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A. Gullo (Editor) Anaesthesia, Pain, Intensive Care and Emergency – A.P.I.C.E. Proceedings of the 20 th Postgraduate Course in Critical Care Medicine Trieste, Italy - November 18 - 21, 2005
Transcript of A. Gullo(Editor) Anaesthesia, Pain, Intensive Care and ...978-88-470-0407-8/1.pdf · A....
A. Gullo (Editor)Anaesthesia, Pain, Intensive Care and Emergency – A.P.I.C.E.
Proceedings of the20 th Postgraduate Course in Critical Care MedicineTrieste, Italy - November 18 - 21, 2005
A. Gullo (Editor)
Anaesthesia, Pain, Intensive Careand Emergency
A.P.I.C.E.Proceedings of the20th Postgraduate Course in Critical Care MedicineTrieste, Italy – November 18-21, 2005
Springer
ANTONINO GULLO, M.D.Head, Department of Perioperative Medicine,Intensive Care and EmergencyTrieste University School of MedicineTrieste, Italy
Library of Congress Control Number: 2005934455
ISBN 10 88-470-0406-3 Springer Milan, Berlin Heidelberg New YorkISBN 13 978-88-470-0406-1 Springer Milan Berlin Heidelberg New York
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Table of Contents
BASICS IN CRITICAL CARE
Chapter 1 – Cellular response to mechanical stressC.S.N.B GARCIA, P.R.M. ROCCO, M.M. MORALES . . . . . . . . . . . . . . . . . . 3
Chapter 2 – Molecular biology: from the bench to clinical applicationM.M. MORALES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
ADVANCES IN CRITICAL CARE
Chapter 3 – Autologous bone marrow cells transplantationin ischaemic cardiomyopathy: initial clinical resultsS. ALMEIDA DE OLIVEIRA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Chapter 4 – Haemorrhagic shockJ. BOLDT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
Chapter 5 – Microdialysis - principles and techniquesC.-H. NORDSTRÖM, U. UNGERSTEDT . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Chapter 6 – Sidestream dark-field imaging and image analysisof oral microcirculation under clinical conditionsD.M.J. MILSTEIN, J.A.H. LINDEBOOM, C. INCE . . . . . . . . . . . . . . . . . . . . . 79
Chapter 7 – Perfusion optimisation at the microcirculatory levelD. DE BACKER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Chapter 8 – Pacemaker resynchronisation in the treatment of severe heart failureJ.L. ATLEE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99
Chapter 9 – The importance of guidelines in airway managementF. PETRINI, M. SORBELLO, M. SCOPONI . . . . . . . . . . . . . . . . . . . . . . . . . 113
Chapter 10 – BioGrid: a collaborative environment for life science researchC.-H. HUANG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
ANTIBIOTICS
Chapter 11 – The classifications of antibioticsR. DE GAUDIO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 135
Chapter 12 – An overview of antibiotic pharmacokineticsM. PALAZZO 143
Chapter 13 – Evidence for immediate adequate parenteral antibioticsV. EMMI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Chapter 14 – Focus on antibiotics: use and misuse in the intensive care unit,and antibiotics monitoringF. PEA, F. PAVAN, M. FURLANUT . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179
CENTRAL NERVOUS SYSTEM
Chapter 15 – Clinical significance of monitoring the central nervous systemin the operation room and the intensive care unitE. FREYE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
Chapter 16 – Global hypothermia for neuroprotection after cardiac arrestW. BEHRINGER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 199
Chapter 17 – Vegetative stateN. LATRONICO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
CARDIOVASCULAR
Chapter 18 – A personal account from four decades of cardiac care:is there a case for mechanical heart rhythm management?J.L. ATLEE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221
