutritional assessment
    Assessing nutritional needs
    When to initiate feeding
    Choosing the most appropriate feeding tube
    Nutritional plan
    Implementing nutritional plan
    Monitoring and reassessment
    Complications
    Conclusions
    References
127.  Parenteral nutrition
    Introduction
    Indications for PN support
    Parenteral nutrition
    Components of parenteral nutrition
    Formulation of parenteral nutrition solutions
    Administering parenteral nutrition
    Monitoring
    Complications
    Summary
    References
Part XIV. Trauma
128.  Traumatic brain injury
    Incidence and prevalence of head injury
    General approach to the patient with a head injury
    Pathophysiology
    Neurologic assessment
    Diagnostic tests and monitoring
    Treatment
    Prognosis
    References
129.  Wound management
    Wound healing principles
    Initial patient assessment
    Debridement and lavage
    Dressing and bandaging
    Wound closure
    Additional wound management modalities
    Antimicrobial therapy
    Patient care
    Complications
    Prognosis
    References
130.  Thermal burn injury
    Definitions
    Patient assessment and medical management
    Burn wound management
    References
Part XV. Anesthesia and Pain Management
131.  Pain assessment
    Pain assessment guidelines and tools
    Pain assessment in critically ill patients
    References
132.  Sedation of the critically ill patient
    Introduction
    Specific drug techniques for sedation
    References
133.  Anesthesia in the critically ill patient
    Stabilization
    Premedication
    Induction
    Induction agents
    Maintenance anesthesia
    Anesthesia monitoring
    Recovery
    Summary
    References
134.  Analgesia and constant rate infusions
    Analgesia
    Opioids
    Nonsteroidal antiinflammatory drugs
    α2-adrenergic agonists
    Transdermal analgesics
    N-methyl-D-aspartate receptor antagonists
    Acepromazine
    Infiltrative and local anesthetics
    Epidural analgesics
    Constant rate infusions
    Morphine-lidocaine-ketamine
    Conclusion
    References
135.  Physical rehabilitation for the critical care patient
    Introduction
    Pain management
    Passive therapy
    Active therapy
    Pulmonary therapy
    Summary
    References
136.  Integrative veterinary medicine for the intensive care unit patient
    Acupuncture
    Massage therapy
    Photomedicine (laser therapy and light-emitting diode)
    Pulsed electromagnetic field therapy
    Music therapy
    Botanical medications and challenges for the critically ill patient
    Conclusion
    References
Part XVI. Environmental Emergencies
137.  Smoke inhalation
    Introduction and epidemiology
    Pathophysiology
    Physical examination
    Diagnosis and initial assessment
    Treatment
    Prognosis
    References
138.  Hypothermia
    Classification
    Review of thermoregulation
    Physiologic effects of hypothermia
    Core body temperature measurement
    Rewarming
    Therapy
    Cardiopulmonary resuscitation
    References
139.  Heat stroke
    Introduction
    Physiology, pathogenesis, and pathophysiology
    Physical examination
    Laboratory evaluation
    Treatment and monitoring
    Prognosis
    References
140.  Drowning and submersion injury
    Definitions
    Incidence and epidemiology
    Pathophysiology of injury
    Diagnostic tests and monitoring
    Treatment
    Outcome
    References
Part XVII. Miscellaneous Disorders
141.  Anaphylaxis
    Mechanisms of anaphylaxis
    Histamine
    Clinical manifestations
    Diagnosis
    Treatment
    References
142.  Gas embolism
    Gas embolization associated with intravenous access
    Gas embolization during scoping procedures
    Gas embolization during surgery
    Gas embolization during cardiac procedures
    Gas embolization from lung biopsy
    Gas embolization during hyperbaric therapy
    Detection of air emboli
    Management of air embolism
    References
143.  Subcutaneous emphysema
    Introduction
    Causes
    Pathophysiology
    Clinical presentation
    Diagnostics
    Treatment
    Outcome
    References
144.  Ocular disease in the intensive care unit
    Warning signs of developing ocular disease
    Ocular diseases most likely to develop in the ICU patient
    References
145.  Critically ill neonatal and pediatric patients
    Physical examination findings
    Laboratory values
    Imaging: Radiographs
    Intravenous and intraosseous catheterization
    Fluid requirements
    Temperature control
    Nutrition
    Monitoring
