2012 the NeuroICU book 1st edition

Aung Kyaw Oo NeuroICU T HE BOOK ZZZPHGLOLEURVFRP Notice Medicine is an ever-changing science As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work Readers are encouraged to confirm the information contained herein with other sources For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration This recommendation is of particular importance in connection with new or infrequently used drugs NeuroICU THE BOOK Editor Kiwon Lee, MD, FACP, FAHA, FCCM Assistant Professor of Neurology and Neurological Surgery Columbia University College of Physicians and Surgeons Department of Neurology, Division of Critical Care Neurological Intensive Care Unit New York Presbyterian Hospital Columbia University Medical Center New York, New York New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2012 by The McGraw-Hill Companies, Inc All rights reserved Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher ISBN: 978-0-07-171432-7 MHID: 0-07-171432-4 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-163635-3, MHID: 0-07-163635-8 All trademarks are trademarks of their respective owners Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in an editorial fashion only, and to the benefit of the trademark owner, with no intention of infringement of the trademark Where such designations appear in this book, they have been printed with initial caps McGraw-Hill eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs To contact a representative please e-mail us at bulksales@mcgraw-hill.com TERMS OF USE This is a copyrighted work and The McGraw-Hill Companies, 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INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE McGraw-Hill and its licensors not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom McGraw-Hill has no responsibility for the content of any information accessed through the work Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise With love, this book is dedicated to my father, Duckhee Lee, who has taught me diligence and hard working; to my mother, Younghee Lee, who has taught me how to lead and trained me to become tough; to my one and only sister, Katelyn Jongmee Lee; to my dearest daughters, Sophia Koen and Charin Lee, who constantly bring me happiness; and to my wife without whose support I would not be at where I am Kiwon Lee, MD This page intentionally left blank Contents Contributors Foreword Preface xiii xxv xxvii Acknowledgments Section xxix neurocritical care Diseases ection editor: Neera Bad atia, MD, M c, FCCM ubarachnoid hemorrhage Kiwon Lee, MD, FACP, FAHA, FCCM ntracerebral hemorrhage 35 Moussa F Yazbeck, MD, Fred Rincon, MD, MSc, FACP, and Stephan A Mayer, MD, FCCM tatus epilepticus 52 Santiago Ortega-Gutierrez, MD, Naman Desai, BA, and Jan Claassen, MD, PhD Neurotrauma 77 Neeraj Badjatia, MD, MSc, FCCM acute schemic troke 91 Joshua Z Willey, MD, MS Neuromuscular Diseases 123 Jennifer Frontera, MD Bacterial Meningitis 142 Mithil Gajera, MD, Quinn A Czosnowski, PharmD, BCPS, and Fred Rincon, MD, MSc, FACP ntensive Care nit ( C ) Management of Brain tumors 155 Simon Hanft, MD and Michael B Sisti, MD nflammatory and Demyelinating Central Nervous ystem Diseases H Alex Choi, MD, Sang-Bae Ko, MD, PhD, and Kiwon Lee, MD, FACP, FAHA, FCCM vii 178 viii n en Cardiac arrest and anoxic Brain n ury 188 Rishi Malhotra, MD and Kiwon Lee, MD, FACP, FAHA, FCCM Fulminant hepatic Failure 204 H Alex Choi, MD, Rebecca Bauer, MD, and Kiwon Lee, MD, FACP, FAHA, FCCM Section neurocritical care Monitoring 213 ection editor: an Claassen, MD, phD Management of ncreased ntracranial pressure 213 Kiwon Lee, MD and Stephan A Mayer, MD Continuous electroencephalogram Monitoring in the ntensive Care nit 226 Santiago Ortega-Gutierrez, MD, Emily Gilmore, MD, and Jan Claassen, MD, PhD Multimodality Neuromonitoring 253 Raimund Helbok, MD, Pedro Kurtz, MD, and Jan Claassen, MD, PhD advanced hemodynamic Monitoring 288 Pedro Kurtz, MD and Kiwon Lee, MD evoked potentials in the Operating room and C 300 Errol Gordon, MD and Jan Claassen, MD Neurophysiologic Decision upport ystems 314 Michael J Schmidt, PhD Section neurocritical care Intervention 325 ection editor: tephan a Mayer, MD, FCCM edation 325 Amy L Dzierba, PharmD, BCPS, Vivek K Moitra, MD, and Robert N Sladen, MBChB, MRCP(UK), FRCP(C), FCCM Fever and temperature Modulation 342 Neeraj Badjatia, MD, MSc, FCCM endovascular urgical Neuroradiology Raqeeb Haque, MD, Celina Crisman, BS, Brian Hwang, MD, E Sander Connolly, MD, and Philip M Meyers, MD 358 n en Section Perioperative Surgical care ix 385 ection editor: e ander Connolly, MD Brain aneurysm and arteriovenous Malformation urgery 385 Raqeeb Haque, MD, Ivan S Kotchetkov, BA, Brian Y Hwang, MD, and E Sander Connolly, MD external entricular Drain Management and entriculoperitoneal hunt 411 Paul R Gigante, MD, Brian Y Hwang, MD, and E Sander Connolly, MD Carotid revascularization and eC- C Bypass 427 Christopher Kellner, MD, Matthew Piazza, BA, Geoffrey Appelboom, MD, and E Sander Connolly, MD postcraniotomy Complication Management 438 Raqeeb Haque, MD, Teresa J Wojtasiewicz, BA, Brian Y Hwang, MD, and E Sander Connolly, MD Section trauma and Surgical Intensive care ection editors: oseph Meltzer, MD and ivek 455 Moitra, MD thoracic trauma and Cardiothoracic ntensive Care nit Management 455 Steven Miller, MD and Vivek K Moitra, MD abdominal trauma 468 Brian Woods, MD traumatic ascular n uries 482 Shahzad Shaefi, MD and Joseph Meltzer, MD abdominal emergencies 492 Carlee Clark, MD enitourinary emergencies 515 Francis Macchio, MD Critical Care ltrasound 528 Oliver Panzer, MD Section cardiovascular Problems 543 ection editor: oseph e parrillo, MD, FCCp acute Coronary yndrome Joanne Mazzarelli, MD and Steven Werns, MD 543 Index neuromuscular