A. Gullo (Editor) Anaesthesia, Pain, Intensive Care and Emergency – A.P.I.C.E. Proceedings of the 19

A. Gullo (Editor)

Anaesthesia, Pain, Intensive Care and Emergency – A.P.I.C.E.

Proceedings of the

19

Postgraduate Course in Critical Care Medicine

Trieste, Italy - November 12 - 15 , 2004

A. Gullo (Editor)

Anaesthesia, Pain, Intensive Care and Emergency

A.P.I.C.E.

Proceedings of the

19 ^th Postgraduate Course in Critical Care Medicine Trieste, Italy – November 12-15, 2004

Springer

A

G

, M.D.

Head, Department of Perioperative Medicine, Intensive Care and Emergency

Trieste University School of Medicine Trieste, Italy

Library of Congress Control Number: 2004115099

ISBN 88-470-0288-5 Springer Milan Berlin Heidelberg New York

This work is subject to copyright. All rights are reserved, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilm or in any other way, and storage in data banks.

Duplication of this publication or parts thereof is permitted only under the provisions of the Italian Copyright Law in its current version, and permission for use must always be obtained from Springer. Violations are liable to prosecution under the Italian Copyright Law.

Springer is a part of Springer Science+Business Media springeronline.com

© Springer-Verlag Italia 2005 Printed in Italy

The use of general descriptive names, registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.

Product liability: The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. In every individual case the user must check such information by consulting the relevant literature.

Cover design: Simona Colombo, Milan, Italy

Typesetting and printing: Arti Grafiche Stella, Trieste, Italy

Table of Contents

ADVANCES IN CRITICAL CARE

Chapter 1 – Effects of body position on ventilation/perfusion matching

G. H

. . . . 3

Chapter 2 – Chest Pain

F. S

. . . . 17

Chapter 3 – The electrocardiogram in the emergency department

F. S

, F. P

, E.G. R

. . . . 27

Chapter 4 – The use of imaging to resolve difficult diagnoses

V. C

, L. C

, M. C

. . . . 37

Chapter 5 – Assessment of Pain

D. C

, A. G

M

P

. . . . 47

Chapter 6 – Titration of opioids for acute pain management

Y. L

. . . . 59

Chapter 7 – Neonatal mechanical ventilation

A. B

. . . . 73

Chapter 8 – Extracorporeal circulation in the intensive care unit

V. G

, M. M

83

Chapter 9 – Clinical decision-making in the management of sepsis and septic shock

F. B

. . . . 89

Chapter 10 – Intracranial haemorrhage: the solution offered by recombinant factor VIIa G. M

, A. C

, S. M

. . . . 101

V

Chapter 11 – An introduction to Open Source software licensing and use in anaesthesia department

V. L

, M. S

. . . . 111 MICRODIALYSIS

Chapter 12 – Lessons we have learnt from microdialysis in animals and humans

N

. . . . 125

Chapter 13 – Secondary brain injury - does microdialysis have a role?

M. S

. . . . 139

Chapter 14 – Liver graft monitoring with intrahepatic microdialysis

G. N

. . . . 147

Chapter 15 – Myocardial metabolism during open heart surgery, assessed with microdialysis

L. B

, J. P

, S. K

. . . . 157 CLINICAL PHARMACOLOGY

Chapter 16 – The journey of a drug to the target site:what is it decisive?

C. T

, C. J

. . . . 167

Chapter 17 – The pharmacokinetics and pharmacodynamics of antimicrobial agents in intensive care unit patients as assessed by microdialysis

V. K

, C. J

. . . . 177 PERIOPERATIVE MEDICINE

Chapter 18 – Anaesthetic effects on regional cerebral blood flow and metabolism:

three contemporary reasons to care

M. A

, J. M

. . . . 187

Chapter 19 – Why and when is inhalation anaesthesia better

I. S

, P. S

, A. C

195

Chapter 20 – Analysis and instrumentations for estimating cerebral activity

E. F

, S. B

, M. M

. . . . 205

VI

Chapter 21 – Neuroimaging pharmacology of attention and memory

U. F

, C. O

. . . . 217

Chapter 22 – Intracranial pressure monitoring

M. M

, S.M. V

, E. F

. . . . 227

Chapter 23 – Improving quality of recovery

M. K

. . . . 237 LUNG AND ARTIFICIAL VENTILATION

Chapter 24 – Molecular biology and lung disease. What is the impact?

