tailieunhanh - Ebook The neuro ICU book: Part 2

(BQ) Part 2 book "The neuro ICU book" presents the following contents: Cardiovascular problems, pulmonary diseases, renal and electrolyte disorders, hamatology, infectious disease, nutrition and endocrinology, ethics and end of life issues. | SECTION 6 Cardiovascular Problems Section Editor Joseph E. Parrillo MD FCCP CHAPTER 31 Acute Coronary Syndrome Joanne Mazzarelli MD Steven Werns MD A 67-year-old man with a history of hypertension hyperlipidemia and tobacco use was found by family members with left-sided paralysis rightward eye deviation and change in mental status and was brought to the emergency department ED . Computed axial tomography CAT of the brain per- formed in the ED Figure 31-1 showed a large acute nonhemorrhagic right hemispheric infarct within the vascular territory of the right middle cerebral artery. The infarct involved large portions of the frontal temporal and parietal lobes as well as underlying basal ganglia structures. The proximal right middle cerebral artery was hyperdense consistent with thrombosis within the vessel. The patient was not administered thrombolytic therapy because of the unknown onset of symptoms. The local ED physicians decided to transfer the patient immediately to the nearest tertiary medical center. On arrival to the intensive care unit the patient was awake and alert but with a left hemiparesis and left hemineglect. Upon admission he complained of dyspnea but no chest pain. Heart rate HR was 77 bpm and regular blood pressure BP 89 55 mm Hg respiratory rate RR 15 breaths min temperature T C F and arterial oxygen saturation SaƠ2 98 on 6 L oxygen. Cardiovascular examination was notable for jugular venous distention with an estimated jugular venous pressure of 9 cm H2O. The first and second heart sounds were noted to be normal and regular. There was a III VI holosystolic murmur at the apex. The lungs were clear to auscultation bilaterally. Initial laboratory test results were notable for a blood urea nitrogen BUN of 65 mg dL creatinine of mg dL white blood cell WBC count of 16 700 pL hemoglobin Hb of g dL and platelets of 413 000 pL. Cardiac biomarkers were elevated with a creatinine kinase of 821 U L a troponin T of ng mL and a .

• Y khoa - Dược
• The neuro ICU book
• Cardiovascular problems
• Pulmonary diseases
• Renal and electrolyte disorders
• Infectious disease
• Nutrition and endocrinology
• Neurocritical care diseases
• Neurocritical care monitoring
• Neurocritical care intervention
• Perioperative surgical care
• Trauma and surgical intensive care
• The NeuroICU book
• Electrolyte disorders
• Surgical intensive care