junction disease, 130 neuromuscular weakness See weakness neuronal injury, CBF and, 229, 230t neuropathy(ies) acute, differential diagnosis, 129t cranial, brainstem disease with, 130 underlying, 130 neurophysiologic decision support systems See also clinical decision support system benefits of, 316 commercial options available for, 321–322 cart-based all-in-one systems, 321 dashboard systems, 322 hybrid systems, 321 ICU-wide enterprise systems, 321 creation of, 317–318 EHR and, 319–320 neurotoxic fish poisoning, 128, 130 neurotrauma spinal cord injury, 85–87 cardiac system and, 87 classification of, 85, 86f DVT prophylaxis and, 87 infectious complications and, 87 respiratory system and, 86–87 steroids after, 85 surgical decompression for, 87 traumatic brain injury, 77–85 antibiotics for, 80 cervical spine clearance and, 82 CPP goal for, 80–81 craniotomy after, 82 CT scan of, 78f–79f DVT prevention and, 82–83 hypertonic saline for, 83–84 hypothermia after, 81 ICP monitoring after, 80 management of, 77–78 mannitol for, 83 osmotic agents for, 83–84 PbtO2 and, 80 prophylactic AED for, 78–80 steroids after, 80 sympathetic storming after, 84–85 transfusions and, 84 ventilation and, 84 New York Islands Arteriovenous Malformation Study, 365 nicardipine, 41t, 801t NICE-SUGAR trial, 838 961 NIHSS See National Institutes of Health Stroke Scale nimodipine, for bacterial meningitis, 151 nitrates, for acute coronary syndrome, 555–556 nitroglycerin, 621, 801t nitroprusside, 41t non aortic great vessel injury, stab wounds and, 489 noncontinuous status epilepticus (NCSE), 64–66, 65f acute brain injury and CT scan of, 66–67, 67f diagnostic tests for, 66–67 evolving seizure, 67, 68f–69f treatment protocol for, 68t criteria for, 65, 66t semiologic spectrum of, 65, 66t nonconvulsive seizures (NCSs), 229, 229t, 230f, 230t nonconvulsive status epilepticus (NCSE), 229, 229t, 230f, 230t qEEG for, 229–233, 232f–234f nonhemorrhagic stroke, 802t non-ST-segment elevation myocardia infarction (NSTEMI), 565–566, 565f, 573–574, 574f differential diagnosis of, 574 management of, 565–566 treatment algorithm for, 569f nonthrombolytic treatment, for acute ischemic stroke, 107–108 norepinephrine, 144, 144t, 624, 833t normal pressure perfusion breakthrough, AVMs and, 404 normothermia, therapeutic core temperature monitoring location during, 350–351 discontinuation of, 355 infection development tracking during, 351 North American Symptomatic Carotid Endarterectomy Trial (NASCET), 429, 435 NovoSeven, 37 NSM See neurogenic stunned myocardium NSTEMI See non-ST-segment elevation myocardia infarction nutrition artificial, complications of, 903–904 for bacterial meningitis, 150 death and, 908 962 Index nutrition (Cont.): enteral tolerance, evaluation of, 901f ICH and, 43 parenteral, complications of, 904t nutritional status, medications affecting, 905t O obesity, tracheostomy and, 730 obstruction See small bowel obstruction OHCA See out-of-hospital cardiac arrest open repair, of aneurysms, 487 operating room (OR) EPs in, 304–305 medications and, 305 EVD placement in, 415 opioids See also specific opioids pain management and, 326 organ donor specialists, brain death and, 927–928 organ injuries AAST Organ Injury Severity Scale bladder injury classification by, 519, 519t renal injury classification by, 516, 516t ureteral injury classification by, 518, 518t urethral injury classification by, 520, 520t blunt trauma and, 483 penetrating trauma and, 483 organophosphate toxicity, 128, 130 ORx See oxygen reactivity index osmotherapy, intracranial hypertension treatment and, 222 osmotic agents for intracranial hypertension, 10 for TBI, 83–84 osteomyelitis, subdural empyema and, 447 out-of-hospital cardiac arrest (OHCA), 189, 191 oxygen for acute coronary syndrome, 555 delivery devices, 658t deprivation to brain, 189 oxygen reactivity index (ORx), autoregulatory status and, 264, 266f oxygenation, 680–681 brain improvement of, 14 PbtO2 monitoring system for, 13–14 cerebral, 680 failure of, 657–659 goal setting, 680 systemic, 680 P PAI See penetrating aortic injury pain bleeding and, 493t in chest acute coronary syndrome and, 548–549 ECG with, 565f, 566 ECG without, 565f, 566 control of for pneumothorax, 457, 458f for rib fractures, 457, 458f management of, with opioids, 326 scrotal causes of, 524 evaluation of, 524–525 PAMORAs See peripherally acting mu opioid receptor antagonists pancreatic injury, from abdominal trauma, 479–480 pancreatitis, 503 acute coronary syndrome and, 504 surgical decompression for, 504 enteral feeding and, 503 head of bed elevation and, 503 papillary muscle rupture, MR and, 575–576 paraneoplastic neurologic diseases, causing encephalitis, 183, 183t parenchymal hematoma type (PH-1), 99, 99f parenchymal hematoma type (PH-2), 99, 99f parenteral agents, for hypertensive emergencies, 801t parenteral nutrition, complications of, 904t parenteral tube feeding, 899–900 partial pressure of brain tissue oxygen tension (PbtO2) monitoring system, 683–684 for brain oxygenation, 13–14 DO2 and, 13–14, 13f SjvO2 and, 13–14, 13f TBI and, 80 traumatic brain injury (TBI), 80, 256–257 blood transfusion and, 261–262 brain glucose decrease and, 266, 269f brain metabolism and, 266 cardiac performance optimization and, 262, 264f CO2 and, 259, 259f CPP correlation with, 259–260, 260f, 261f decrease in, 257, 259 FiO2 increase and, 260 Index partial pressure of brain tissue oxygen tension (PbtO2) monitoring system, traumatic brain injury (TBI) (Cont.): LPR increase and, 266, 269f treatment to increase, 257, 258f, 262, 262f, 263f passive leg raise test, 534 Patient State Index, 242 PAV See proportional assist ventilation PbtO2 See partial pressure of brain tissue oxygen tension monitoring system PCC See prothrombin-complex concentrate PCI See percutaneous