A.C. A

, M.M. M

. . . . 245

Chapter 25 – Surfactant metabolism: factors affecting lipid uptake in vivo and in vitro D.L.H. P

, J.F. V

I

, B. L

. . . . 259

Chapter 26 – Respiratory mechanics at the bedside

T. L

, F. F

, P. P

. . . . 279

Chapter 27 – PEEP and cardiac output

T. L

, R. G

, P. P

. . . . 297

Chapter 28 – Expiratory flow limitation and intrinsic PEEP

J. M

-E

. . . . 317

Chapter 29 – Mechanical ventilation strategies for lung protection

N.R. M

I

. . . . 323

Chapter 30 – Recruitment and oxygenation

T. M

, H. W

, C. P

. . . . 331

Chapter 31 – Lung oedema in acute lung injury (ALI)

S. N

. . . . 345

Chapter 32 – Grading severity of respiratory dysfunction, clinical correlates and indications for mechanical ventilation

N. T

, H. W

, C. P

. . . . 357

Chapter 33 – Weaning as a cardiac stress test

B. L

, J.-L. T

. . . . 371

VII

Chapter 34 – Respiratory management in obese patients

P. P

, T. L

, P. C

. . . . 379

Chapter 35 – Is the acute respiratory distress syndrome a systemic disease?

L. B

, A.S. S

, H. Z

. . . . 395 CARDIOVASCULAR CRITICAL CARE

Chapter 36 – Invasive versus non-invasive haemodinamic monitoring in major vascular surgery

B. A

, M. R

. . . . 405

Chapter 37 – Analysis of arterial pulse – clinical implications

G

, S. S

, S.M. R

. . . . 417

Chapter 38 – Beat–by–beat monitoring of cardiac output with pressure recording analytical method

S. S

, P. G

, B. BIAGIOLI . . . . 425

Chapter 39 – Haemodynamic standardisation procedures in high-risk surgery

T. Y

, S. M

K

, J.O.C. A

. . . . 437

Chapter 40 – From Frank–Starling relationships to ventriculo–arterial coupling

R. N

. . . . 449

Chapter 41 – Pharmacology and selection of inotropic therapy

J.O.C. A

. . . . 461

Chapter 42 – Decision–making in critical care: cardiac arrhythmias and related topics

J.L. A

. . . . 473

Chapter 43 – Management for the patient with an implanted cardiac rhythm management device (CRMD)

J.L. A

. . . . 483

Chapter 44 – Hypothemia in cardiac surgery

J.O.C. A

. . . . 495

VIII

CARDIOPULMONARY RESUSCITATION

Chapter 45 – Pharmacological management of cardiopulmonary resuscitation

T. P

. . . . 509

Chapter 46 – Myocardial preservation, reperfusion injury, and postresuscitation myocardial dysfunction

R.J. G

, J. R

, J. K

. . . . 517 MICROCIRCULATION AND SHOCK

Chapter 47 – Regional blood flow distribution in septic, cardiogenic and haemorrhagic shock

D. D

B

. . . . 529

Chapter 48 – Orthogonal polarisation spectral imaging: principles, techniques, human studies

D. D

B

. . . . 535

Chapter 49 – Carbon dioxide monitoring to evaluate cell oxygenation

J. C

. . . . 543

Chapter 50 – The microcirculation in distress; monitoring and recruitment

P. G

, C. I

. . . . 557

Chapter 51 – Tissue metabolism in different types of shock

S. K

, J. P

, L. B

. . . . 565

Chapter 52 – Organ dysfunction in circulatory shock – altered perfusion, metabolism or tight junctions? Do we need a shift of paradigm?

J. T

. . . . 577

Chapter 53 – Haemodynamic support of paediatric patients in septic shock

G. Z

, S. R

, H.-M. G

. . . . 587 PAEDIATRIC CRITICAL CARE

Chapter 54 – Recent advances in artificial ventilation in paediatric age

G.A. M

. . . . 599

IX

Chapter 55 – Complications in paediatric regional anaesthesia

G. I

, V. M

. . . . 611

Chapter 56 – Home ventilation in paediatric patients with chronic respiratory failure

B. F

. . . . 619

Chapter 57 – Decision–making in paediatric extracranial trauma

E. C

, R. S

, D. N

. . . . 633

Chapter 58 – Development in the treatment of postoperative pain in paediatrics

P. B

, A. M

. . . . 653 TRAUMA AND EMERGENCY SYSTEM

Chapter 59 – Prehospital care: triage and primary survey

O. P

, A. B

. . . . 663

Chapter 60 – Spine and spinal cord trauma

O. P

, A. B

. . . . 673

Chapter 61 – Treatment of the acute pneumothorax in the field

G. B

, D. M

, E. C

. . . . 683 CLINICAL STUDY DESIGN

Chapter 62 – Critical appraisal skills

S. M

, A. Z

, W. Z

. . . . 695

Chapter 63 – Literature search

S. M

, A. Z

, W. Z

. . . . 707

Chapter 64 – Study design

S. M

, A. Z

, W. Z

. . . . 719

Index . . . . 749

X

Alkire M.T.

Department of Anaesthesiology, University of California, Irvine, Medical Center, Orange, California (USA)

Allaria B.