Chapter 19 – Oesophageal pacing and cardioversion-defibrillationJ.L. ATLEE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 231
VI
Chapter 20 – Thrombolysis during cardiopulmonary resuscitationB.W. BÖTTIGER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Chapter 21 – Cardiac resynchronisation therapy: do we know everything?C. FANTONI, A. AURICCHIO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 257
Chapter 22 – Minimising reperfusion injury in settings of myocardial ischaemiaR. GAZMURI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Chapter 23 – Non invasive haemodynamic monitoring: where we are in 2005R. MUCHADA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 277
Chapter 24 – Role of shock timing in cardiac vulnerability to electric shocksB. RODRIGUEZ, N. TRAYANOVA, D. GAVAGHAN . . . . . . . . . . . . . . . . . . . . . 287
Chapter 25 – Analysis of arterial pulse and ventricular devicesS. SCOLLETTA, S.M. ROMANO, B. BIAGIOLI . . . . . . . . . . . . . . . . . . . . . . . 295
Chapter 26 – Ventilatory-metabolic monitoring and analysis of arterial pulseP. GIOMARELLI, E. CASADEI, S. SCOLLETTA . . . . . . . . . . . . . . . . . . . . . . . 305
Chapter 27 – The assessment of cardiac performance in critically ill patientsC. SORBARA, A. ROSSI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Chapter 28 – Haemodynamic monitoring of septic patients with pressurerecording analytical method: preliminary observationsG. TULLI, S.M. ROMANO, R. FEMINÒ . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Chapter 29 – The dark side of the moon: in-hospital cardiopulmonary resuscitationE. CERCHIARI, N. CILLONI, F. SEMERARO . . . . . . . . . . . . . . . . . . . . . . . . 341
LUNG
Chapter 30 – Physiopathology of atelectasis during anaesthesiaG. HEDENSTIERNA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353
Chapter 31 – Effect of mechanical ventilation on right ventricular afterloadB. LACHMAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
VII
Chapter 32 – Computed tomography evaluation of lung collapseand recruitment manoeuvres during anaesthesiaL.M.S. MALBOUISSON, J.O.C. AULER JR . . . . . . . . . . . . . . . . . . . . . . . . . 369
Chapter 33 – Mechanisms of repair and remodelling in ARDSC. DOS SANTOS, P.R.M. ROCCO . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381
Chapter 34 – Corticosteroids in ARDS: back to the futureA.B. SOUZA-FERNANDES, W.A. ZIN, P.R.M. ROCCO . . . . . . . . . . . . . . . . . . 405
Chapter 35 – Nitric oxide should be used in ARDSH. GERLACH . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419
Chapter 36 – Formation and clearance of pulmonary oedema in ALI/ARDSB. ALLARIA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431
FLUID, ELECTROLYTES AND ACID/BASE BALANCE
Chapter 37 – Diabetic ketoacidos: incidence, biochemical abnormalities,pathophysiology, and diagnosisK. HILLMAN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 441
Chapter 38 – Endogenous metabolic acid-base abnormalities: lactate and other strong ionsJ. KELLUM . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 447
Chapter 39 – Metabolic acidosisF. SCHIRALDI, G. ESPOSITO, E.G. RUGGIERO . . . . . . . . . . . . . . . . . . . . . . 455
Chapter 40 – Metabolic alkalosisF. SCHIRALDI, E. MIRANTE, F. PALADINO . . . . . . . . . . . . . . . . . . . . . . . . 463
Chapter 41 – Blood-gas monitoringR.G.G. TERZI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471
INFECTIONS, SEPSIS, MODS
Chapter 42 – Epidemiology of infections in the PICUI. SALVO, F. IZZO, A. WOLFLER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495
Chapter 43 – Strategy in the treatment of secondary peritonitisR. HAHN, S. STORTECKY, C. SPISS . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503
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Chapter 44 – Combination therapy for sepsis: the wave of the futureor too complex to consider?S. OPAL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 519