coronary intervention PE See plasmapheresis; pulmonary embolism PEA See pulseless electrical activity peak pressures, 678f PEDs See periodic epileptiform discharges PEEP See positive end expiratory pressure pelvic fractures, retroperitoneal bleed from, 480 penetrating aortic injury (PAI), stab wounds and, 489 penetrating cardiac trauma, stab wounds and, 488–489 penetrating trauma solid organ injuries and, 483 vascular injuries and, 483 penicillin, 855t penicillin/tazobactam, 855t pentobarbital, intracranial hypertension treatment and, 222–223 Penumbra System, 107, 373–374 peptic ulcer, bleeding, 494 ICU management of, 495, 496f medical consultation for, 495 percutaneous coronary intervention (PCI), 563 delayed, 563–564, 564f percutaneous dilational tracheostomy, technique for, 746t percutaneous tracheostomy, 726–727 bronchoscopy for, 745 pericallosal aneurysm, 415, 416f EVD for management after, 416–418, 417f rebleeding risk and, 415 settings for, 417–418 peri-infarct depolarization (PID), 279, 281 periodic epileptiform discharges (PEDs), 63–64, 63f, 65t, 229, 229t peripherally acting mu opioid receptor antagonists (PAMORAs), 336 peritoneal dialysis, 769–770 963 permissive hypercapnia, 705 persistent electrographic seizures, cEEG for, 55, 58f PES See postextubation stridor PH-1 See parenchymal hematoma type PH-2 See parenchymal hematoma type phenobarbital, 11, 55, 59, 59t phenobarbital bolus, for TBI, cEEG of, 239, 241, 241f phenylephrine, 144, 144t, 833t phenytoin, 54t, 55, 79–80, 156 valproic acid and, 61 Philips InnerCool RTx Endovascular System, 348f PICCO, 289, 291 PID See peri-infarct depolarization pituitary adenoma, 165 pituitary apoplexy adrenal crisis and, 166 brain tumors and, 165–168, 166f EVD for, 166, 168 hydrocephalus and, 166 MRI of, 167, 167f postoperative goals, 168 surgical decompression of, 167–168 plaque rupture, 547 plasma arginine vasopressin concentration, 777–778, 778f plasma osmolality, 777–778, 778f plasmapheresis (PE) for ADEM, 181 for neuromuscular diseases, 138t plateau pressures, 678f plateau waves See Lundberg A waves pleural effusion, chest ultrasonography of, 537, 537f PML See progressive multifocal leukoencephalopathy pneumonia, 457, 459, 460 health care-associated, 736 hospital-acquired, 878–879 antibiotic therapy for, 880–882, 881f, 882f risk reduction for, 884 ventilator-associated, 736, 878–879 antibiotic therapy for, 880–882, 881f chest radiograph of, 295f risk reduction for, 884 pneumothorax, 456, 457, 458f chest ultrasonography of, 538–539, 539f after CPB, 463 intercostal nerve block for, 457, 458f pain control for, 457, 458f 964 Index poisoning, neurotoxic fish, 128, 130 polymorphic ventricular tachycardia, 611, 612f polyneuropathies, 128 portable monitoring solution, 317–318, 317f positioning, for bacterial meningitis, 149 positive end expiratory pressure (PEEP), 681–683 ICP and, 709 postcraniotomy complications, 438–440, 440t, 442t risk factors for, 439 seizures, 443, 444f hemorrhage prevention, 444–445 hydrocephalus and, 450 monitoring, 440–443 blood pressure, 442 hypertension, 442 hypotension, 442 nausea, 443, 443f neurologic examination, 440, 441t subgaleal hematoma, 444, 445f posterior fossa surgery, craniotomy and, 439t posterior reversible encephalopathy syndrome (PRES), 797, 799f postextubation stridor (PES), bronchoscopy and, 743–745 prasugrel, 568, 570 prednisone, for neuromuscular diseases, 138t PRES See posterior reversible encephalopathy syndrome pressure microsensors, for ICP monitoring, 219 pressure natriuresis, 800 pressure reactivity index (PRx), 263–264, 265f pressure-regulated volume control (PRVC), 692 pressure-volume (PV) curve, 678f primary abdominal compartment syndrome, 497t primary survey, 476 for vascular injuries, 482 Prinzmetal angina See coronary artery spasm PRIS See propofol infusion syndrome PROACT See Prolyse in Acute Cerebral Thromboembolism study progressive multifocal leukoencephalopathy (PML), 180 prolonged QT intervals, 611, 613t Prolyse in Acute Cerebral Thromboembolism (PROACT) study, 106 prone positioning, for ARDS, 706 prophylactic antibiotics for EVD infections, 418, 419t subdural empyema and, 446–449, 447f propofol, 10, 11, 58, 59t, 143 initial changes with, 333 propofol infusion syndrome (PRIS), 335 proportional assist ventilation (PAV), 693–694 propranolol, 608t protected specimen brush (PSB), 736–737 BAL vs., 737 sample handling after, 737 prothrombin-complex concentrate (PCC), for warfarin-induced coagulopathy, deep brain hemorrhage and, 814, 814t proton pump inhibitor, for GIB, 493 PRVC See pressure-regulated volume control PRx See pressure reactivity index PSB See protected specimen brush pseudoaneurysm, 486 Pseudomonas aeruginosa, 868t pulmonary artery catheter, for acute heart failure, 625–626 pulmonary contusion, 457 chest radiograph of, 459f complications of, 459–460, 460f CT scan of, 460f pulmonary embolism (PE), 714–717, 714t, 716f after acute ischemic stroke, 114 V/Q scan and, 717 pulmonary system, complications after acute ischemic stroke, 114 pulseless electrical activity (PEA), CA and, 194–196, 195t putaminal hemorrhage, CEA after CHS and, 433–434 PV See pressure-volume curve pyridostigmine, for neuromuscular diseases, 138t pyridoxine hydrochloride, 62 pyruvate concentration variation, 272–273, 274f pyuria, 887 Q qEEG See quantitative electroencephalography QT prolongation, 613t quantitative electroencephalography (qEEG), 277, 279, 279f, 280f IVH and, 239, 240f–241f for nonconvulsive status epilepticus, 229–233, 232f–234f Index R radiocontrast-induced nephropathy (RCIN), 757–759 preventive measures for, 758t risk factor for, 757t radiograph of pulmonary contusion, 459f of SBO, 506f Randomized Controlled Trial of Brain Tissue Oxygenation Monitoring, 257 rapid coronary revascularization, 643–645 rapid