Second School of Anaesthesia and Intensive Care, University of Milan (Italy)

Andrade A.C.

Cellular and Molecular Physiology Laboratory, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro

(Brazil) Atlee J.L.

Department of Anaesthesiology, Medical College of Wisconsin, Froedtert Memorial Lutheran Hospital, Milwaukee, Winsconsin (USA)

Auler J.O.C.

Anaesthesia and Critical Medicine, Director of Anaesthesia and Surgical ICU, Heart Institute, Incor, Hospital

das Clínicas, School of Medicine, Saõ Paulo University,

Saõ Paulo (Brazil) Bahlmann L.

Department of Anaesthesiology, University of Lübeck (Germany) Baker A.

Departments of Critical Care and Anaesthesia, St Michael’s Hospital, University of Toronto

(Canada)

Baratto F.

Department of Pharmacology

and Anaesthesiology, Padua University Medical School, Padua (Italy)

Barbieri S.

Department of Pharmacology

and Anaesthesiology, Padua University Medical School, Padua (Italy)

Berlot G.

Department of Anaesthesia,

Perioperative Medicine, Intensive Care and Emergency, University Hospital, School of Medicine, Trieste (Italy) Biagioli B.

Department of Surgery and Bioengineering, Thoracic and

Cardiovascular Unit, University of Siena (Italy)

Bougatef A.

Neonatal Intensive Care Unit, Academic Hospital, VUB, Brussels (Belgium) Brandner L.

Departments of Anaesthesia and Critical Care Medicine,

Interdepartmental Division of Critical Care Medicine, Division of Respiratory Medicine, University of Toronto, St. Michael’s Hospital, Toronto (Canada) Busoni P.

Department of Anaesthesia and Intensive Care, “A. Meyer” Paediatric Hospital, Florence (Italy)

List of Contributors

XI

Caironi P.

Department of Anaesthesiology and Critical Care Medicine, University of Milano, Department of Anaesthesia and Critical Care Medicine, IRCCS Hospital, Milan (Italy)

Calderan L.

Department of Radiology, University Hospital, School of Medicine, Trieste (Italy)

Calderini E.

Paediatric Intensive Care Unit, Pain Unit, Clinical Specialisation Institutes, Milan (Italy)

Camporesi A.

Department of Anaesthesia and Intensive Care Medicine, Children’s Hospital

“V. Buzzi”, Milan (Italy) Carchietti E.

Department of Anaesthesia, Perioperati- ve

Medicine, Intensive Care and Emergency, University Hospital, School of Medicine, Trieste (Italy)

Caristi D.

Department of Perioperative Medicine, Intensive Care and Emergency, Trieste University School of Medicine, Trieste (Italy)

Cavallini A.

Stroke Unit, Cerebrovascular Division, IRCCS Neurological Institute

“C. Mondino Foundation”, Pavia (Italy) Cioffi V.

Department of Radiology, University Hospital, School of Medicine, Trieste (Italy)

Cova M.

Department of Radiology, University Ho- spital, School of Medicine, Trieste (Italy) Creteur J.

Department of Intensive Care, Erasme University Hospital, Free University of Brussels (Belgium)

De Backer D.

Department of Intensive Care, Erasme University Hospital, Free University of Brussels (Belgium)

Facco E.

Department of Pharmacology

and Anaesthesiology, Padua University Medical School, Padua (Italy)

Fauroux B.

Department of Paediatric Pneumology and Research Unit INSERM E 213, Paediatric Hospital “A. Trousseau”, Paris (France)

Fiedler F.

Department of Anaesthesiology and Critical Care Medicine, University Hospi- tal Mannheim, Faculty of Clinical Medici- ne Mannheim, University of Heidelberg, Theodor-Kutzer Ufer, Mannheim (Germany)

Freo U.

Department of Pharmacology

and Anaesthesiology, Padua University Medical School, Padua (Italy)

Galzerano A.

Department of Perioperative Medicine, Intensive Care and Emergency, Trieste University School of Medicine, Trieste (Italy)

Ga{parovi} V.

Department of Emergency and Intensive Care Medicine, Rebro,

Zagreb (Croatia) Gazmuri R.

Department of Medicine, Division of Critical Care and Department of Physiology & Biophysics, Rosalind Franklin University of Medicine and Science;

Medical Service,

Section of Critical Care Medicine,

North Chicago VA Medical Center,

North Chicago, Illinois (USA)

XII

Gieser R.

Department of Anaesthesiology and Critical Care Medicine, University Hospital Mannheim, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Theodor-Kutzer Ufer, Mannheim (Germany)

Giomarelli P.

Department of Surgery and Bioengineering, Thoracic and Cardiovascular Unit, University of Siena (Italy) Goedhart P.

