Metabolic Disorders and Critically Ill Patients

The purpose of this book is to bring together the latest findings on metabolic disorders that are strongly implicated in various critically ill patients. Since the beginning of the 20th century, maintaining the "milieu intérieur" has been a major challenge for intensivists. In addition to considerable technological developments in intensive care units, important advances in our understanding of metabolic disorders observed in critically ill patients have been made during the 10 last years. Today, the intensivit can-t ignore these disorders when selecting the most appropriate treatment for an illness. Cellular metabolic abnormalities are responsible for systems and organ failures, so the modern approach of organ dysfunctions now includes prevention or treatment of such disorders. This book is a comprehensive tool, allowing the physician to understand, diagnose and treat these metabolic disorders. Water, electrolyte, acid-base, glycemic and endocrinologic problems, as well as metabolic abnormalities observed in renal, cerebral and hepatic failure are presented in different chapters. The last part of the book is devoted to modern nutritional concepts, the consequences of energy modifications, mitochondrial dysfunction, hypothermia, oxidative stress and ischemia reperfusion, which open the way for new therapies.-

Dr Carole Ichai, MD and PhD, is Professor of Anesthesiology and Intensive Care Medicine at the University of Nice and is the head of the medico surgical Intensive Care Unit at the Saint Roch Hospital. She is a Past-member of the scientific and intensive care unit of the French Society of Anesthesiology and Intensive Care Unit (SFAR). She is the Director of the "Sud Méditerranée" European Courses in Anesthesiology and Intensive Care. Her main research interest is all metabolic disturbances and consequences (glycemia disturbances, acid-base water and electrolytes disorders, acute renal failure and hemofiltration) in critically ill patients. Dr Hervé Quintard is a specialist in Anesthesiology and Intensive Care Medicine at the University of Nice and is a full practician of the medico surgical Intensive Care Unit at the Saint Roch Hospital. He is the co-responsible with Pr Ichai of a University Diploma of "Metabolic Intensive Care". His main research interest is in the management and metabolic disturbances of cerebral injury with an experimental research (affiliation in a CNRS laboratory) and a clinical one focused on severe head trauma and sub-arachnoid hemorrhage. Dr Jean-Christophe Orban, PhD, is a specialist in Anesthesiology and Intensive Care Medicine at the University of Nice and is a full practician of the medico surgical Intensive Care Unit at the Saint Roch Hospital. He is the co-responsible with Pr Ichai of a University Diploma of "ICU competences for nurses". His main research interest is in the metabolic consequences of cardiac arrest, therapeutic hypothermia and mitochondrial dysfunction with an experimental research (affiliation in a INSERM laboratory) and a clinical one.

Section 1. Fluid and electrolytes disorders.- Chapter 1. Water and sodium balances.- Chapter 2. Sodium disorders.- Chapter 3. Potassium disorders.- Chapter 4. Phosphate and calcium disorders.- Section 2. Acid-base disorders.- Chapter 5. Interpretation of acid-base disorders.- Chapter 6. Acidosis : diagnosis and treatment.- Chapter 7. Alkalosis : diagnosis and treatment.- Chapter 8. Lactate : metabolism, physiopathology.- Section 3. Kidney and metabolic disorders.- Chapter 9. Metabolism et renal functions.- Chapter 10. Extra-renal removal therapies in acute kidney injury.- Chapter 11. Strategies for preventing acute kidney failure.- Section 4. Brain and metabolic disorders.- Chapter 12. Cerebral metabolism and function.- Chapter 13. Cerebral ischemia: patholophysiology, diagnosis and treatment.- Chapter 14. Evaluation of cerebral blood flow in the intensive care unit.- Section 5. Endocrine disorders in intensive care unit.- Chapter 15. Acute complications of diabetes.- Chapter 16. Neuroendocrine dysfunction in the critically ill patients.- Chapter 17. Hyperglycemia in intensive care unit.- Section 6. Energetic metabolism, Nutrition.- Chapter 18. Nutritional requirements in intensive care unit.- Chapter 19. Pharmaconutrition in the critically ill patient.- Chapter 20. Oxygen, oxidative stress.- Chapter 21. Energetic metabolism : from the organ to the cell.- Chapter 22. Ischemia-reperfusion concepts of myocardial preconditionning and postconditioning.- Chapter 23. Targeted temperature management in severe brain injured patient.