    Pharmacology
    Sepsis
    Conclusion
    References
146.  Critically ill geriatric patients
    Laboratory values
    Imaging
    Fluid therapy
    Nutrition
    Pharmacology
    Neurological function
    Conclusion
    References
Part XVIII. Pharmacology
147.  Catecholamines
    Hypotension
    Decreased myocardial contractility
    Catecholamine drugs
    Norepinephrine
    Choosing the right catecholamine
    Combination therapies
    Push-dose vasopressors
    Other effects of catecholamines
    Acknowledgements
    References
148.  Vasopressin
    Physiology of vasopressin
    Physiologic effects of vasopressin
    Pharmacology
    Clinical uses
    Adverse effects
    Vasopressin antagonists
    References
149.  Antihypertensives
    Antihypertensive drugs
    Goals of treatment
    References
150.  Pimobendan
    Mechanisms of action
    Pharmacology
    Clinical uses
    Adverse effects
    Conclusions
    References
151.  Diuretics
    Physiology of diuresis and antidiuresis
    Pharmacology
    Indications for diuretic therapy
    References
152.  Appetite stimulants
    Introduction
    Defining abnormal appetite
    Appetite regulation
    Nutritional assessment and patient monitoring
    When to intervene
    Appetite stimulants
    Summary
    References
153.  Gastrointestinal protectants
    Proton pump inhibitors
    Sucralfate
    Histamine-2 receptor antagonists
    Prostaglandin analogs
    Traditional oral antacids that titrate gastric acid
    Future drug therapy
    Potential complications of increased gastric pH
    References
154.  Antiemetics and prokinetics
    Antiemetics
    Prokinetic drugs
    References
155.  Opioid agonists and antagonists
    Terminology and history
    Opioid receptors and mechanism of action
    Physiologic effects of opioids
    Metabolism and excretion
    Potency and effectiveness of opioids
    Epidural opioids
    Characteristics of clinically useful opioids
    Opioid antagonists: Naloxone, nalmefene, and naltrexone
    References
156.  Benzodiazepines
    Action
    Diazepam versus midazolam
    Benzodiazepine effects
    Benzodiazepines and cats
    Indications
    Hepatic encephalopathy
    References
157.  α2-agonists and antagonists
    α2 adrenoceptors
    Effects of α2-agonists
    Imidazoline receptors
    Drugs
    Clinical use
    α2-antagonists
    Conclusion
    References
158.  Nonsteroidal antiinflammatory drugs
    Brief overview of cox enzymes and prostaglandin production
    Potential adverse effects
    Other antiinflammatory drugs
    Selecting candidates for the administration of NSAIDs in critical care
    References
159.  Gabapentin
    Use of gabapentin for anxiolysis
    Neuropathic pain
    Seizures
    Adverse effects of gabapentin
    Pharmacokinetics and dosing
    Summary
    References
160.  Tramadol
    Mechanisms of action
    Pharmacology
    Clinical uses
    Adverse effects
    Conclusions
    References
161.  Trazodone
    Mechanism of action
    Adverse effects
    Medication interactions
    Serotonin syndrome
    References
162.  Cannabinoid medicine in intensive care unit patients
    Regulatory hurdles
    Veterinary research
    Cannabis basics for critical care providers
    Visions for veterinary cannabinoid medicine
    References
163.  Anticonvulsants
    Introduction
    Phenobarbital
    Bromide
    Zonisamide
    Levetiracetam
    Benzodiazepines (see also Chapter 156)
    Imepitoin
    Cannabinoids (see also Chapter 162)
    References
164.  Antiplatelet drugs
    Platelet physiology
    Antiplatelet drugs
    References
165.  Anticoagulants
    Pathogenesis
    Indications for anticoagulant use
    Anticoagulants
    Conclusion
    References
166.  Thrombolytic agents
    Pathophysiology of thrombolysis
    Streptokinase
    Urokinase
    Tissue plasminogen activator
    Other thrombolytic agents
    Indications for thrombolysis
    References
167.  Hemostatic drugs
    Systemic hemostasis
    Local hemostasis
    Dressings
    References
168.  Antiarrhythmic agents
    Classification schemes
    Class I antiarrhythmic agents
    Class III antiarrhythmic agents
    Class IV antiarrhythmic agents
    Other antiarrhythmic agents
    Antiarrhythmic devices and procedures
    References
169.  Inhaled medications
    Introduction
    Principles of aerosol deposition in the lungs
    Delivery systems
    Clinical applications
    Conclusion
    References
170.  Complications of chemotherapy agents
    Principles of chemotherapy
    Testing for chemotherapy drug sensitivity