Chapter 45 – Implementation of the Surviving Sepsis Campaign guidelinesJ.-L. VINCENT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 525
PERIOPERATIVE MEDICINE
Chapter 46 – Perioperative cardiac risk stratificationJ.O.C. AULER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537
Chapter 47 – Risk evaluation and anaesthetic strategyin perioperative myocardial ischaemiaB. DRENGER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 551
Chapter 48 – Practice recommendations guidelines for pulmonary artery catheterJ.O.C. AULER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 559
Chapter 49 – Perioperative neuroprotection: is it possible to preventbrain injury in high risk patients?J.O.C. AULER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573
Chapter 50 – Drug interactions in anaesthetic practiceV. FODALE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 585
Chapter 51 – Perioperative myocardial ischaemiaP. FOËX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 595
Chapter 52 – Left ventricular systolic and diastolic dysfunctionP. FOËX . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 603
Chapter 53 – Challenges in perioperative medicine: positioningM. KLIMEK . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 609
Chapter 54 – The neurotoxicity of commonly used general anaesthetics: is it possible?V. JEVTOVIC-TODOROVIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 617
Chapter 55 – Neuroprotection by N-methyl-D-aspartate antagonistsE. KOCHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 627
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Chapter 56 – Neuroprotection by dexmedetomidineE. KOCHS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 633
Chapter 57 – Choice of anaesthetics for neurosurgical anaesthesiaP.M. PATEL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 641
Chapter 58 – Brain protection - the clinical realityP.M. PATEL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 651
Chapter 59 – Challenges in perioperative medicine: neuroanesthesiaK.J. RUSKIN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 661
Chapter 60 – Does anaesthesia influence the apoptosis pathway?G. DELOGU, M. SIGNORE, A. ANTONUCCI . . . . . . . . . . . . . . . . . . . . . . . . 669
Chapter 61 – Anaesthesia in orthopaedic surgeryB. BORGHI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 677
CRITICAL BLEEDING AND TRANSFUSION
Chapter 62 – Severe bleeding in critical careM. GIRARDIS, S. BUSANI, M. MARIETTA . . . . . . . . . . . . . . . . . . . . . . . . 687
Chapter 63 – Transfusion triggers in surgeryP. VAN DER LINDEN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 695
TRAUMA AND DISASTER MEDICINE
Chapter 64 – Pre-hospital trauma care: controversial aspectsG. BERLOT, B. BACER, S. ROCCONI . . . . . . . . . . . . . . . . . . . . . . . . . . . 707
Chapter 65 – The unstable trauma patientG. GORDINI, M. MENARINI, E. BIGI . . . . . . . . . . . . . . . . . . . . . . . . . . . 715
Chapter 66 – What to do next: major chest trauma beyond the “recipe books”F. PLANI, J. GOOSEN . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 727
Chapter 67 – Application of new educational methodologies in disaster medicineF. DELLA CORTE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 745
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Chapter 68 – Terrorist attacks: what have we learned?P. SINGER . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 751
PAEDIATRICS
Chapter 69 – Difficult airwayG. MARRARO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 763
Chapter 70 – Rationale for the use of noninvasive ventilation in childrenC. GREGORETTI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 779