Department of Physiology, Academic Medical Center, University of Amsterdam (The Netherlands)

Grubbauer H.-M.

Paediatric Intensive Care Unit,

Department of Paediatrics, University of Medicine, Graz (Austria)

Hedenstierna G.

Department of Medical Sciences, Clinical Physiology, Academic University Hospital, Uppsala (Sweden)

Ince C.

Department of Physiology, Academic Medical Center, University of Amsterdam (The Netherlands)

Ivani G.

Department of Anaesthesiology and Intensive Care, Regina Margherita Children’s Hospital, Turin (Italy) Joukhadar C.

Department of Clinical Pharmacology, Division of Clinical Pharmacokinetics, Medical University, Vienna (Austria) Klaus S.

Department of Anaesthesiology, University of Lübeck (Germany) Klimek M.

Department of Anaesthesiology, Erasmus MC Faculty, University Medical Center, Rotterdam (The Netherlands)

Kolarova J.

Department of Medicine, Division of Critical Care and Department of Physiology & Biophysics, Rosalind Franklin University of Medicine and Science; Medical Service, Section of Critical Care Medicine, North Chicago VA Medical Center, North Chicago, Illinois (USA)

Kulemann V.

Department of Clinical Pharmacology, Division of Clinical Pharmacokinetics, Medical University, Vienna (Austria) Lachmann B.

Department of Anaesthesiology, Erasmus MC Faculty, University Medical Center, Rotterdam (The Netherlands)

Lamia B.

Medical Intensive Care Unit, University Hospital, Bicêtre (France) Lanza V.

Department of Anaesthesia and Intensive Care Medicine, University of Palermo (Italy) Leykin Y.

Department of Anaesthesia

and Intensive Care, “S. Maria degli Angeli”

Hospital, Pordenone (Italy) Luecke T.

Department of Anaesthesiology and Critical Care Medicine, University Hospital Mannheim,

Faculty of Clinical Medicine

Mannheim, University of Heidelberg, Theodor-Kutzer Ufer,

Mannheim (Germany) MacIntyre N.R.

Division of Pulmonary and Critical Care Medicine, Duke University Medical Center, Durham, North Carolina (USA)

Marcheselli S.

Stroke Unit, Cerebrovascular Division, IRCCS Neurological Institute

“C. Mondino Foundation”, Pavia (Italy)

XIII

Marraro G.

Department of Anaesthesiology and Intensive Care, Paediatric Intensive Care and Paediatric Emergency,

“Fatebenefratelli & Ophthalmiatric”

Hospital, Milan (Italy) Martins S.B.

Institute for Health Policy Studies, University of California, San Francisco, California (USA)

Massarutti D.

Department of Anaesthesia, Perioperative Medicine, Intensive Care and Emergency,

University Hospital, School of Medicine, Trieste (Italy)

Merkler M.

Department of Emergency and Intensive Care Medicine, Rebro, Zagreb (Croatia) Messeri A.

Department of Anaesthesia and Intensive Care, “A. Meyer” Paediatric Hospital, Flo- rence (Italy)

Micieli G.

Stroke Unit, Cerebrovascular Division, IRCCS Neurological Institute

“C. Mondino Foundation”, Pavia (Italy) Milic-Emili J.

Meakins-Christie Laboratories, McGill University, Quebec (Canada) Miller J.

Department of Anaesthesiology, University of California, Irvine, Medical Center,

Orange, California (USA) Minhye Kim S.

Anaesthesia and Critical Medicine, Heart Institute, Incor, Hospital das Clínicas, School of Medicine, Saõ Paulo University, Saõ Paulo (Brazil)

Morales M.M.

Cellular and Molecular Physiology Laboratory, Carlos Chagas Filho Biophysics Institute, Federal University of Rio de Janeiro (Brazil)

Mossetti V.

Department of Anaesthesiology and Intensive Care, Regina Margherita Children’s Hospital, Turin (Italy) Muders T.

Department of Anaesthesiology and Intensive Care Medicine, University of Bonn (Germany)

Munari. M.

Department of Pharmacology

and Anaesthesiology, Padua University Medical School, Padua (Italy)

Naeije R.

Department of Pathopysiology, Erasme University Hospital, Free University of Brussels (Belgium)

Niro D.

Paediatric Intensive Care Unit, Pain Unit, Clinical Specialisation Institutes, Milan (Italy)

Nordström C.

Department of Clinical Neuroscience, Division of Neurosurgery, University Hospital, Lund (Sweden)

Nowak G.

Karolinska Institute, Centrum for Surgical Sciences, Division of Transplantation Surgery, Huddinge University Hospital,

Stockholm (Sweden) Nunes S.

Division of Intensive Care, Department of Anaesthesiology and Intensive Care, Kuopio University Hospital,

Kuopio (Finland) Ori C.

