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By Frederic S. Bongard

'Fast recommendations to significant scientific and diagnostic difficulties ...A needs to for the serious care medical professional or the ER health practitioner' - on-line overview of the 1st variation. assembly the original wishes of "intensivists" - specially these whose fundamental backgrounds are in inner drugs, surgical procedure, or anesthesiology - "CURRENT serious Care prognosis and remedy" presents a unified method of difficulties encountered in grownup severe care perform. Crossing the limits between disciplines, this publication brings you fast entry to significant diagnostic positive factors, proper pathophysiology, concise descriptions of ailment strategies, and functional administration ideas for the vast variety of stipulations encountered in severe care.It is appropriate for these treating the significantly unwell and desiring solutions in a rush. It serves as a one-stop reference for grownup severe care practitioners. It enables severe care educating, perform, and evaluation - particularly for these getting ready for area of expertise tests. It integrates clinical and surgical views with diagnostic and remedy knowledge.It expertly but concisely covers forty key issues in serious care fundamentals, clinical serious care, and necessities of surgical in depth care. It comprises info on being pregnant, psychiatric issues, imaging methods, shipping, and extra in severe instances. It deals new remedy concepts for respiration misery syndrome and gives updates at the pathophysiology of breathing failure and fluid and electrolyte problems. It presents the easiest present tips about serious care supportive measures, together with food, bleeding prevention, and prevention of deep venous thrombosis. It is helping scholars doing clerkships in medication, surgical procedure, and significant care; citizens and fellows; and practitioners who desire a succinct reference for day by day serious care perform.

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Extra resources for Current Critical Care Diagnosis and Treatment (Lange Medical Books)

Sample text

Enalapril given to elderly patients is reported to cause hyponatremia. Excessive water drinking can be identified from the history and the presence of polyuria, but large volumes of water may be inadvertently given in the ICU. Adrenal insufficiency and hypothyroidism should be considered if there are features suggesting these disorders. Hyponatremia has been associated with hospitalized AIDS patients. Volume depletion from gastrointestinal fluid losses and SIADH were the most common causes and there was an increase in morbidity and mortality of those with hyponatremia.

C. Hyponatremia With Normal Extracellular Volume Hyponatremia in association with normal extracellular volume is seen with psychogenic water ingestion, decreased solute intake, and, most commonly, the syndrome of inappropriate secretion of ADH (SIADH). Massive intake of water rarely results in severe hyponatremia if ability to excrete water is unimpaired. However, decreased solute intake as described above limits the maximum volume of water that can be excreted even when urine is maximally diluted.

When serum sodium is extremely low, hyponatremia is manifested by altered mental status (hyponatremic encephalopathy), seizures, and high mortality. Correction of severe hyponatremia must be done carefully and in a controlled fashion to avoid further complications. In the absence of hyponatremia associated with normal or increased tonicity (see below), low serum sodium indicates excess total body water for the amount of solute (dilutional hyponatremia). In normal subjects, this condition would initiate compensatory mechanisms that would facilitate rapid excretion of water and correct the imbalance.

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