tailieunhanh - Medicine of intensive care (Eighth edition): Part 2

(BQ) Continued part 1, part 2 of the document Medicine of intensive care (Eighth edition) has contents: Rheumatologic, immunologic, and dermatologic diseases in the intensive care unit, infectious disease problems in the intensive care unit, hematologic and oncologic problems in the intensive care unit, and other contents. Invite you to refer. | Section RHEUMATOLOGIC IMMUNOLOGIC AND DERMATOLOGIC DISEASES IN THE INTENSIVE CARE UNIT NANCY . LIU Chapter I Rheumatologic Diseases in the Intensive Care Unit NANCY . LIU JUDITH A. STEBULIS Patients with established rheumatologic diseases are rarely admitted to the intensive care unit ICU because of their inflammatory joint disease. However because many of these diseases include systemic involvement organ system failure and complications of therapy are common reasons for ICU admission. Other musculoskeletal problems frequently encountered in the intensive care setting include a patients whose underlying rheumatic diseases may pose certain problems in the planning and execution of some critical care procedures such as endotracheal intubation or b patients for whom acute rheumatic syndromes develop during their hospitalization. ACUTE RHEUMATIC DISEASES IN THE INTENSIVE CARE SETTING Several acute musculoskeletal disorders occur with increasing frequency among selected hospitalized patients including those in the ICU. The most common is crystal-induced arthritis because of monosodium urate calcium pyrophosphate dihydrate CPPD basic calcium phosphate BCP -hydroXyapatite or calcium oxalate crystals. Two other acute arthritides include septic arthritis from bacteremia and spontaneous hemarthrosis because of complications from anticoagulation therapy or bleeding diathesis. Gout Pathogenesis Gout is characterized by initial and intermittent attacks of mono- or polyarticular arthritis in the setting of prolonged hyperuricemia. Over many years attacks become more freqUent and chronic arthropathy may develop. AcUte gout is triggered by precipitation or shedding of monosodium urate crystals in the joint space or nearby soft tissues provoking an intense inflammatory reaction. Regardless of a primary or secondary etiology of hyperuricemia marked fluctuations of serum urate levels increase the risk of acute gout. Although the specific triggering event that initiates an .

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