Department of Pharmacology

and Anaesthesiology, Padua University Medical School, Padua (Italy)

Paladino. F.

Department of Emergency Medicine, S. Paolo Hospital,

Naples (Italy)

XIV

Pellis T.

Department of Perioperative Medicine, Intensive Care and Emergency, Trieste University School of Medicine, Trieste (Italy)

Pelosi P.

Department of Clinical and Biological Sciences, University of Insubria, Varese (Italy)

Piva M.

Department of Perioperative Medicine, Intensive Care and Emergency, Trieste University School of Medicine, Trieste (Italy)

Poelna D.L.H.

Department of Anaesthesiology, Erasmus MC Faculty, University Medical Center,

Rotterdam (The Netherlands) Pöling J.

Department of Cardiac Surgery, Schüchtermann Klinik, Bad Rothenfelde (Germany)

Predescu O.

Trauma and Neurosurgery Intensive Care Unit, St Michael’s Hospital, University of Toronto (Canada)

Putensen C.

Department of Anaesthesiology and Intensive Care Medicine, University of Bonn (Germany)

Radhakrishnan J.

Department of Medicine, Division of Critical Care and Department of Physiology & Biophysics, Rosalind Franklin University

of Medicine and Science;

Medical Service, Section of

Critical Care Medicine, North Chicago VA Medical Center, North Chicago, Illinois (USA)

Resta M.

Anaesthesia and Intensive Care Service, Sant’Ambrogio Clinical Institute, Milan (Italy)

Rödl S.

Paediatric Intensive Care Unit, Department of Paediatrics, University of Medicine, Graz (Austria)

Romano S.M.

Department of Critical Care Medicine, Internal Medicine and Cardiology Service, University of Florence (Italy) Ruggiero E.G.

Department of Emergency Medicine, S.

Paolo Hospital, Naples (Italy) Sajeva M.

University of Palermo, Visioni WE Network, Palermo (Italy)

Salvo I.

Department of Anaesthesia and Intensive Care Medicine, Children’s Hospital

“V. Buzzi”, Milan (Italy) Scarani R.

Paediatric Intensive Care Unit, Istituti Clinici di Perfezionamento, Milan (Italy) Schiraldi F.

Department of Emergency Medicine, S. Paolo Hospital, Naples (Italy) Scolletta S.

Department of Surgery and Bioengineering, Thoracic and

Cardiovascular Unit, University of Siena (Italy)

Scolletta S.

Department of Surgery and Bioengineering, Thoracic and

Cardiovascular Unit, University of Siena (Italy)

Silvani P.

Department of Anaesthesia

and Intensive Care Medicine, Children’s Hospital “V. Buzzi”, Milan (Italy) Slutsky A.S.

Departments of Anaesthesia and Critical Care Medicine, Interdepartmental Division of Critical Care Medicine, Divi- sion of Respiratory Medicine, University of Toronto, St. Michael’s Hospital, Toronto (Canada)

XV

Smith M.

The National Hospital for Neurology and Neurosurgery, Centre for Anaesthesia, Unversity College, London (UK)

Teboul J.-L.

Medical Intensive Care Unit, University Hospital, Bicêtre (France)

Tenhunen J.

Department of Critical Care Medicine, University of Pittsburg Medical Center, Pittsburg, Pennsylvania (USA) Thallinger C.

Department of Clinical Pharmacology, Division of Clinical Pharmacokinetics, Medical University, Vienna (Austria) Theuerkauf N.

Department of Anaesthesiology and Intensive Care Medicine, University of Bonn (Germany)

van Iwaarden J.F.

Department of Neonatology, University Hospital, Maastricht (The Netherlands) Volpin S.M.

Department of Pharmacology

and Anaesthesiology, Padua University Medical School, Padua (Italy)

Wrigge H.

Department of Anaesthesiology and Intensive Care Medicine, University of Bonn (Germany)

Yamaguti T.

Anaesthesia and Critical Medicine, Heart Institute, Incor, Hospital das Clínicas, School of Medicine, Saõ Paulo University,

Saõ Paulo (Brazil) Zhang H.

Departments of Anaesthesia and Critical Care Medicine, Interdepartmental Division

of Critical Care Medicine, Division of Respiratory Medicine, University of Toronto, St. Michael's Hospital, Toronto (Canada)

Zin A.

Department of Neonatology, Fernandes Figueira Institute, Rio de Janeiro (Brazil) Zin W.A.

Federal University of Rio de Janeiro, Health Sciences Centre, Rio de Janeiro (Brazil)

Zobel G.