Chapter 71 – Neonatal helmet-continuous positive airway pressure in preterm infantsD. TREVISANUTO, N. DOGLIONI, N. GRAZZINA . . . . . . . . . . . . . . . . . . . . . 787
Chapter 72 – Helmet-delivered CPAP in childrenwith acute hypoxaemic respiratory failureG. CHIDINI, P. PELOSI, E. CALDERINI . . . . . . . . . . . . . . . . . . . . . . . . . . 795
PAIN
Chapter 73 – Organisation of an Acute Pain ServiceM. STADLER, J. BOOGAERTS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 809
Chapter 74 – Pain management and patient satisfactionD. CARISTI, L. MIOTTO, M. PIVA . . . . . . . . . . . . . . . . . . . . . . . . . . . . 819
QUALITY OF CARE
Chapter 75 – Monitoring process quality in intensive careM. HIESMAYR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 833
Chapter 76 – Evaluating quality of life after intensive careM. CAPUZZO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 843
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 853
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Adducci A.Anesthesia Research Staff, IRCCS IstitutiOrtopedici Rizzoli, Bologna, Italy
Allaria B.2nd School of Specialisation in Anaesthe-sia and Intensive Care, University of Mi-lan, Milan, Italy
Almeida de Oliveira S.Heart Institute (InCor), University of SãoPaulo Medical School, São Paulo, Brazil
Antonucci A.Department of Anaestesia and IntensiveCare, Policlinico Umberto I, ‘La Sapienza’University, Rome, Italy
Atlee J.L.Department of Anesthesiology, MedicalCollege of Wisconsin, Froedtert Memo-rial Lutheran Hospital, Milwaukee, Win-sconsin, United States
Auler J.O.C. Jr.Department of Anesthesiology and Surgi-cal Intensive Care, Heart Institute, Uni-versity of São Paulo Medical School, SãoPaulo, Brazil
Auricchio A.Division of Cardiology, University Hospi-tal of Magdeburg, Magdeburg, Germany
Behringer W.Department of Emergency Medicine,Vienna General Hospital, Vienna, Austria
Berlot G.Department of Perioperative Medicine,Intensive Care and Emergency, School ofAnaesthesia and Intensive Care, Cattina-ra University Hospital, Trieste, Italy
Bertacchini S.Department of Surgical, Anaesthetic andRadiological Sciences, Section ofAnaesthesiology and Intensive Care,University Hospital of Ferrara, Ferrara,Italy
Biagioli B.Department of Surgery and Bioenginee-ring, Unit of Cardiothoracic Anaesthesio-logy, University of Siena, Italy
Bigi EU.O. Rianimazione – 118 Ospedale Mag-giore, Bologna, Italy
Boldt J.Department of Anesthesiology and Inten-sive Care Medicine, Klinikum der StadtLudwigshafen, Ludwigshafen, Germany
Boogaerts JDepartment of Anesthesia CHU-Charle-roi, Charleroi, Belgium
Borghi B.Anesthesia Research Staff, IRCCS IstitutiOrtopedici Rizzoli, Bologna, Italy
Böttiger B.W.Department of Anaesthesiology, Universi-ty of Heidelberg, Heidelberg, Germany
Brudniewski M.Department of Anesthesiology, Hospitaldas Clínicas, University of São Paulo Me-dical School, São Paulo, Brazil
Busani S.Surgical Intensive Care Unit, Policlinicodi Modena, Modena, Italy
List of Contributors
Calderini E.Terapia Intensiva de Marchi, FondazionePoliclinico Mangiagalli Regina Elena, Mi-lan, Italy
Capuzzo M.Department of Surgical, Anaesthetic andRadiological Sciences, Section ofAnaesthesiology and Intensive Care, Uni-versity Hospital of Ferrara, Ferrara, Italy
Caristi D.Department of Perioperative Medicine,Intensive Care and Emergency, TriesteUniversity School of Medicine, CattinaraUniversity Hospital, Trieste, Italy
Casadei E.Department of Surgery and Bioenginee-ring, Anaesthesiology and Intensive CareUnit, University of Siena, Italy
Cerchiari E.U.O. Anestesia e Terapia Intensiva, Ospe-dale Maggiore, Bologna, Italy
Chiani C.Department of Surgical, Anaesthetic andRadiological Sciences, Section ofAnaesthesiology and Intensive Care, Uni-versity Hospital of Ferrara, Ferrara, Italy
Chidini G.Terapia Intensiva de Marchi, FondazionePoliclinico Mangiagalli Regina Elena, Mi-lan, Italy