sequence intubation (RSI), for ICH, 39 RASS See Richmond Agitation-Sedation Scale rCBF See regional cerebral blood flow monitoring RCIN See radiocontrast-induced nephropathy rebleeding risks clipping of UIAs and, 396, 397t from EVD, for pericallosal aneurysm, 415 SAH and, 288 due to ruptured aneurysms, 388 recombinant activated factor VII (rFVIIa), for warfarin-induced coagulopathy, deep brain hemorrhage and, 814 recombinant tissue plasminogen activator (r-tPA), for acute ischemic stroke, 97t refractory status epilepticus (RSE), 56 causes of, 60, 61t CSF test for, 61t fecal test for, 61t immunomodulatory agents for, 62 mechanism for, 57 surgery for, 63 therapeutic hypothermia for, 62 treatment for, 58–60, 59t, 61–63, 62t regional anticoagulants, 773 regional cerebral blood flow (rCBF) monitoring, 273–275 remifentanil, 326 remodeling, 629, 629f renal injuries causes of, 516 classification of, 516, 516t evaluation of, 517 nonsurgical management of, 517–518 postoperative complications for, 517 surgical indications for, 517 renal replacement therapy (RRT), 768–769, 768f, 769f anticoagulant for, 772 dialysate, 772 965 renal replacement therapy (RRT) (Cont.): dialysis and, 768 continuous dialysis/hemofiltration therapies, 771–772 intermittent hemodialysis/hybrid therapies, 770–771, 770f, 771f peritoneal, 769–770 ICP increase during, 774 indications for, 767t initiation of, 766–768 replacement fluid, 772 renal salt wasting, 781 reperfusion therapy, for STEMI, 558, 561 repetitive stimulation, acute bilateral weakness and, 131, 133t residual volumes, increased, differential diagnosis for, 504–505, 505t respiratory failure, tracheostomy and, 730 respiratory system mechanics, 677–679 SCI and, 86–87 resuscitation after, after SAH, 3–4 reteplase, 558 retroperitoneal bleed, from pelvic fractures, 480 reversible posterior leukoencephalopathy syndrome, 797 rFVIIa See recombinant activated factor VII rib fractures intercostal nerve block for, 457, 458f pain control for, 457, 458f Richmond Agitation-Sedation Scale (RASS), 329, 330t RIFLE (Risk, Injury, Failure, Loss, and End-stage) staging, 752–753, 752t Riker Sedation-Agitation Scale (SAS), 330 Risk, Injury, Failure, Loss, and End-stage (RIFLE)staging, 752–753, 752t RRT See renal replacement therapy RSE See refractory status epilepticus RSI See rapid sequence intubation r-tPA See recombinant tissue plasminogen activator ruptured aneurysms craniotomy for, 439t endovascular therapy for, 358–360 SAH due to antifibrinolytic therapy and, 388 DSA for, 386, 387f management of, 385–386 medications for, 387 rebleeding risks and, 388 966 Index ruptured aneurysms, SAH due to (Cont.): surgical clipping for, 388–389 third nerve palsy and, 387–388, 388t treatment strategy for, 386–387 ruptured arteriotomy closure, after CEA, 432 S Safar, Peter, CA approach, 189, 190t SAFE See Saline versus Albumin Fluid Evaluation study SAH See subarachnoid hemorrhage SAINT See Stroke Acute Ischemic NXY-059 Trial Saline versus Albumin Fluid Evaluation (SAFE) study, 832 Saline versus Albumin Fluid Evaluation trial, 77 SAS See Riker Sedation-Agitation Scale SBO See small bowel obstruction scalp electroencephalography, depth electrode monitoring as component of, 242–243, 242f–247f Scandinavian Candesartan Acute Stroke Study, 108 SCI See spinal cord injury scrotal pain, acute causes of, 524 evaluation of, 524–525 SE See status epilepticus seashore sign, lung pattern on chest ultrasonography, 535–536, 536f, 539f secondary abdominal compartment syndrome, 497t secondary survey, 478–479 second-degree atrioventricular block, 590–591, 591f treatment of, 592–593, 593t–594t sedation, 327t for acute ischemic stroke, 111 analgesia vs., 325–326 interdependence, 326, 328, 328f assessment of, 329–330, 330t bacterial meningitis and, 150 CMR and, 328 daily interruption of, with intracranial hypertension, 335 depth of, BIS and, 334 goals for, 328 for ICH, 42 ICP and, 328 intracranial hypertension and, 10 sedation (Cont.): intracranial hypertension treatment and, 220–221 lab monitoring with, 335 management of, 326 monitoring level of, 242 scales, 329–30, 330t seizure threshold and, 328 therapeutic hypothermia and, 331–332 pharmacologic algorithm for, 331f seizures See also generalized convulsive status epilepticus; noncontinuous status epilepticus; refractory status epilepticus acute brain injury and, 69–70, 71f analgesia and, 328 cardiac arrest and, 70–72, 71f cEEG interpretation, 71 treatment of, 71, 72, 72f cEEG monitoring and, 230, 231f detection time, 229, 230f control of, 60 etiology of, 57t evolving, acute brain injury and, 67, 68f–69f intracranial hypertension treatment and, 219–220 persistent electrographic, cEEG for, 55, 58f postcraniotomy complications, 443, 444f precipitants of, 57t prevention of, ICH and, 43 sedation and, 328 sensory nerve action potentials (SNAPs), 301 sensory weakness, differential diagnosis for, 123, 124t–126t SENTIS, randomized controlled trial, 22 sepsis, 824–825 antibiotic therapy and, 830–831 bundles, 829t diagnostic criteria for, 827t host response modulation and, 836–837 lactate increase and, 830 management bundle, 829t management of, 826–830 model, 828f organ failure in, 828f recombinant human activated protein C in, 837t resuscitation bundle, 829t source control techniques, 831t supportive therapies for, 838t treatment approach, 828f Index sepsis hemodynamic support protocol, 835f septic shock corticosteroids and, 836 host response modulation and, 836–837 hypotension and, 832–835 supportive therapies for, 838t vasoactive drugs for, 833t serology studies, for neuromuscular diseases, 134t serum glucose, brain glucose and, 271, 273f shivering, 194 BSAS for, 353, 353t buspirone and, 354 dexmedetomidine and, 355 importance of, 352–353 magnesium and, 354 meperidine and, 333, 355 stepwise