Anaesthesia, Pain, Intensive Care and Emergency Medicine - A. P. I. C. E.: Proceedings of the 12th Postgraduate Course in Critical Care Medicine Trieste, Italy - November 19-21 1997

The management of critically ill patients has,in the past few years, been a discipline at the forefront of development which continues to make progress with the support of basic and clinical research in the broadest sense. The application of biotechnology in this particular area has revealed itself to be essential in an attempt to provide the best interpretation of the bio-humoral and functional alterations present in a long series of often complex clinical conditions. The care of the critically ill is also at the forefront in the application of increasingly sophisticated clinical monitoring systems that also contribute to standardizing certain procedures, establish guidelines, and evaluate the efficacy of therapeutic interventions and their costs. Front Matter....Pages II-XX Front Matter....Pages 21-21 Cytokine Activity in Experimental Sepsis....Pages 23-32 Role of Nitric Oxide in Septic Shock....Pages 33-47 Novel Approaches to Improve Tissue Oxygen Extraction Capabilities: Lessons Learned from Experimental Septic Shock Models....Pages 49-56 Should Beta-Blockers Have a Place in the Treatment of Septic Shock?....Pages 57-65 Front Matter....Pages 67-67 Relationship between Chronic Dyspnea and Expiratory Flow Limitation in Patients with COPD....Pages 69-74 Pathophysiology of Flow Limitation....Pages 75-81 Pharmacological Reversibility of Flow Limitation in COPD and Asthmatic Patients....Pages 83-90 Respiratory Muscle Fatigue in COPD Patients....Pages 91-98 Front Matter....Pages 99-99 Patient-Ventilator Interaction....Pages 101-109 Spontaneous Breathing Trial with T-Tube....Pages 111-116 Continuous Flow Systems....Pages 117-122 Lung Damage by Artificial Ventilation Proof by Radiological Techniques....Pages 123-131 Barotrauma, Volume Trauma and Their Relation to FRC....Pages 133-139 Iatrogenic Lung Damage by Artificial Ventilation: What Is the Role of the Pulmonary Surfactant System?....Pages 141-146 Side Effects of Mechanical Ventilation: Molecular Mechanisms....Pages 147-154 Physiological Rationale to Prevent Ventilation-Induced Lung Injury....Pages 155-163 Iatrogenic Lung Damage by Artificial Ventilation Clinical Confirmation....Pages 165-169 Mechanical Ventilation in ARDS: What a Fine Mess!....Pages 171-179 Rationale for Reduction of Alveolar Ventilation in ARDS....Pages 181-189 Front Matter....Pages 191-191 Perioperative Hypertension....Pages 193-210 Front Matter....Pages 191-191 Therapy of Perioperative Myocardial Ischemia....Pages 211-221 Selection of Patients for Invasive Haemodynamic Monitoring....Pages 223-227 Anaesthetic Considerations for Major Cardiovascular Surgery....Pages 229-240 Therapeutic Strategies in Patients Suffering from Myocardiopathy (Awaiting Transplantation)....Pages 241-252 Front Matter....Pages 253-253 Pathophysiology of Head Trauma....Pages 255-263 Cerebral Edema in Brain Ischemia and Trauma....Pages 265-275 Cerebral Blood Flow and Metabolism in Severe Head Injury....Pages 277-281 Monitoring of Jugular Bulb Hemoglobin Oxygen Saturation (SjvO 2 )....Pages 283-289 Integrated Monitoring in Intensive Care Head Injured Patients....Pages 291-295 Surgical Management of Severely Head Injured Patients....Pages 297-301 Front Matter....Pages 303-303 Heat Exchange....Pages 305-311 Perioperative Hypothermia Prevention and Treatment....Pages 313-318 Alternative Strategies to Deal with Perioperative Hypothermia....Pages 319-326 Hypothermia for Neuroprotection....Pages 327-333 Metabolism after Injury: The Effects of G.H.....Pages 335-339 Front Matter....Pages 341-341 Evolution of Hemofiltration....Pages 343-352 Prevention of Acute Oliguric Renal