Paediatric Intensive Care Unit,

Department of Paediatrics, University of Medicine, Graz (Austria)

XVI

Abbreviations

ABRs Auditory Brainstem Responses AC/VT Assist Control/Volume-Targeted ACCI Acceleration Index

ACLS Advanced Cardiac Life Support ACS Acute Coronary Syndrome

AD Antiarrhythmic Drug

ADP Adenosine

AHA American Heart Association ALI Acute Lung Injury

ALIVE Amiodarone versus Lidocaione in Prehospital Ventricular Fibrillation Evaluation

ALS Advanced Life Support AMI Acute Myocardial Infarction AMP Adenosine Monophosphate

AP Augmented Pressure

APACHE Acute Physiology and Chronic Health Evaluation APRV Airway Pressure Release Ventilation

APS Acute Pain Service

AR Adaptive-Rate

ARDS Acute Respiratory Distress Syndrome ARR Absolute Risk Reduction

ARREST Amiodarone in the Resuscitation of Refractory Sustained Ventricular Tachyarrhytmias

ASA American Society of Anaesthesiology ATLS Advanced Trauma Life Support ATP Antitachycardia Pacing ATPase Adenosine Triphospatase AV Atrioventricular

AVO

Arterial-Venous Oxygenation AVP Arginine Vasopressin BAL Broncho Alveolar Lavage BBB Bundle-Branch Block

BIPAP Biphasic Positive Airway Pressure

BMI Body Mass Index

BNP B-Type Natriuretic Peptide

BP Blood Pressure

BPD Broncho Pulmonary Dysplasia BPI Brief Pain Inventory

BSD Berkley Software Distribution

XVII

CAA Cerebral Amyloid Angiopathy

CAAH Haemorrhage with Cerebral Amyloid Angiopathy CABG Coronary Artery Bypass Grafting

CAD Coronary Artery Disease

cAMP Cyclic Adenosine Monophosphate CaO

Oxygen Content

CARD Caspase Recruiting Domain CBF Cerebral Blood Flow

CBV Cerebral Perfusion Blood Volume CCO Continuous Cardiac Output CCP Cerebral Perfusion Pressure CCT Central Conduction Time

CCTR Cochrane Controlled Trials Register CDSR Cochrane Database of Systematic Reviews

CF Cardiac Function

CFTR Cystic Fibrosis Transmembrane Conductance Regulator CHEOPS Children’s Hospital of Eastern Ontario Postoperative Scale CHF Congestive Hearth Failure

CI Cardiac Index

CK-MB Creatine Kinase MB isoenzyme C-LQTS Congenital Long QT Syndrome CMV Conventional Mechanical Ventilation CNS Central Nervous System

CO Cardiac Output

CONSORT Consolidated Standards of Reporting Trials COPD Chronic Obstructive Pulmonary Disease CPAP Continuous Positive Airway Pressure CPB Cardiopulmonary Bypass

CPE Cardiogenic Pulmonary Oedema CPP Coronary Perfusion Pressure CPR Cardiopulmonary Resuscitation CPU Chest Pain Unit

CRMD Cardiac Rhytm Management Device CRP C-Reactive Protein

CRRT Continuous Renal Replacement Therapy CRT Cardiar Resynchronisation Therapy CSF Cerebrospinal Fluid

CT Computed Tomography

CV/DF Cardioversion/Defibrillation CVP Central Venous Pressure

CX Chest X-Ray

DARE Database of Abstracts of Reviews of Effectiveness DB RTC Double Blind Randomized Controlled Trial DCA Dichloracetat

DeltaP Pressure Amplitude DNA Deoxi-ribonucleic Acid DO

Oxygen Delivery

DPL Diagnostic Peritoneal Lavage

DVT Deep Vein Thrombosis

XVIII

Ea Arterial Elastance EAD Early Afterdepolarizations EBM Evidence-Based Medicine ECC Extracorporeal Circulation ECF Extracellular Fluid ECG Electrocardiography

ECMO Extracorporeal Membrane Oxigenation ECT Electroconvulsive Therapy

ED Emergency Department

EDV End-Diastolic Volume EEG Electroencephalography EELV End-Expiratory Lung Volume EF Ejection Fraction

EIT Electrical Impedance Tomography ELSO Extracorporeal Life Support Organization Emax Maximal Elastance

EMD Electromechanical dissociation

EMEA European Agency for the Evaluation of Medical Products EMI Electromagnetic Interference

EPAP Expiratory Positive Airway Pressure

ER Emergency Room

ERBF Effective Renal Blood Flow ERC European Resuscitation Council Ers Respiratory System Elastance

ES Endotoxin Shock

ESICM European Society of Intensive Care Medicine Estat L Static Lung Elastance

ESWL Extracorporeal Shock Wave Lithotripsy

ET Ejection Time

EVLW Extravascular Lung Water

FAST Focused Assessment with Sonography for Trauma FDA Food and Drug Administration