Cilloni N.U.O. Anestesia e Terapia Intensiva, Ospe-dale Maggiore, Bologna, Italy
Cross A.S.Division of Infectious Diseases, BrownMedical School, Memorial Hospital ofRhode Island, Pawtucket, Rhode Island,United States
De Backer D.Department of Intensive Care, ErasmeUniversity Hospital, Free University ofBrussels, Belgium
De Gaudio A.R.Istituto di Anestesiologia e Rianimazione,
Policlinico Careggi, Florence University,Florence, Italy
Della Corte F.SCDU Anestesia e Rianimazione, Ospeda-le Maggiore della Carità, Università delPiemonte Orientale ‘A. Avogadro’, Nova-ra, Italy
Delogu G.Department of Anaestesia and IntensiveCare, Policlinico Umberto I, ‘La Sapienza’University, Rome, Italy
Doglioni N.Paediatric Department, Medical School,Padua University, Padua, Italy
Dos Santos C.Department of Critical Care Medicine,and Interdepartmental Division of Criti-cal Care, Saint Michael’s Hospital, Univer-sity of Toronto, Toronto, Canada
Drenger B.Department of Anaesthesia, HadassahUniversity Hospital at Mount Scopus, Je-rusalem, Israel
Emmi V.Servizio di Anestesia e Rianimazione I,IRCCS, Policlinico San Matteo, Pavia,Italy
Esposito G.Medicina d’Urgenza Ospedale S. Paolo,Naples, Italy
Fantoni C.Division of Cardiology, University Hospi-tal of Magdeburg, Magdeburg, Germany
Feminò R.Institute of Anesthesiology and IntensiveCare, A.O.U. Careggi, University of Flo-rence, Florence, Italy
Fodale V.Department of Neuroscience, Psychiatricand Anesthesiological Sciences, School ofMedicine. Policlinico Universitario ‘G.Martino’, University of Messina, Messina,Italy
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Foëx P.Nuffield Department of Anaesthetics,University of Oxford, The John RadcliffeHospital, Oxford, United Kingdom
Freye E.Clinics of Vascular Surgery and RenalTransplantation, Heinrich-Heine-Univer-sity Clinics, Düsseldorf, Germany
Frugiuele J.Anesthesia Research Staff, IRCCS IstitutiOrtopedici Rizzoli, Bologna, Italy
Furlanut M.Institute of Clinical Pharmacology andToxicology, Department of Experimentaland Clinical Pathology and Medicine,University of Udine, Udine, Italy
Garcia C.S.N.B.Laboratory of Pulmonary Investigation,Carlos Chagas Filho Institute of Biophy-sics, Federal University of Rio de Janeiro,Rio de Janeiro, Brazil
Gazmuri R.J.Department of Medicine, Division of Cri-tical Care, and Department of Physiologyand Biophysics, Rosalind Franklin Uni-versity of Medicine and Science, and Me-dical Service, Section of Critical Care Me-dicine, North Chicago VA Medical Cen-ter, North Chicago, Illinois, United States
Gerlach H.Vivantes – Klinikum Neukoelln, Klinik fürAnaesthesie, operative Intensivmedizinund Schmerztherapie, Berlin, Germany
Giomarelli P.Department of Surgery and Bioenginee-ring, Anaesthesiology and Intensive CareUnit, University of Siena, Italy
Girardis M.Surgical Intensive Care Unit, Policlinicodi Modena, Modena, Italy
Gommers D.Department of Anesthesiology, ErasmusMedical Centre, Rotterdam, The Nether-lands
Goosen J.Trauma Unit Johannesburg Hospital, Di-vision of Trauma and Critical Care, De-partment of Surgery, Faculty of HealthSciences, University of the Witwater-srand, Johannesburg, South Africa
Gordini G.U.O. Rianimazione – 118 Ospedale Mag-giore, Bologna, Italy
Gowdak L.H.W.Heart Institute (InCor), University of SãoPaulo Medical School, São Paulo, Brazil
Gratarola A.SCDU Anestesia e Rianimazione, Ospeda-le Maggiore della Carità, Università delPiemonte Orientale ‘A. Avogadro’, Nova-ra, Italy
Grazzina N.Paediatric Department, Medical School,Padua University, Padua, Italy
Gregoretti C.Dipartimento di emergenza e accettazio-ne, Azienda Ospedaliera CTO-CRF-ICOR-MA, Turin, Italy
Grüne F.Department of Anesthesiology, ErasmusUniversity Medical Centre, Rotterdam,The Netherlands
