Directly from the ACCP serious Care drugs Board assessment 2012 path, this new interactive on-line source is the most recent instrument within the ACCP s accomplished learn software. each subject is roofed in a concise, easy-to-use layout with many stronger evaluation techniques. Navigate worthy board evaluation content material simply with a trouble-free, interactive on-line layout; locate subject matters of curiosity speedy with complex key-phrase seek features built-in with different ACCP on-line courses, together with CHEST; receive referenced articles quick with totally linked-out annotated bibliographies; use as a self-study source to organize for the severe care drugs subspecialty board exam.
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Extra resources for ACCP Critical Care Medicine Board Review: 21st Edition
Grasso S, Stripoli T, De Michele M, et al. ARDSnet ventilatory protocol and alveolar hyperinflation: role of positive end-expiratory pressure. Am J Respir Crit Care Med. 2007;176(8):761–767. Brochard L, Rauss A, Benito S, et al. Comparison of three methods of gradual withdrawal from ventilatory support during weaning from mechanical ventilation. Am J Respir Crit Care Med. 1994;150(4):896–903. Esteban A, Al´ıa I, Gordo F, et al. Extubation outcome after spontaneous breathing trials with T-tube or pressure support ventilation.
Sodium Nitroprusside Sodium nitroprusside (NTP) is a nitric oxide donor that induces a potent arteriolar and venous vasodilation. Although it quickly lowers BP, some of its systemic effects are potentially problematic. 31–33 When combining several studies comparing clevidipine (CLV) with nitroglycerin, sodium nitroprusside, or nicardipine in patients after cardiac surgery. there was no difference in the incidence of myocardial infarction, stroke, or renal dysfunction for CLV-treated patients compared with the other treatment groups.
23 Although this occasionally compounds the dynamic hyperinflation, potentially compromising cardiac output, usually autoPEEP increases little as long as PEEP is not set higher than about 85% of the autoPEEP. The goals are (1) to minimize alveolar overdistention (Pplat , 30) and (2) to minimize dynamic hyperinflation (autoPEEP , 15 cm H2O or end-inspiratory lung volume , 20 mL/kg), a strategy that largely prevents barotrauma. Reducing minute ventilation to achieve these goals generally causes the PCO2 to rise above 40 mm Hg, often to 70 mm Hg or higher.
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