    Toxicities and treatment of chemotherapy-related emergencies
    References
171.  Antitoxins and antivenoms
    Tetanus antitoxin
    Tick antitoxin
    Botulism antitoxin
    Black widow spider antivenom
    Scorpion antivenom
    Snake antivenom
    References
Part XIX. Antimicrobial Therapy
172.  Antimicrobial use in the critical care patient
    Principles of antimicrobial prescriptions
    Antimicrobial stewardship and deescalation
    Conclusion
    References
173.  β-lactam antimicrobials
    Mechanism of action
    Resistance to β-lactams
    Pharmacokinetics
    Specific antimicrobials
    Dosing
    Adverse effects
    References
174.  Aminoglycosides
    Introduction
    Spectrum
    Mechanism of action
    Pharmacology
    Nonparenteral use of aminoglycoside
    References
175.  Fluoroquinolones
    Introduction
    Mechanism of action
    Spectrum of activity
    Pharmacology
    Resistance
    Clinical use
    Dosing and administration
    Adverse effects
    Selected fluoroquinolones
    Acknowledgments
    References
176.  Antifungal therapy
    Classes of antifungal drugs
    Recommendations for specific fungal infections
    References
177.  Miscellaneous antibiotics
    Introduction
    Metronidazole
    Chloramphenicol
    Clindamycin
    Tetracycline
    Sulfonamides and trimethoprim
    Antimicrobials used specifically to treat multidrug-resistant pathogens
    Acknowledgments
    References
Part XX. Extracorporeal Therapy
178.  Renal replacement therapies
    Principles of dialysis
    Indications
    Contraindications
    Components of dialysis
    Dialysis prescription
    Complications and other considerations
    Outcome and prognosis
    Summary
    References
179.  Apheresis
    Equipment
    Principles of apheresis
    Indications
    Future applications
    References
180.  Extracorporeal therapies for blood purification
    Introduction
    Medical management of intoxications
    Basic pharmacokinetics
    Considerations for blood purification with ECT
    Treatment modalities
    Treatment guidelines
    Conclusions
    References
Part XXI. Monitoring
181.  Hemodynamic monitoring
    Continuous electrocardiogram monitoring
    Blood pressure monitoring
    Central venous pressure monitoring
    Pulmonary artery pressure monitoring
    Mixed venous and central venous oxygen saturation
    Sonographic assessment of caudal vena cava collapsibility
    References
182.  Cardiac output monitoring
    Normal determinants of cardiac output
    Indications for monitoring cardiac output
    Measurement of cardiac output
    Conclusions
    References
183.  Electrocardiogram evaluation
    Indications
    Electrocardiographic principles
    Technique and placement of the ECG
    Electrocardiogram waveforms
    Electrocardiogram interpretation
    Effects of disease states on the electrocardiogram
    References
184.  Oximetry monitoring
    Oxygen transport
    Technology of oximetry
    Co-oximetry
    Pulse oximetry
    References
185.  Colloid osmotic pressure and osmolality
    Colloid osmotic pressure
    Osmolality
    References
186.  Coagulation and platelet monitoring
    Assessment of primary hemostasis
    Assessment of secondary hemostasis
    Assessment of fibrinolysis
    Global assessment of coagulation – viscoelastic testing (see also Chapter 187, viscoelastic monitoring)
    Monitoring anticoagulation – anti-Xa activity assay
    References
187.  Viscoelastic monitoring
    Introduction
    Instrumentation
    Provets recommendations
    Tracing, parameters, and global coagulation indices
    Viscoelastic assays
    VCM-Vet
    Clinical applications
    Limitations
    Acknowledgments
    References
188.  Intraabdominal pressure monitoring
    Definitions and incidence
    Risk factors
    Pathophysiology
    Methods of intraabdominal pressure measurement
    Physiologic effects of intraabdominal hypertension
    General considerations
    Acknowledgments
    References
189.  Point-of-care ultrasound in the ICU
    Equipment
    Binary or closed questions
    Abdominal pocus
    Pleural and lung ultrasound
    Cardiac pocus
    Ultrasound-guided vascular access
    References
190.  Capnography
    Nondiverting and diverting monitors
    Technology
    Physiology
    Capnogram interpretation
    References
191.  Intracranial pressure monitoring
    Intracranial pressure
    Intracranial pressure monitoring systems
    ICP monitoring in small animals
    References
192.  Urine output
    Measurement of urine output
    Determinants of urine output