Gunnerson K.J.The Virginia Commonwealth UniversityReanimation Engineering and Shock Cen-ter (VCURES) Laboratory, Departmentsof Anesthesiology/Critical Care and Emer-gency Medicine, Virginia CommonwealthUniversity Medical Center, Richmond,Virginia, United States
Hahn R.Department of Anesthesiology and Gene-ral Intensive Care, Medical University ofVienna, Vienna, Austria
Hedenstierna G.Department of Medical Sciences, ClinicalPhysiology, University Hospital, Uppsala,Sweden
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Hiesmayr M.Department of Cardiac Thoracic Vascu-lar Anaesthesia and Intensive Care,Medi-cal University Vienna,Austria
Hillman KDivision of Critical Care,The SimpsonCentre for Health Service Innovation,Li-verpool Hospital,Sydney,Australia
Himmelseher S.Klinik für Anaesthesiologie,Klinikumrechts der Isar,Technische UniversitätMünchen,München,Germany
Holzer M.Department of Emergency Medicine,Vienna General Hospital,Vienna,Austria
Huang C.-H.Department of Computer Science and En-gineering,University of Connecticut,Storrs,Connecticut,United States
Ince C.Department of Physiology,Academic Me-dical Center,University of Amsterdam,Amsterdam,The Netherlands
Izzo F.Department of Anesthesia and IntensiveCare Unit,Children Hospital V.Buzzi,Milan,Italy
Jevtovic-Todorovic V.Department of Anesthesiology,Universi-ty of Virginia Health System,Charlot-tesville,Virginia,United States
Kellum J.A.The CRISMA (Clinical Research,Investi-gation,and Systems Modeling of AcuteIllness)Laboratory,Department of Criti-cal Care Medicine,University ofPittsburgh,Pittsburgh,Pennsylvania,Uni-ted States
Klimek M.Department of Anesthesiology,ErasmusUniversity Medical Centre,Rotterdam,The Netherlands
Kochs E.F.Klinik für Anaesthesiologie,Klinikum
rechts der Isar,Technische UniversitätMünchen,München,Germany
Krieger J.E.Heart Institute (InCor),University of SãoPaulo Medical School,São Paulo,Brazil
La Mura F.SCDUAnestesia e Rianimazione,Ospeda-le Maggiore della Carità,UniversitàdelPiemonte Orientale ‘A.Avogadro’,Nova-ra,Italy
Lachmann B.Department of Anesthesiology,ErasmusMedical Centre,Rotterdam,The Nether-lands
Latronico N.Institute of Anesthesiology-IntensiveCare,University of Brescia,Spedali Civili,Brescia,Italy
Lindeboom J.A.H.Department of Oral and Maxillofacial Sur-gery,Academic Medical Center,Universi-ty of Amsterdam,Amsterdam,The Net-herlands
Malbouisson L.Department of Anesthesiology and Surgi-cal Intensive Care,Heart Institute,Hospi-tal das Clínicas,University of São PauloMedical School,São Paulo,Brazil
Marietta M.Surgical Intensive Care Unit,Policlinicodi Modena,Modena,Italy
Marraro G.A.Anaesthesia and Intensive Care Depart-ment,and Paediatric Intensive Care Unit,Fatebenefratelli and Ophthalmiatric Ho-spital,Milan,Italy
Menarini M.U.O.Rianimazione –118Ospedale Mag-giore,Bologna,Italy
Milstein D.M.J.Department of Physiology;Departmentof Oral and Maxillofacial Surgery,Acade-mic Medical Center,University of Am-sterdam,Amsterdam,The Netherlands
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Miotto L.Department of Perioperative Medicine,Intensive Care and Emergency, TriesteUniversity School of Medicine, CattinaraUniversity Hospital, Trieste, Italy
Mirante E.Medicina d’Urgenza Ospedale S. Paolo,Naples, Italy
Morales M.M.Laboratory of Cellular and MolecularPhysiology, Carlos Chagas Filho Instituteof Biophysics, Federal University of Riode Janeiro, Rio de Janeiro, Brazil
Muchada R.Department of Anaesthesia and IntensiveCare, ‘Eugène Andre’ Hospital, Lyon,France
Nordström C.-H.Department of Clinical Science, Divisionof Neurosurgery, University Hospital,Lund, Sweden
Opal S.M.Division of Infectious Diseases, BrownMedical School, Memorial Hospital ofRhode Island, Pawtucket, Rhode Island,United States
Paladino F.Medicina d’Urgenza Ospedale S. Paolo,Naples, Italy
Palazzo M.Department of Critical Care Medicine,Charing Cross Hospital, London, UnitedKingdom