FDL Free Documentation License

FEV

Forced Expiratory Volume in One Second

FL Flow Limitation

FRC Functional Residual Capacity FTc Corrected Flow Time

FV Flow Velocity

FVC Forced Vital Capacity Fvmean Mean Flow Velocity GABA Gamma-Aminobutryc Acid GCP Good Clinical Practice GEDV Global End Diastolic Volume GFR Glomerular Filtration Rate GIK Glucose-Insulin-Potassium

GIMBE Gruppo Italiano per la Medicina Basata sulla Evidenza

GNU GNU’s Not Unix

GP Ground Plate

GPL GNU General Public License

XIX

GSC Glasgow Coma Scale HCMV Human Cytomegalovirus HFJV High Frequency Jet Ventilation HFOV High Frequency Oscillatory Ventilation HFPV High Frequency Percussive Ventilation HFV High Frequency Ventilation

HGF Hepatocyte Growth Factor

HR Heart Rate

HS Haemorrhage Shock

hs-CRP High-Sensitivity C-Reactive Protein HSD Hypertonic Saline/DextraneBaker

HT Haemothorax

IAPB Intraaortic Balloon Pump

ICD Implanted Cardioverterdefibrillator ICF Informed Consent Form

ICG Indocyanine Green ICH Intracranial Haemorrhage ICP Intracranial Pressure ICU Intensive Care Unit

IL Interleukin

ILCOR International Liaison Committee on Resuscitation IMV Intermittent Mandatory Ventilation

INO Inhaled Nitric Oxide IP Intracranial Pressure

IPAP Inspiratory Positive Airway Pressure IPM Intraperitoneal microdialysis IPN Interpeduncular Nucleus

IPPV Intermittent Positive Pressure Ventilation ISF International Sepsis Forum

ISF Interstitial Space Fluid ISS Injury Severity Score ITBV Intrathoracic Blood Volume KGF Keratinocyte Growth Factor

LAD Left Anterior Descending Coronary Artery LGPL Lesser GNU General Public License LIDCO Lithium Dilution System

LIDO Levosimendan-Dobutamine Study

LILACS Latin American and Caribbean Health Science Information Database LIMA Left Internal Mammaria Artery

LIP Lower Inflection Point LP ratio Lactate to Pyruvate Ratio LQTS Long QT Syndrome

LT Lithotripsy

LV Left Ventricular

LVEF Left Ventricular Ejection Fraction LVSWI Left Ventricular Stroke Work Index MAC Minimum Alveolar Concentration MAP Mean Arterial Pressure

MCP Mean Circulatory Pressure

XX

MEAC Minimum Effective Analgesic Concentration MeSH Medical Subject Heading

MI Myocardial Infarction

MIC Minimal Inhibitory Concentration MIS Modified Injury Score

MODS Multiple Organ Dysfunction Score MPAP Mean Pulmonary Artery Pressure MPQ McGill Pain Questionnaire

MPT Mitochondria permeability transition MRI Magnetic Resonance Imaging mRNA messenger Ribonucleic Acid MTT Mean Transit Time MV Mechanical Ventilation nAChRs Nicotin Receptors

NASCIS National Acute Spinal Cord Injury Studies NCA Nurse or Parent Controlled Analgesia NCPE Non-Cardiogenic Pulmonary Oedema

NE Norepinephrine

NEP Negative Expiratory Pressure Method NFCS Neonatal Facial Coding System NHE-1 Sodium-Hydrogen Exchanger Isoform-1 NICO

CO2 Partial Rebreathing System NICU Neonatal Intensive Care Unit

NIPPV Non-Invasive Positive Pressure Ventilation NIRS Near Infrared Spectroscopy

NISS New Injury Severity Score NMR Nuclear Magnetic Resonance NNT Number Needed to Treat

NPPV Noninvasive Positive Pressure Ventilation NRS Numerical Rating Scale

NSAID Non-Steroideal Anti-Inflammatory Drugs NSCLC Non-Small Cell Lung Cancers

NSE Neuron Specific Enolase O

ER Oxygen Extraction Ratio

OA Oleic-Acid Group

OP Operative System

OPS Orthogonal Polarisation Spectral

OR Odds Ratio

OSA Obstructive Sleep Apnea PAC Pulmonary Artery Catether

PaCO

Partiarl Arterial Carbon Dioxide Pressure PaO

Oxygen Pressure

PACU Post Anaesthesia Care Unit

PAOP Pulmonary Artery Occlusion Pressure PAV Proportional Assisted Ventilation Paw Airway Pressure

PC Phosphatidylcholine PCA Patient-Controlled Analgesia PCBF Pulmonary Capillary Blood Flow

XXI

PCM Pulse Contour Method PCR Polymerase Chain Reaction P

Critical Closing Pressure PCT Procalcitonin

PCV Pressure Control Ventilation PCWP Pulmonary Capillary Wedge Pressure PEA Pulseless Electrical Activity

