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(BQ) Part 1 book The protocol book for intensive care presents the following contents: Acute ST-Elevation myocardial infarction, management of unstable angina and non ST-Elevation myocardial infarction, cardiogenic shock, acute heart failure, management of chronic heart failure,...
THE PROTOCOL BOOK for Intensive Care THE PROTOCOL BOOK for Intensive Care Fourth Edition Editor Soumitra Kumar MBBS MD DM FCSI FACC FESC FSCAI FICC FICP Professor, Division of Cardiology Department of Medicine Vivekananda Institute of Medical Sciences Kolkata, West Bengal, India Forewords Sukumar Mukherjee Manotosh Panja Amal Kumar Banerjee Pradip Kumar Deb ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi London Philadelphia Panama đ Jaypee Brothers Medical Publishers (P) Ltd Headquarters Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj New Delhi 110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 Email: jaypee@jaypeebrothers.com Overseas Offices J.P Medical Ltd 83, Victoria Street, London SW1H 0HW (UK) Phone: +44-2031708910 Fax: +02-03-0086180 Email: info@jpmedpub.com Jaypee-Highlights Medical Publishers Inc City of Knowledge, Bld 237, Clayton Panama City, Panama Phone: +507-301-0496 Fax: +507-301-0499 Email: cservice@jphmedical.com Jaypee Medical Inc The Bourse 111, South Independence Mall East Suite 835, Philadelphia, PA 19106, USA Phone: + 267-519-9789 Email: joe.rusko@jaypeebrothers.com Jaypee Brothers Medical Publishers (P) Ltd 17/1-B Babar Road, Block-B, Shaymali Mohammadpur, Dhaka-1207 Bangladesh Mobile: +08801912003485 Email: jaypeedhaka@gmail.com Jaypee Brothers Medical Publishers (P) Ltd Shorakhute, Kathmandu Nepal Phone: +00977-9841528578 Email: jaypee.nepal@gmail.com Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2014, Jaypee Brothers Medical Publishers All rights reserved No part of this book may be reproduced in any form or by any means without the prior permission of the publisher Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com This book has been published in good faith that the contents provided by the contributors contained herein are original, and is intended for educational purposes only While every effort is made to ensure accuracy of information, the publisher and the editor specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work If not specifically stated, all figures and tables are courtesy of the editor Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device The Protocol Book for Intensive Care First Edition: 2003 (by Editor) Second Edition: 2008 Third Edition: 2010 Fourth Edition: 2014 ISBN 978-93-5090-740-5 Printed at To My Family, Friends and Well-wishers Swami Vivekananda The secret of religion lies not in theories but in practice To be good and to good — that is the whole of religion Contributors Achyut Sarkar Associate Professor Department of Cardiology Institute of Postgraduate Medical Education and Research Kolkata, India Amitava Majumder Assistant Professor Department of Medicine Vivekananda Institute of Medical Sciences, Kolkata, India Aniket Niyogi Senior Registrar, ITU Belle Vue Clinic, Kolkata, India Arghya Chattopadhyay Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Arup Ratan Datta Head, Department of Nephrology Fortis Hospital, Anandapur Kolkata, India Basab Bijoy Sarkar Consultant Physician Fortis Hospital, Anandapur Kolkata, India Bipul Barman Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Debashis Datta Consultant Gastroenterologist Fortis Hospital, Anandapur Kolkata, India Debashis Sarkar Consultant Physician Sri Aurobindo Seva Kendra Kolkata, India Dinobandhu Naga Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Dipankar Mondal Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Jayanta Roy Consultant Neurologist Apollo Gleneagles Hospital Kolkata, India Joydeep Mukherjee Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Kayapanda M Mandana Chief Cardiac Surgeon Fortis Hospital, Anandapur Kolkata, India Samar Ranjan Pal Associate Professor Division of Rheumatology Department of Medicine Vivekananda Institute of Medical Sciences, Kolkata, India Saptarshi Mukhopadhyay Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India viii The Protocol Book for Intensive Care Shuvanan Ray Chief of Cardiac Interventions Fortis Hospital Anandapur, Kolkata, India Siddhartha Bandopadhyay Deputy Visiting Cardiologist Department of Medicine Ramakrishna Mission Seva Pratishthan Kolkata, India Soumitra Kumar Professor Division of Cardiology Department of Medicine Vivekananda Institute of Medical Sciences, Kolkata, India Subhasis Chakraborty Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan Kolkata, India Sudeshna Majumder Professor Division of Cardiology Department of Medicine Vivekananda Institute of Medical Sciences, Kolkata, India Sudip Mondal Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan Kolkata, India Sudipto Chatterjee Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Sujata Majumder Assistant Professor Department of Medicine Vivekananda Institute of Medical Sciences, Kolkata, India Sujoy Ghosh Assistant Professor Department of Endocrinology Institute of Postgraduate