Patel P.Department of Anesthesiology, Anesthe-sia Service VA Medical College, Universi-ty of California, San Diego, California,United States
Pavan F.Institute of Clinical Pharmacology andToxicology, Department of Experimentaland Clinical Pathology and Medicine,University of Udine, Udine, Italy
Pea F.Institute of Clinical Pharmacology andToxicology, Department of Experimentaland Clinical Pathology and Medicine,University of Udine, Udine, Italy
Pelosi P.Terapia Intensiva de Marchi, FondazionePoliclinico Mangiagalli Regina Elena, Mi-lan, Italy
Petrini F.Anestesia e Rianimazione – PO SS.ma An-nunziata, Università G. d’Annunzio diChieti, Pescara, Italy
Piva M.Department of Perioperative Medicine,Intensive Care and Emergency, TriesteUniversity School of Medicine, CattinaraUniversity Hospital, Trieste, Italy
Plani F.Trauma Unit Johannesburg Hospital, Di-vision of Trauma and Critical Care, De-partment of Surgery, Faculty of HealthSciences, University of the Witwater-srand, Johannesburg, South Africa
Racca F.Dipartimento di emergenza e accettazio-ne, Azienda Ospedaliera CTO-CRF-ICOR-MA, Turin, Italy
Reis Miranda D.Department of Anesthesiology, ErasmusMedical Centre, Rotterdam, The Nether-lands
Rocco P.R.M.Laboratory of Pulmonary Investigation,Carlos Chagas Filho Institute of Biophy-sics, Federal University of Rio de Janeiro,Rio de Janeiro, Brazil
Rodriguez B.Oxford University Computing Laborato-ry, Oxford, United Kingdom
Romano S.M.Department of Critical Care, Internal Me-dicine and Cardiology, University of Flo-rence, Florence, Italy
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Rossi A.Anaesthesia and Intensive Care Unit, Car-diovascular Department, University Ho-spital ‘Careggi’, Florence, Italy
Ruggiero E.G.Medicina d’Urgenza Ospedale S. Paolo,Naples, Italy
Ruskin K.J.Department of Anesthesiology, Yale Uni-versity School of Medicine, New Haven,Connecticut, United States
Salvo I.Department of Anesthesia and IntensiveCare Unit, Children Hospital V. Buzzi,Milan, Italy
Santamaria L.B.Department of Neuroscience, Psychiatricand Anesthesiological Sciences, School ofMedicine. Policlinico Universitario ‘G.Martino’, University of Messina, Messina,Italy
Schiraldi F.Medicina d’Urgenza Ospedale S. Paolo,Naples, Italy
Schmidlin D.Anaesthesia and Intensive Care, Hirslan-den Klinik im Park, Zürich, Switzerland
Schmidt A.P.Department of Anesthesiology, Hospitaldas Clínicas, University of São Paulo Me-dical School, São Paulo, Brazil
Scolletta S.Department of Surgery and Bioenginee-ring, Anaesthesiology and Intensive CareUnit, University of Siena, Italy
Scoponi M.Anestesia e Rianimazione – PO SS.ma An-nunziata, Università G. d’Annunzio diChieti, Pescara, Italy
Semeraro F.U.O. Anestesia e Terapia Intensiva, Ospe-dale Maggiore, Bologna, Italy
Signore M.Department of Haematology, Oncologyand Molecular Medicine, BiotecnologyDivision, Istituto Superiore di Sanità,Rome, Italy
Singer P.General Intensive Care Department, Ra-bin Medical Center, Campus Beilinson,Petah Tikva; The Sackler School of Medi-cine, Tel Aviv University, Tel Aviv, Israel
Sorbara C.Anaesthesia and Intensive Care Unit, Car-diovascular Department, University Ho-spital ‘Careggi’, Florence, Italy
Sorbello M.Anestesia e Rianimazione – PO SS.ma An-nunziata, Università G. d’Annunzio diChieti, Pescara, Italy
Souza-Fernandes A.BLaboratory of Pulmonary Investigation,Carlos Chagas Filho Institute of Biophy-sics, Federal University of Rio de Janeiro,Rio de Janeiro, Brazil
Spiss C.Department of Anesthesiology and Gene-ral Intensive Care, Medical University ofVienna, Vienna, Austria
Spöhr F.Department of Anaesthesiology, Universi-ty of Heidelberg, Heidelberg, Germany
Stadler M.Department of Anesthesia CHU-Charle-roi, Charleroi, Belgium
Sterz F.Department of Emergency Medicine,Vienna General Hospital, Vienna, Austria
