I. Respiratory Crises.- Respiratory Monitoring.- Mechanics Monitoring.- Tidal Volume.- Pressure, Compliance, and Resistance Monitoring.- Monitoring Inspired and Expired Gases.- Blood-Gas Monitoring.- Blood and Gas Calculations.- Monitoring off the Ventilator.- Future Developments.- References.- Management of Acute Hypoxia and Hypercarbia in the Patient with Advanced Obstructive Airway Disease.- Morphologic Basis for Abnormal Distribution of Ventilation and Perfusion.- Oxygen and Carbon Dioxide Transfer in Chronic Airways Obstruction.- Respiratory Failure in Chronic Airways Obstruction.- Intubation and Artificial Ventilation in Chronic Airways Obstruction.- References.- Humidification, Nebulization, and Bronchodilator Agents.- Pulmonary Clearing Mechanisms.- Heated Humidification.- Nebulization.- Nebulization Equipment.- Clinical Selection.- Mucolytics and Detergents.- Drug Aerosols.- Adjunctive Physical Measures.- Summary.- References and Selected Readings.- Acute Respiratory Failure in the Critically Ill: "Shock Lung".- Description and Historical Perspective.- Management of Pulmonary Edema in ARF.- Reference.- Selected Readings.- Mechanical Ventilators: Critical Assessment and Methods of Use.- Choosing a Ventilator.- Volume- or Pressure-cycled.- Electric or Pneumatic.- Assistor Controller or Controller.- Oxygen Concentration (FIo2).- Maximum Flow Rate and Pressure.- Advantages and Disadvantages of Specific Ventilators.- Gas Powered, Pressure-cycled Ventilators.- Electrically Operated Strict Controllers.- Gas-Powered, Volume-cycled.- Testing a Ventilator.- Guidelines in Purchasing Ventilators.- Summary.- References.- Weaning from Mechanical Ventilation.- General Principles of Weaning.- "Conventional" Weaning: Techniques and Principles.- Physiologic Effects of Weaning.- Intermittent Mandatory Ventilation.- Difficulties in Weaning.- Summary.- References.- Management of Flail Chest.- Emergency Measures.- Endotracheal Intubation.- Categorization of Chest Injuries.- Mechanical Factors versus Gas Exchange in Chest Injury.- Management.- Positive-end Expired Pressure (PEEP).- Crystalloid Overinfusion.- Tracheostomy.- Continuing Care.- Weaning from the Ventilator.- Summary.- Selected Readings.- Diagnosis and Treatment of Acute Pulmonary Thromboembolism and Fat Emboli.- Symptoms.- Pulmonary Embolism.- Pulmonary Infarction.- Physical Signs.- Pulmonary Embolism.- Pulmonary Infarction.- Laboratory Studies.- Treatment.- Fat Embolism Syndrome.- Summary.- References.- Selected Readings.- II. Shock and Trauma.- Treatment of Shock and Trauma States: Use of Cardiorespiratory Patterns to Define Therapeutic Goals, Predict Survival, and Titrate Therapy.- Pathophysiologic Mechanisms.- Physiologic Common Denominator in Various Types of Shock.- Therapy.- Therapeutic Goals.- Priorities of Therapy.- Summary.- References.- Prognostic Indices as a Basis for Assessing Severity of Shock.- Patient Material.- Methods.- Measurements.- Statistical Analysis.- Results.- Discussion.- Summary.- References.- Disseminated Intravascular Coagulation.- Summary.- References.- Principles of Fluid Challenge for Routine Treatment of Shock.- Rationale of Volume Repletion.- The Standard Fluid Challenge.- Summary.- References.- The Diagnosis and Treatment of Anaphylactic Shock.- Clinical Presentation.- Principles of Treatment.- Summary.- References.- Indications for Use of Corticosteroid Agents in Treatment of Shock.- Septic Shock.- Refractory Hypovolemic Shock.- Post-Traumatic Pulmonary Insufficiency.- Therapeutic Regime.- Summary.- References.- Hemodynamic Defects Underlying Shock with Indications for Treatment: An Appraisal of Vasopressors and Vasodilators.- Hemodynamic Mechanisms.- Pharmacotherapy.- Clinical Therapy.- Distributive Defects.- Summary.- References.- III. Neurologic Crises and Opportunistic Infections.- Brain Monitoring and Homeostasis in Comatose, Critically Ill Patients.- Pathophysiology and Monitoring.- Cerebrospinal Fluid.- Cerebral Edema and Intracran
During the past twelve years, a course on critical care medicine has been sponsored by the Post Graduate Division of the University of Southern California School of Medicine in association with its Center for the Criti cally Ill. The content of each of the symposia has paralleled the evolution of critical care medicine as a recognized service specialty. The annual program was planned as a teaching session for physicians and allied medical personnel who sought to advance their involvement in this rapidly advancing field. A panel of highly regarded authorities on sub jects bearing on critical care medicine, faculty members of the USC School of Medicine, and staff members of our own Center for the Critically 111 at the Hollywood Presbyterian Medical Center serve as faculty of these symposia. Although the primary commitment of the organizers to maintain this as a teaching and demonstration session was not abandoned, the number of annual registrants progressively increased from fewer than 100 to more than 1200, gradually outstripping local hotel facilities in central Los Angeles. The symposium for the past two years has been held in the large and at tractive Anaheim Convention Center adjacent to Disneyland.
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