Failure....Pages 353-364 High Volume Slow Continuous Venovenous Hemofiltration in Septic Nonoliguric Burned Patients....Pages 365-370 The Role of the Liver in Acid-Base Regulation....Pages 371-379 Acid-Base Disturbances during Fulminant Hepatic Failure....Pages 381-384 Front Matter....Pages 341-341 Acid-Base Regulatory Mechanisms during Orthotopic Liver Transplantation....Pages 385-396 Front Matter....Pages 397-397 Sedation and Analgesia in ICU Paediatric Patients....Pages 399-405 The Strategy of Sedation and Analgesia in ICU Patients....Pages 407-415 Use of Propacetamol in Postoperative Pain....Pages 417-421 Tramadol - Acute Postoperative Pain Management....Pages 423-430 Front Matter....Pages 431-431 Neurological Monitoring in the ICU....Pages 433-441 Critical Neurologic Dysfunctions: Status Epilepticus and Guillain-Barré Syndrome....Pages 443-449 Front Matter....Pages 451-451 Hemodynamic Effects of Hyperoxia in Hemorrhagic Shock....Pages 453-458 Hyperbaric Oxygen in the Treatment of Posthanging Cerebral Anoxia....Pages 459-473 Front Matter....Pages 475-475 The Problem of Fever in ICU Patients....Pages 477-484 Diagnosis of Pneumonia: Do We Really Need Invasive Techniques in ICU Patients?....Pages 485-489 How and Why to Prevent Respiratory Tract Infections in ICU....Pages 491-494 Is Reduction in Mortality in Intensive Care Just Another Holy Grail?....Pages 495-500 Clinical Assessment, Monitoring and Therapeutic Strategies for Septic Patients....Pages 501-509 Receptor Blocking Agents: Why Did They Fail?....Pages 511-519 Front Matter....Pages 521-521 Risk Factors and Maternal Mortality....Pages 523-528 Decision Making in High Risk Obstetric Patients....Pages 529-534 Coagulation Disorders in the Obstetric Patient....Pages 535-542 High Risk Patients and ICU Management....Pages 543-548 Front Matter....Pages 549-549 Biology of Aging and Anaesthesia....Pages 551-556 Front Matter....Pages 549-549 Preoperative Assessment....Pages 557-569 Options for Induction and Maintenance of Hypnosis in Anaesthesia....Pages 571-577 The Role of Combined Anesthesia: Pros and Cons....Pages 579-586 Preemptive Analgesia....Pages 587-596 Is It Possible to Monitor the Depth of Anesthesia?....Pages 597-606 Remifentanil: When and How to Use It....Pages 607-610 Update on the Use of the Laryngeal Mask....Pages 611-624 Front Matter....Pages 625-625 Training in Anaesthesia and Intensive Care....Pages 627-634 Rationing Resources in the ICU: Perspectives for the Future....Pages 635-641 Anaesthesiology and Intensive Care: Steps for the Future....Pages 643-647 Front Matter....Pages 649-649 Perioperative Management of Mentally Handicapped Patients....Pages 651-655 Management of Diabetes in the Perioperative Period....Pages 657-667 Management of Emergency Aortic Aneurysmectomy....Pages 669-679 Acute Abdomen in the Emergency Department....Pages 681-689 Metabolic Disorders and Electrolyte Derangement during Hypoperfusion Syndrome....Pages 691-696 Organization and Management of Organ Donors....Pages 697-703 Back Matter....Pages 705-712 The management of critically ill patients has, in the past few years, been a discipline at the forefront of development which continues to make progress with the support of basic and clinical research in the broadest sense. The application of biotechnology in this particular area has revealed itself to be essential in an attempt to provide the best interpretation of the bio-humoral and functional alterations present in a long series of often complex clinical conditions. The care of the critically ill is also at the forefront in the application of increasingly sophisticated clinical monitoring systems that also contribute to standardizing certain procedures, establish guidelines, and evaluate the efficacy of therapeutic interventions and their costs