Medical Education and Research Kolkata, India Sulagna Banerjee Medical Officer Division of Non-invasive Cardiology Ramakrishna Mission Seva Pratishthan, Kolkata, India Sumit Sen Gupta Consultant Pulmonologist Fortis Hospital Anandapur, Kolkata, India Susanta Chakraborty Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Sweety Trivedi Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Uttio Gupta Senior Resident Department of Medicine Ramakrishna Mission Seva Pratishthan, Kolkata, India Yashesh Paliwal Consultant Intensivist In-charge, ICU, Fortis Hospital Anandapur, Kolkata, India Foreword to the Fourth Edition Medical Sciences have progressed by leaps and bounds—not only in understanding of pathogenesis but also in formulation of evidence-based and cost-effective approach in their management Parallel to novel diagnostic aids, technological improvement in acute care medicine has supplemented quality of management to a greater extent to achieve precision The medical practice is ever-changing with the introduction of newer concepts and devices in an algorithmic manner as it is done in this fourth edition of the book The Protocol Book for Intensive Care under the able editorship of Professor Soumitra Kumar and his team This book covers all the major branches of medical emergencies such as cardiology, pulmonary medicine, central nervous system, metabolic medicine, and of course, rheumatology In this multidisciplinary and multiauthor book the presentations are simple, logical and maintain orderly flow of decision-making process The compilation of most of the ‘acute care medicine’ by thoughtful contribution of senior experienced clinicians of Kolkata under the guidance of erudite Professor Kumar has come out like ‘Pocket Guidelines Update’ I am sure this algorithmic approach with holistic vision would be very practical for the clinicians who practice acute emergencies I am convinced that timely arrival of this edition will improve level of acute care further in patients with health crisis And for this laudable effort of educational promotion, Professor Soumitra Kumar and his associates deserve special appreciation and thanks Sukumar Mukherjee MD FRCP(Lond) FRCP(Edinburgh) FSMF FICP FISE FIMSA Ex-Professor and HOD of Medicine Medical College, Kolkata, India Past President Association of Physicians of India Foreword to the Fourth Edition It is indeed a pleasure for me to write a Foreword for this fourth edition of The Protocol Book for Intensive Care I have known Dr Soumitra Kumar since he started working with me in his postgraduation days and his academic zeal was always very commendable He has indeed matured a great deal with times and along with his team of acclaimed colleagues and enthusiastic students, he has produced a real praise-worthy publication I am given to understand that the first editions have been very popular and I am very hopeful that the fourth one too will be equally well-appreciated and read I wish Dr Kumar and his team all success for the book Manotosh Panja MD DM FCSI FACC FICP Ex-Director, Professor and HOD Department of Cardiology Institute of Postgraduate Medical Education and Research Kolkata, India President Cardiological Society of India (1995-96) President Association of Physicians of India (2003-04) Dean Indian College of Physicians (2012-13) Foreword to the Fourth Edition Medical Sciences, in the past few decades, have progressed at lightning speed The advent of intensive care has decreased morbidity and mortality in patients with medical emergencies which constitute nearly 30-40% of medical practice today Professor Soumitra Kumar first published the Protocol Book in 2003 This year, he is going to publish the 4th edition of the book with a focus on intensive care Truly speaking, we need this sort of protocol book which presents in a brief and practical manner, the approach towards diagnosis and management of medical emergencies This compilation of treatment approaches on various aspects of intensive care pertaining to the various systems has been well-chosen and written by very experienced faculty Professor Soumitra Kumar needs to be complimented for the excellent selection of topics This book shall be useful to all sections of medical profession Professor Kumar has set up a healthy trend in publishing the 4th edition of this book I am sure that this book will find a permanent place on the shelves of all physicians Amal Kumar Banerjee MD DM FACC FESC FACP FAPSC FICC FCSI FICP Past President Cardiological Society of India Association of Physicians of India SAARC Cardiac Society ... Headquarters Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj New Delhi 11 0 002, India Phone: + 91- 11- 43574357 Fax: + 91- 11- 43574 314 Email: jaypee@jaypeebrothers.com Overseas... Director—National Heart Institute Preface In the Fourth edition, The Protocol Book has been renamed as The Protocol Book for Intensive Care on the basis of feedback from the publishers that many potential... Vasodilators in CHF 12 9 Positive Inotropic Therapy in CHF 13 1 Antithrombotics in CHF 13 1 Antiarrhythmics in CHF 13 1 Worsening Heart Failure 13 2 Follow-up of CRT 13 6 Contents Syncope 14 6 Saptarshi