    Normal urine output
    Abnormal urine output
    Fluid balance
    References
Part XXII. Procedures
193.  Peripheral venous catheterization
    Catheter types
    Catheter insertion site
    Percutaneous insertion technique
    Challenging vascular access
    Intraosseous cannulation
    Complications associated with catheterization
    Catheter maintenance
    References
194.  Intraosseous catheterization
    Introduction
    Physiology
    Indications
    Contraindications
    Methods
    Complications
    References
195.  Central venous catheterization
    General concepts
    Catheter types
    Catheter insertion site
    Catheter insertion
    Ultrasound-guided central venous catheter insertion
    Complications and catheter maintenance
    Central venous catheter removal
    Summary
    References
196.  Blood film evaluation
    Blood film preparation
    Blood film evaluation
    White blood cell responses1,2
    Red blood cell responses
    Platelet responses
    Leukemia (myeloid and lymphoid)
    References
197.  Endotracheal intubation and tracheostomy
    Introduction
    Endotracheal intubation
    Tracheostomy
    Summary
    References
198.  Thoracocentesis
    Indications
    Materials
    Techniques
    Diagnostic evaluation of the aspirate
    Postprocedure care
    Complications
    References
199.  Thoracostomy tube placement and drainage
    Introduction
    Indications
    Materials
    Techniques
    Drainage
    Maintenance and care
    Removal
    Complications
    References
200.  Abdominocentesis
    Indications
    Technique
    Abdominal fluid analysis
    Conclusion
    References
201.  Arterial catheterization
    Patient preparation
    Percutaneous arterial catheter placement
    Ultrasound-guided arterial catheterization
    Surgical cutdown for arterial catheter placement
    Maintenance of the arterial catheter
    Complications of arterial catheterization
    Three-syringe technique
    References
202.  Blood gas sampling
    Introduction
    Sampling basics
    Temperature correction
    Preanalytical error
    Analytical errors
    Summary
    References
203.  Temporary cardiac pacing
    Indications for temporary cardiac pacing
    Description of the temporary pacemaker systems
    Troubleshooting
    Complications
    References
204.  Cardioversion
    Definitions
    Mechanism of cardioversion
    Cardioverter-defibrillator
    Approach to synchronized cardioversion
    References
205.  Defibrillation
    Introduction
    Mechanism of action
    Equipment
    Technique and timing
    Precautions
    Monitoring and post-resuscitation care
    References
206.  Cerebrospinal fluid sampling and interpretation
    CSF formation and functions
    Indications for CSF collection and analysis
    Contraindications and risks of CSF tap
    CSF collection techniques
    Analysis of CSF
    Interpretation of common CSF findings
    References
207.  Urinary catheterization
    Indications
    Risk and complications
    Catheter types
    Placement technique
    Securing the catheter
    Closed collection system
    Care of an indwelling urinary catheter
    References
208.  Urinary diversion techniques
    Upper urinary tract
    Lower urinary tract
    Conclusions
    References
Part XXIII. Intensive Care Unit Design and Management
209.  Intensive care unit facility design
    The design process
    Location in the hospital
    Arrangement and size
    Unit configuration
    Utilities
    Environmental aspects
    Details and common design elements
    References
210.  Management of the intensive care unit
    Staffing
    Veterinarians
    Nursing staff
    Scheduling
    Staff/patient ratio
    Communication
    Handling stress and burnout
    References
211.  Client communication, grief, and veterinary wellness
    Other client considerations
    Understanding grief and loss
    Veterinary wellness and well-being
    Partnering with mental health professionals
    References
212.  Prevention of compassion fatigue and burnout
    Introduction
    Compassion fatigue
    Burnout
    Helpful resources
    References
Appendices
Index
 

Deborah Silverstein
DVM, DACVECC
Assistant Professor (Critical Care), Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, PA, USA
 
Kate Hopper
BVSc, PhD, DACVECC
Assistant Professor, Department of Surgical & Radiological Sciences, School of Veterinary Medicine, University of California, Davis, CA

Codice Articolo: MEDUR71
ISBN: 9780323764698
Peso: 2800 g
Area: Cane/Gatto
Disciplina: Medicina d'urgenza
IVA: Esente IVA