protocol for control of, 353, 354t treatment of, 353–355 SHOCK See SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK Trial Registry shock CA and, 196 cardiogenic AMI and, 638, 640–641, 642t, 643 causes of, 642t pathogenesis of, 643f categories of, 641f septic corticosteroids and, 836 host response modulation and, 836–837 hypotension and, 832–835 supportive therapies for, 838t vasoactive drugs for, 833t SHould we emergently revascularize Occluded Coronaries for cardiogenic shocK (SHOCK) Trial Registry, 640 SIADH See syndrome of inappropriate antidiuretic hormone sick euthyroid syndrome, 910–911 sick sinus syndrome (SSS), 588, 589, 590f singed hair, of nares, intubation and, 457 sinus bradycardia, 587 causes of, 588, 588f treatment of, 588, 589f sinus node dysfunction (SND), permanent pacing recommendations in, 589t sinus tachycardia, 596, 597f SIRPIDs See stimulus-induced rhythmic periodic, or ictal discharges 967 SIRS See systemic inflammatory response system SjvO2 See jugular venous oxygen saturation small bowel obstruction (SBO) appendicitis vs., 508 complications of, 506–507 epidemiology of, 507f etiology of, 507f, 507t management of, 507–508, 508t, 509f radiograph of, 506f surgery for, 505–506 systemic inflammatory response and, 508 terminology of, 506t snake venom, 127 SNAPs See sensory nerve action potentials SND See sinus node dysfunction sodium nitroprusside, 801t solid organ injuries blunt trauma and, 483 penetrating trauma and, 483 somatosensory evoked potentials (SSEPs), 301, 302, 302f, 303 after CA, 305–306 therapeutic hypothermia and, 306 normal values, 302t TBI and, 308, 309, 309f Spetzler and Martin Grading System, 368t, 400t spinal cord disorders, 130 lesions, 130 surgery, minimize bleeding during, 815–816, 816t spinal cord injury (SCI) cardiac system and, 87 cervical, tracheostomy and, 730 classification of, 85, 86f DVT prophylaxis and, 87 fever control after brain injury and, 349 infectious complications and, 87 respiratory system and, 86–87 steroids after, 85 surgical decompression for, 87 splenic injury, from abdominal blunt trauma, 483–484 sputum, carbonaceous, in nares, intubation and, 457 SSEPs See somatosensory evoked potentials SSS See sick sinus syndrome ST elevation, changes on ECG, 551, 551f, 553–555, 555f, 567t 968 Index stab wounds abdominal trauma from, 475–479 for, 477 abdominal compartment syndrome due to, 478 antibiotics for, 478 blood transfusion for, 477 FAST examination for, 476, 477 fluid administration for, 477 IAH due to, 478 liver injury and, 479, 479t primary survey for, 476 secondary survey for, 478–479 staging of, 479 tertiary survey for, 477 to mediastinum, 488 BAI, 489 blunt cardiac trauma, 488–489 management of, 488 non aortic great vessel injury, 489 PAI, 489 penetrating cardiac trauma, 488–489 STA-MCA See superficial temporal artery/ middle cerebral artery bypass Staphylococcus aureus, 447f Staphylococcus epidermidis, 447f statins, for bacterial meningitis, 151 status epilepticus (SE) See also generalized convulsive status epilepticus; noncontinuous status epilepticus; refractory status epilepticus benzodiazepine trial for, 64t myoclonic, 71 prognosis of, 71–72 STEMI See ST-segment elevation myocardial infarction stenting for acute ischemic stroke, 107 for ICAD, 374–377 steroids for ARDS, 707 after SCI, 85 after TBI, 80 STICH See Surgical Trial in Intracerebral Hemorrhage study stimulus-induced rhythmic periodic, or ictal discharges (SIRPIDs), 69 streptokinase, 558 stress-induced cardiomyopathy, 547, 575 stroke acute, 371–374, 372f stroke (Cont.): fever control after brain injury and, 349–350 hemorrhagic, 802t ischemic acute See stroke, acute ischemic carotid angioplasty and stenting for, 429 CEA for, 429, 429f, 430–431, 430t ECG abnormalities and, 577 management of, 427–428 MRI for, 178 plaque rupture and, 547 workup for, 427–428 nonhemorrhagic, 802t stroke, acute ischemic biomarkers for, 95 complications after, 113–114 cardiovascular events, 113–114 death, 114 infections, 113 neurologic, 113 pulmonary, 114 CT scan for, 93–95, 93f, 94f, 95f CTP for, 94, 94f diagnosis of, 92–93, 93f DVT after, 114 DWI for, 95 EPs and, 310 evaluation and, 112–113 flow sheet for, 92f hemorrhages and, 99–100 classification of, 99, 99f ICP management clinical pathway, 109, 110f magnetic-resonance perfusion for, 95, 95f MRI for, 95, 95f prevalence of, 91 public health burden of, 91 pulmonary embolism after, 114 risk factors for, 91–92 symptomatic intracerebral hemorrhage after, 99 TCD for, 95 treatment of after hours onset, 101–102, 101f under hours onset, 96, 96f, 104 antithrombotics, 101, 103 carotid angioplasty and stenting for, 108–109 carotid revascularization, 108–109 CEA, 108–109 clinical pathways, 96f, 101f clinical trials, 104t Index stroke, acute ischemic, treatment of (Cont.): complications, 99 heparin, 106 hyperventilation, 111 ICP elevation, 109, 110f, 111 intra-arterial, 103, 106–107 intravenous thrombolysis, 96, 98, 102–103 NeuroFlo, 113 nonthrombolytic, 107–108 pharmacology, 103 r-tPA contraindications, 97t sedation, 111 stenting, 107 surgical decompression, 111 vasopressors, 112–113 Stroke Acute Ischemic NXY-059 Trial (SAINT), 108 Stroke Council of American Heart Association guidelines, 395–396 stroke volume variation (SVV), 289 ST-segment elevation myocardial infarction (STEMI), 638, 639f anticoagulant therapy in, 561t antiplatelet therapy for, 562 CA and, 196 criteria, ECG and, 545f, 549–550 emergency management of, 644f fibrinolytic contraindications for, 560t fondaparinux for, 562 glycoprotein IIb/IIIa and, 562 reperfusion therapy for, 558, 561 treatment algorithm for, 564, 564f subarachnoid hemorrhage (SAH) See also aneurysmal subarachnoid hemorrhage aneurysmal endovascular treatment for, 360–362 morbidity rates of, 358 mortality rates of, 358 brain