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Download Civetta, Taylor and Kirby's Critical Care (Critical Care by Andrea Gabrielli MD FCCM, A. Joseph Layon MD FACP, Mihae PDF

By Andrea Gabrielli MD FCCM, A. Joseph Layon MD FACP, Mihae Yu MD FACS

The prime serious care textbook on the grounds that 1988, Civetta, Taylor and Kirby's serious Care is now in its Fourth version, with a brand new editorial group, over thirty new chapters, and fully up to date info. The publication addresses each challenge encountered within the extensive care unit and covers surgical serious care extra completely than the other textual content. every one bankruptcy starts off with instant issues and proceeds to broader-based discussions of appropriate pathophysiologic and medical matters. This variation has new sections on surprise states; pharmacology, foodstuff, toxicology and the surroundings; and catastrophe administration. New chapters comprise bedside ultrasound, element of care trying out, neurogenic surprise, anaphylactic surprise, surgical infections, and acute coronary syndrome. A better half site will supply quick entry to the totally searchable textual content.

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Additional info for Civetta, Taylor and Kirby's Critical Care (Critical Care (Civetta)), 4th edition

Example text

Höhere Dosierung bei Einsatz der Larynxmaske notwendig geringere bzw. -Inotropie und Vasodilatation (bei langsamer Injektion geringer ausgeprägt) 26 2 Kapitel 2 · Injektionsanästhetika • Bradykardie (bes. 000) beschrieben. Bei der Elektrokrampftherapie ist die Dauer der ausgelösten Krampfanfälle aber kürzer als bei Methohexital • Hustenreiz in 5 % der Fälle; nasaler Juckreiz • zusätzliche Fettzufuhr bes. 1%ige Lösung bei Langzeitgabe wichtig (1 ml = 0,1 g Fett) • Laktazidose, Leberverfettung, Leberversagen (bes.

Zentrale Atemdepression Miosis Dämpfung des Hustenreflexes Harnverhalt zentrale Vagusstimulation (bes. Morphin) Übelkeit und Erbrechen durch Triggerung der Area postrema am Boden des IV. Ventrikels → Früheffekt • Krampfanfälle bzw. Myoklonien (in hohen Dosen, bzw. Metabolit des Pethidin [Norpethidin] als ZNS-Stimulans) • selten Schwitzen und Ödembildung aufgrund permanenter Vasodilatation bei Langzeittherapie Kardiovaskuläre Wirkungen • Bradykardie, vermutlich durch Stimulation vagaler und Hemmung sympathischer Efferenzen • arterielle und venöse Dilatation ist gering Respiratorische Wirkungen • dosisabhängige zentrale Atemdepression (paCO2↑, ↓ Atemfrequenz, ↑ Tidalvolumen, ↓ AMV, ↓ Atemanreiz auf ↑ paCO2) verstärkt bei älteren Patienten oder bei Kombination mit anderen Anästhetika • Hypoventilation (paCO2↑) ⇒ Hirndruckanstieg, daher frühzeitig gefährdete Patienten beatmen!

KI: • Schwangerschaft, Stillzeit (geht nach tierexperimentellen Untersuchungen in die Muttermilch über) • Kinder < 1 Jahr Pethidin, Meperidin (Dolantin) • reiner µ-Agonist • 1 Amp. (≈ 1 ml) = 50 mg, 1 Supp. = 100 mg Pha: • maximale Wirkung nach ca. 15 min • Wirkdauer: 2–4 h • HWZ: 3,2–4,4 h • Metabolisierung in Leber, dabei Entstehung des Metaboliten Norpethidin als ZNS-Stimulanz (halbe analgetische, doppelte krampfauslösende Potenz) mit HWZ 8–12 h, Cave: hohe Dosen 3–4 g • weniger als 5% werden renal ausgeschieden ⇒ pH abhängig: pH < 5 → 25%ige renale Ausscheidung, Norpethidin ist von der Nierenausscheidung abhängig!

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