PEEP Positive End Expiratory Pressure PEEP

Intrinsic Positive End Expiratory Pressure PEP Ejection Period

Pes Oesophageal pressure

PET Positron Emission Tomography

PG Pulse Generator

PG Phospatidylglycerol PGF Placental Growth Factor PGI2 Prostacyclin2 pedice P-gp P-Glycoprotein PI Phosphatidylinositol

PK/PD Pharmacokinetic/Pharmacodynamic Plip Lower Inflection Point of PV Curve

PM Pacemaker

Pms Mean Systemic Pressure

PMT Pacemaker-Mediated Tachycardia

PNX Pneumothorax

PONV Post-Operative Nausea and Vomiting PPB Plasma Protein Binding

PPC Postoperative Pulmonary Complications

PPHN Persistent Pulmonary Hypertension of the Newborn Ppl Pleural pressure

PPV Pulse Pression Variation

PRAM Pressure Recording Analytical Method PRMD Postresuscitation Myocardial Dysfunction PRT Pacemaker Reentry Tachycardia

PRVC Pressure Regulated Volume Controlled

PS Pressure Support

PSV Pressure Support Ventilation

PTA Percutaneous Transluminal Angioplasty

PtcCO

Transcutaneous Partial Arterial Carbon Dioxide Pressure PtcO

Transcutaneous Partial Arterial Oxygen Pressure Ptp Transpulmonary Pressure

PTP Pressure Time Product PTS Paediatric Trauma Score PTV Patient-Triggered Ventilation

PV Pressure-Volume

PVI Pressure-Volume Index PVR Pulmonary Vascular Resistance PWV Pulse Wave Velocity

rAAV Recombinant Adeno-Associated Viruses RAP Right Atrial Pressure

XXII

rAV Recombinant Adenoviruses rCBF Regional Cerebral Blood Flood

rCMRglc Regional Cerebral Metabolic Rates for Glucose RDS Respiratory Distress Syndrome

RFA Radiofrequency Arrhythmia Ablation rFVIIa Recombinant Human Factor VIIa

RM Recruitmen Manoeuvre

RNA Ribonucleic Acid

RNAi Ribonucleic Acid Interference ROS Reactive Oxygen Species

ROSC Return of Spontaneous Circulation RPA RNase Protection Assay

RR Recovery Room

RT Radiation Therapy

RTC Routine Thermal Care RV Right Ventricular

RVEDV Right Ventricular End-Diastolic Volume RVEDVI Right Ventricular End-Diastolic Volume Index RVEF Right Ventricle Ejection Fraction

RVSWI Right Ventricular Stroke Work Index

SA Sinoatrial

SAH Subarachnoid Haemorrhage SaO

Oxygen Saturation

SAPS Simplified Acute Physiology Score SB Spontaneous Breathing

SBP Systolic Blood Pressure

SCCM Society of Critical Care Medicine SCI Spinal Cord Injury

SCIWORA Spinal Cord Injury Without Obvious Radiographic Abnormality SCLC Small Cell Lung Cancers

ShvO

Hepatic Venous Oxygen Saturation

SIMV Synchronised Intermittent Mechanical Ventilation SOFA Sequential Organ Failure Assessment

SOO Single-Chamber Pacing SP Surfactant Proteins

SPECT Single Photon Emission Computed Tomography SpO

Pulse Oximetry

SSC Surviving Sepsis Campaign

ST Simple Thoracostomy

SV Stroke Volume

SVC Superior Vena Cava SvO

Oxygen Venous Saturation SVR Systemic Vascular Resistance SVV Stroke Volume Variation SW Saline Washout Group TBI Traumatic Brain Injury

TCD Transcranial Doppler Ultrasonography TCO Total Cost Ownership

TdP Torsade de Pointe

XXIII

TEB Thoracic Electrical Bioimpedance TEE Transoesophageal Echocardiography TENS Transcutaneous Electric Nerve Stimulation

TF Tissue Factor

TG Triglycerides

T

Inspiratory Duration

TIVA Total Intravenous Anaesthesia TLC Total Lung Capacity

TNF Tumor Necrosis Factor

TREM-1 Triggering Receptor Expressed in Myeloid Cells TTP Thrombotic Thrombocytopenic Purpura UIP Upper Inflection Point

V/Q Ventilation-Perfusion Ratio VALI Ventilator-Associated Lung Injury VAPS Volume Assured Pressure Support VAS Visual Analogue Scale

VCV Volume-Controlled Ventilation V

Minute Ventilation

VE Volume Expansion

VF Ventricular Fibrillation VILI Ventilator-Induced Lung Injury

VR Venous Return

VRS Verbal Rating Scale VT Ventricular Tachycardia

V

Tidal Volume

vWF von Willebrand Factor

WPW Wolff-Parkinson-White Syndrome

ZEEP Zero End-Espiratory Pressure

XXIV