oxygenation and, PbtO2 monitoring system for, 13–14 computed angiographic scan of, 390f CT scan of, 1, 2f, 253, 254f, 289, 289f, 386f, 390f DSA of, 390f due to ruptured aneurysms antifibrinolytic therapy and, 388 DSA for, 386, 387f management of, 385–386 medications for, 387 rebleeding risks and, 388 surgical clipping for, 388–389 969 subarachnoid hemorrhage (SAH), due to ruptured aneurysms (Cont.): third nerve palsy and, 387–388, 388t treatment strategy for, 386–387 EPs and, 310 external ventricular drain for, 3–4 fever control after brain injury and, 346, 349 fluid resuscitation and, 288 grading systems for, 4–8 with hydrocephalus, 411, 412f EVD placement for, 411–414, 412f, 414f management algorithm for, 413f ventriculostomy for, 411–412 ICH and, 392, 392f surgery for, 392 intracranial hypertension in See intracranial hypertension intracranial pressure treatment and, 9–12 jugular bulb oximetry monitoring for, 275, 275f rebleeding and, 288 resuscitation after, 3–4 treatment of, 390 vasospasm after, 292, 294 ventriculomegaly and, 391, 391f subdural empyema, 448t CT of, 446f infection and, 446–449 brain abscess, 449, 449t meningitis, 448, 448t osteomyelitis, 447 prophylactic antibiotics and, 446–449, 447f of surgical site, 447 subfulminant hepatic failure, 206 subgaleal hematoma, postcraniotomy, 444, 445f succinylcholine, 143 superficial temporal artery/middle cerebral artery (STA-MCA) bypass, 435 suprapubic catheters, for acute urinary retention, 523, 524t supratentorial tumor resection, craniotomy for, 439t supraventricular tachycardia, 611–612 with aberration, 608–612, 609f–610f, 610t supraventricular tachycardias, 595f surface electroencephalo-cardiogram, aSAH and, 235, 236f surgery for ICH, 392 970 Index surgery (Cont.): minimally invasive, 45 posterior fossa, craniotomy and, 439t for RSE, 63 for small bowel obstruction, 505–506 of spinal cord bleeding and, 815–816, 816t minimize bleeding during, 815–816, 816t surgical aneurysmal repair, postoperative complications with, 440t surgical decompression for acute ischemic stroke, 111 for intracranial hypertension, for SCI, 87 Surgical Trial in Intracerebral Hemorrhage (STICH) study, 44, 392 Surviving Sepsis Campaign, 827, 829 SVV See stroke volume variation sympathetic storming, after TBI, 84–85 syndrome of inappropriate antidiuretic hormone (SIADH), 24–25, 780–781 causes of, 782t systemic anticoagulants, 773–774 systemic inflammatory response system (SIRS), 826 SBO and, 508 T T3 syndrome, 911 T4 syndrome, 911 tachycardias atrial, 600–601, 601f multifocal, 601, 602f junctional, 599–600, 601f narrow complex, 595–606 adenosine for, 602–603, 603f atrial flutter, 596–597, 597f atrial tachycardia, 600–601, 601f, 602f AV reciprocating tachycardia, 598–599, 599f–600f AVNRT, 597–598, 598f, 599f causes of, 601–602 differential diagnosis of, 595 on ECG, 595–601, 596f junctional tachycardia, 599–600, 601f management of, 603–604 maneuvers to differentiate, 602–603, 602f medications to differentiate, 602–603, 602f, 603f precipitants of, 601–602 sinus tachycardia, 596, 597f tachycardias (Cont.): sinus, 596, 597f supraventricular, 595f ventricular, significance of, 614, 615f wide complex, 606–616, 608f accelerated idioventricular rhythm, 611, 611f differential diagnosis for, 606–608 management of, 614–616 monomorphic ventricular tachycardia, 610 polymorphic ventricular tachycardia, 611, 612f prolonged QT intervals, 611, 613t supraventricular tachycardia, 611–612 supraventricular with aberration, 608–612, 609f–610f, 610t of ventricular origin, 608–612, 609f–610f, 610t Takotsubo cardiomyopathy, 27, 28f Takotsubo syndrome, 547 TBI See traumatic brain injury TCD See transcranial Doppler temperature See body temperature Temperature-modulation devices, FDA approved, 345, 346f–348f tenecteplase, 559 tertiary survey, 477 testicular torsion, management of, 525 TEVAR See thoracic endovascular aortic repair therapeutic normothermia core temperature monitoring location during, 350–351 discontinuation of, 355 infection development tracking during, 351 thiazides, 621 third nerve palsy, SAH due to ruptured aneurysms and, 387–388, 388t third-degree atrioventricular block, 590–591, 592f treatment of, 592–593, 593t–594t thoracic endovascular aortic repair (TEVAR), 488 thoracic trauma ARDS, 460–462, 460f chest radiograph of, 461f ECMO for, 460–462, 461f burn injury, 457 life-threatening complications of, 455–457, 456f hemothorax, 456 pneumothorax, 456, 457, 458f Index thoracic trauma (Cont.): pneumonia, 457, 459, 460 pulmonary contusion, 457, 459 chest radiograph of, 459f complications of, 459–460, 460f CT scan of, 460f rib fractures, 457, 458f thrombolysis for ICH, 45 intravenous, for acute ischemic stroke, 96, 98, 102–103 thrombosis, risk reduction for, 377 thrombotic thrombocytopenic purpura, 807 thymectomy, for neuromuscular diseases, 139t thyroid crisis, 908–909 thyroid storm, 909–910 ticagrelor, 570 tick paralysis, 127 ticlopidine, 568, 570 TIMI risk score calculation, 566t tobramycin, 855t torsades de pointes, 613t torsemide, 620 toxicity, organophosphate, neuromuscular diseases, 128, 130 tracheostomy, 723 after acute brain injury, 724t anatomical considerations for, 724 cervical spine injury and, 730 coagulopathy and, 729 complications of, 728–729, 728t indications for, 724t intracranial hypertension and, 729–730 obesity and, 730 percutaneous dilational, 726–727 bronchoscopy for, 745 technique for, 746t programmatic approach to, 731 severe respiratory failure and, 730 tube selection for, 725–726 transcranial Doppler (TCD) for acute ischemic stroke, 95 of symptomatic vasospasm, 14–16 Transfusion Requirements in Critical Care (TRICC) trial, 84 transfusions for abdominal trauma, 480 for stab wounds, 477 TBI and, 84 PbtO2 and, 261–262 971 trauma brain injury, 77–85 antibiotics for, 80 cervical spine clearance and, 82 CPP goal for, 80–81 craniotomy after, 82 CT scan of, 78f–79f DVT prevention and, 82–83 hypertonic saline for, 83–84 hypothermia after, 81 ICP monitoring after, 80 management of, 77–78 mannitol for, 83 osmotic agents for, 83–84 PbtO2 and, 80 prophylactic AED for, 78–80 steroids after, 80 sympathetic storming after, 84–85 transfusions and, 84 ventilation and, 84 spinal cord injury, 85–87 cardiac system and, 87 classification of, 85, 86f DVT prophylaxis and, 87 infectious complications and, 87 respiratory system and, 86–87 steroids after, 85 surgical decompression for, 87 trauma, abdominal from automobile collision, 470–471 blood transfusion for, 480 CT scan for, 471–472, 473, 473t DPL for, 471–473, 473t FAST examination for, 471–472, 472f, 473, 473t, 474f fluid administration for, 471 higher level of care transfer indications for, 474, 475t, 476t intraperitoneal bleeding and, 474 retroperitoneal bleed from pelvic fractures, 480 blunt penetration hepatic injury from, 484 splenic injury from, 483–484 exploratory laparotomy indications in, 477, 478t from gunshot wounds, 477 pancreatic injury from, 479–480 from stab wounds, 475–479 abdominal compartment syndrome due to, 478 972 Index trauma, abdominal, from stab wounds (Cont.): antibiotics for, 478 blood transfusion for, 477 FAST examination for, 476, 477 fluid administration for, 477 IAH due to, 478 laparotomy for, 477 liver injury and, 479, 479t primary survey for, 476 secondary survey for, 478–479 tertiary survey for, 477 trauma, blunt to abdomen hepatic injury from, 484 splenic injury from, 483–484 cardiac, stab wounds and, 488–489 compression forces in, 483 deceleration forces in, 483 solid organ injuries and, 483 vascular injuries and, 483 trauma, cardiac, stab wounds and blunt, 488–489 penetrating, 488–489 trauma, penetrating solid organ injuries and, 483 vascular injuries and, 483 trauma, thoracic ARDS, 460–462, 460f chest radiograph of, 461f ECMO for, 460–462, 461f burn injury, 457 life-threatening complications of, 455–457, 456f hemothorax, 456 pneumothorax, 456, 457, 458f pneumonia, 457, 459, 460 pulmonary contusion, 457, 459 chest radiograph of, 459f complications of, 459–460, 460f CT scan of, 460f rib fractures, 457, 458f traumatic brain injury (TBI), 77–85, 802t antibiotics for, 80 BAEPs after, 310 cEEG and, 241 on phenobarbital bolus, 239, 241, 241f cervical spine clearance and, 82 CPP goal for, 80–81 CPP management and, 294–295 craniotomy after, 82 CT scan of, 78f–79f traumatic brain injury (TBI) (Cont.): DVT prevention and, 82–83 EPs after, 309 fever control and, 350 hypertonic saline for, 83–84 hypothermia after, 81 ICP monitoring after, 80 jugular bulb oximetry monitoring for, 275, 275f ketamine and, 328–329 management of, 77–78 mannitol for, 83 osmotic agents for, 83–84 PbtO2 and, 80, 256–257 blood transfusion and, 261–262 brain glucose decrease and, 266, 269f brain metabolism and, 266 cardiac performance optimization and, 262, 264f CO2 and, 259, 259f CPP correlation with, 259–260, 260f, 261f decrease in, 257, 259 FiO2 increase and, 260 LPR increase and, 266, 269f treatment to increase, 257, 258f, 262, 262f, 263f prophylactic AED for, 78–80 SSEPs and, 308, 309, 309f steroids after, 80 sympathetic storming after, 84–85 transfusions and, 84 ventilation and, 84 TRICC See Transfusion Requirements in Critical Care trial triggering, in mechanical ventilation, 673–674, 674t triple-H therapy, for symptomatic vasospasm, 18–20 troponin See biomarkers tumors of brain acoustic neuroma, 174–175, 174f, 175f CT scan of, 155, 156f, 159f, 162f DWI of, 157, 158f hemangioblastoma, 161–162 hemorrhagic brain lesions, 168–172 hydrocephalus and, 161 hyperosmolar therapy, 156 ICP and, 155, 156, 157 malignant glioma, 172–173, 172f, 173f management of, 155–157 Index tumors, of brain (Cont.): MRA of, 157, 157f MRI of, 157, 157f, 161f, 163f operative resection of, 158, 159 pituitary adenoma, 165 pituitary apoplexy and, 165–168, 166f cerebellopontine angle, postoperative complications with, 440t supratentorial resection, craniotomy for, 439t T-wave, changes on ECG, 567t U UA See unstable angina UFH See unfractionated heparin UIAs See unruptured intracranial aneurysms ultrasonography, chest, 534, 535f for acute severe dyspnea, 539–540, 540f of air bronchograms, 537, 538f of alveolar consolidation, 537–538, 538f clinical scenarios for, 539–540 limitations of, 540 lung pattern on, 535–536, 536f, 537f, 539f pathologic process suspicion on, 537–539, 537f, 538f, 539f of pleural effusion, 537, 537f of pneumothorax, 538–539, 539f role for performing, 534 scanning zones for, 534–535, 535f ultrasound, volume responsiveness assessment by, 528, 529f, 539 IVC variation measurement, 530, 532–533, 532f, 533f, 534 measurement location, 530, 532–533, 533f passive leg raise test and, 534 requisite images, 530, 531f, 532–533, 532f unfractionated heparin (UFH), 150, 714 unruptured intracranial aneurysms (UIAs) craniotomy for, 439t DSA of, 393, 393f hydrocephalus and, 396 management of, 393, 394 myocardial infarction and, 398 neurologic deficits and, 388t rupture rates for, 394t rupture risk for, 393–394 surgical clipping for, 396 complications from, 397t diagnostic modalities in NICU status post, 398 perioperative management, 396 postoperative management, 398 973 unruptured intracranial aneurysms (UIAs), surgical clipping for (Cont.): rebleeding after, 396, 397t symptoms of, 395 unstable angina (UA), 545 treatment algorithm for, 569f upper gastrointestinal bleeding See gastrointestinal bleed (GIB) ureteral injury causes of, 518 classification by, 518, 518t evaluation of, 518 management of, 518 urethral catheters, for acute urinary retention, 523, 524t urethral injury causes of, 519–520 classification of, 520, 520t evaluation of, 520 management of, 520 urinalysis, in intrinsic renal disease, 756t urinary catheter, urine specimen and, 887 urinary retention, acute See acute urinary retention urinary tract infection (UTI), 884–885, 885f urine osmolality, 777–778, 778f UTI See urinary tract infection V VA-ECMO See veno-arterial extracorporeal membrane oxygenation valproate, 54t valproic acid, phenytoin and, 61 vancomycin, 80, 147t, 855t VAP See ventilator-associated pneumonia variceal bleeding, 493t VAS See Verbal or Visual Analog Scale vascular injuries acute coronary syndrome, 485 aneurysm dissection formation, 486–487 mechanism of, 486–487 mesenteric ischemia from, 488 open repair of, 487 surgical options for, 487–488 TEVAR for, 488 blunt trauma and, 483 carotid artery dissection, 484–485 carotid bruit, 484–485 interventional radiology role in, 484 from motor vehicle accident, 482 974 Index vascular injuries (Cont.): penetrating trauma and, 483 primary survey for, 482 stab wounds See stab wounds vasculitis, serologic evaluation of, 756t vasodilators, intravenous, 621 vasogenic edema, 159, 159f, 160 vasopressin, 144, 144t, 833t vasopressors, 624 for acute ischemic stroke, 112–113 cerebral circulation and, 144t vasospasm cerebral angiography of, 269f, 293f multimodality pattern seen during, 268, 269f after SAH, 292, 294 treatment of, 271, 272f vasospasm, symptomatic approach to, 14–18 cEEG, 18 CTA, 16–17, 17f CTP, 16–17, 17f transcranial Doppler, 14–16 therapy for, 18–22 basal cistern implants of calcium channel blockers, 21–22 blood pressure management, 19–20 cerebral angiography, 21, 21f intra-aortic balloon counterpulsation therapy, 22 intrathecal infusion of calcium channel blockers, 21–22 NeuroFlo device, 22, 23f, 24f triple-H, 18–20 volume management, 19–20 veno-arterial extracorporeal membrane oxygenation (VA-ECMO), 461–462 venous blood compartment, 684–686, 685f venous thromboembolism (VTE), 712–713 incidence of, 713t veno-venous extracorporeal membrane oxygenation (VV-ECMO), 461–462 ventilation failure of, 657–659 high-frequency, ARDS and, 706 mechanical, 672, 703 airway pressures, 677–679 approach to, 705–706 for ARDS, 703 cerebral blood flow and, 684–686 controlled ventilation vs., 676–677 ventilation, mechanical (Cont.): cycling, 674–676, 674t expiration, 676 hypoxemia mechanisms, 680t indications for, 673, 673t inspiration, 674, 674t mode of, 676 respiratory system mechanics, 677–679 triggering, 673–674, 674t TBI and, 84 weaning from, weakness and, 135, 137 ventilation perfusion (V/Q ) scan, pulmonary embolism and, 717 ventilator-associated pneumonia (VAP), 736, 878–879 antibiotic therapy for, 880–882, 881f chest radiograph of, 295f risk reduction for, 884 ventilator-induced lung injury (VILI), 687–688 brain and, 688–689 ventricular arrhythmias, 606–616, 608f See also wide complex tachycardias development of, 612, 614 ventricular septal rupture, 576 ventricular tachycardia, significance of, 614, 615f ventriculitis, 418 ventriculomegaly, CT of, 391, 391f ventriculoperitoneal shunt (VPS) placement, in EVD for hydrocephalus, 422–423 ventriculostomy, for SAH with hydrocephalus, 411–412 ventriculostomy-related infections (VRIs), 418 VEPs See visual evoked potentials verapamil, 608t Verbal or Visual Analog Scale (VAS), 330 Veterans Administration Cooperative Study, 556 VHL See Von Hippel–Lindau disease Vigileo, 289 VILI See ventilator-induced lung injury VINDICATE mnemonic, weakness and, 124t–126t Virchow triad, 713f visual evoked potentials (VEPs), 301 vitamin K, for warfarin-induced coagulopathy, deep brain hemorrhage and, 813 volume management, for symptomatic vasospasm, 19–20 volume responsiveness assessment, by ultrasound, 528, 529f, 539 IVC variation measurement, 530, 532–533, 532f, 533f, 534 Index volume responsiveness assessment, by ultrasound (Cont.): measurement locations, 530, 532–533, 533f passive leg raise test and, 534 requisite images, 530, 531f, 532–533, 532f Von Hippel–Lindau (VHL) disease, 162 VPS See ventriculoperitoneal shunt placement VQ See ventilation perfusion scan VRIs See ventriculostomy-related infections VTE See venous thromboembolism VV-ECMO See veno-venous extracorporeal membrane oxygenation W Wake up and Breathe trial, 135 warfarin, ICH and, 37, 38t Warfarin Versus Aspirin Symptomatic Intracranial Disease Study for Stroke (WASID), 375 warfarin-induced coagulopathy, deep brain hemorrhage and, 813–814 FFP, 813–814 PCC, 814, 814t rFVIIa and, 814 vitamin K and, 813 WASID See Warfarin Versus Aspirin Symptomatic Intracranial Disease Study for Stroke waveforms, ICP, 3f, 214–216, 216f, 217f, 418– 419, 420t intracranial compliance and, 215, 216f weakness See also acute bilateral weakness bedrest and, 133, 135 mobilization and, 133, 135 975 weakness (Cont.): motor, differential diagnosis for, 123, 124t–126t sensory, differential diagnosis for, 123, 124t–126t ventilator weaning and, 135, 137 VINDICATE mnemonic and, 124t–126t Wenckebach See second-degree atrioventricular block West Haven Criteria, 205–206, 205t WFNS See World Federation of Neurosurgical Societies Scale wide complex tachycardias, 606–616, 608f accelerated idioventricular rhythm, 611, 611f differential diagnosis for, 606–608 management of, 614–616 monomorphic ventricular tachycardia, 610 polymorphic ventricular tachycardia, 611, 612f prolonged QT intervals, 611, 613t supraventricular tachycardia, 611–612 supraventricular with aberration, 608–612, 609f–610f, 610t of ventricular origin, 608–612, 609f–610f, 610t Wolff-Parkinson-White (WPW) syndrome, 598, 599f, 604 World Federation of Neurosurgical Societies (WFNS) Scale, 5, 6t WPW See Wolff-Parkinson-White syndrome Z Zoll Intravascular Temperature Management System, 348f ... the time of publication However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the. .. 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