Stortecky S.Department of Anesthesiology and Gene-ral Intensive Care, Medical University ofVienna, Vienna, Austria
Terzi R.G.G.Faculdade de Ciências Médicas – UNI-CAMP – Universidade Estadual de Cam-pinas, Campinas, SP, Brazil
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Trevisanuto D.Paediatric Department,Medical School,Padua University,Padua,Italy
Tulli G.Department of Anaesthesia and IntensiveCare,Hospital Nuovo San Giovanni diDio,Florence,Italy
Ungerstedt U.Department of Clinical Science,Divisionof Neurosurgery,University Hospital,Lund,Sweden
Van der Linden P.Department of Anesthesiology,CHUBrugmann –HUDERF,Brussels,Belgium
Vincent J.-L.Department of Intensive Care,ErasmeHospital,Free University of Brussels,Brussels,Belgium
Wolfler E.A.Department of Anesthesia and IntensiveCare Unit,Children Hospital V.Buzzi,Milan,Italy
Zin W.A.Laboratory of Respiration Physiology,Carlos Chagas Filho Institute of Biophy-sics,Federal University of Rio de Janeiro,Rio de Janeiro,Brazil
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List of Abbreviations
ACC American College of CardiologyACEI Angiotensin-Converting Enzyme InhibitorsACP American College of PhysiciansACS American College of SurgeonsAD Antiarrhythmic DrugsADH Antidiuretic HormoneAED Automated External DefibrillatorsAF Atrial FibrillationAFV Aortic Flow VariationAG Anion GapAHA American Heart AssociationAHCPR Agency for Health Care Policy and ResearchALI Acute Lung InjuryAMI Acute Myocardial InfarctionAOR Adjusted Odd RatioAPACHE Acute Physiology and Chronic Health EvaluationAPS Acute Pain ServiceAR AdrenoreceptorARAS Ascending Reticulate Activating SystemARDS Acute Respiratory Distress SyndromeARF Acute Respiratory FailureASA American Society of AnesthesiologistsAT Anaerobic ThresholdATLS Advanced Trauma Life SupportAV AtrioventricularAVJT Atrioventricular Junctional TachycardiaAVM Arteriovenous MalformationsBAEP Brainstem Auditory Evoked PotentialBAER Brainstem Auditory Evoked ResponseBALF Bronchoalveolar Lavage FluidBB Buffer BaseBBB Blood-Brain BarrierBCT Blunt Cardiac TraumaBIVAD Biventricular Assist DeviceBMC Bone Marrow CellsBMI Body-Mass IndexBNP Brain Natriuretic PeptideBSAC British Society for Antimicrobial ChemotherapyBSI Bloodstream InfectionBVP Biventricular Pacing
CA Combined AnaesthesiaCABG Coronary Artery Bypass GraftingCAD Coronary Artery DiseaseCAD Coronary Artery DiseasecAMP Cyclic Adenosyne MonophosphateCAP Community Acquired PneumoniaCARE-HF Study Cardiac Resinchronisation in Heart Failure StudyCARP Coronary Artery Revascularization ProphylaxisCAST Cardiac Arrhythmia Suppression TrialCBF Cerebral Blood FlowCBF Cerebral Blood FlowCBV Cerebral Blood VolumeCCE Cardiac Cycle EfficiencyCCO Continuous Cardiac OutputCF Cystic FibrosisCFTR Cystic Fibrosis Transmembrane Conductance RegulatorCHF Congestive Heart FailureCI Cardiac IndexCICD Caspase-Independent Cell DeathCl ClearanceCMAP Compound Muscle Action PotentialCMR Cerebral Metabolic RateCNS Central Nervous SystemCOP Colloid Oncotic PressureCOPD Chronic Obstructive Pulmonary DiseaseCPAP Continuous Positive Airway PressureCPC Cerebral Performance CategoryCPO Cardiogenic Pulmonary OedemaCPP Cerebral Perfusion PressureCPR Cardiopulmonary ResuscitationCPRC Cardiopulmonary-Cerebral ResuscitationCRI Chronic Renal InsufficiencyCRRT Continuous Renal Replacement TherapyCRT Cardiac Resinchronisation TherapyCT Computed TomographyCUSUM Cumulative Sum ChartCV CardioversionCVC Central Venous CatheterCVP Central Venous PressureCVVHDF Continuous Veno-Venous HaemodiafiltrationDAD Diffuse Alveolar DamageDAG DiacylglycerolDEX dexmedetomidineDF DefibrillationDHP DehydropeptidaseDicBP Dicrotic Blood PressureDIPOM Danish Diabetic Postoperative Mortality and MorbidityDKA Diabetic KetoacidosisDNA Deoxyribonucleic AcidDO2 Oxygen Delivery
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DSD Delayed Spontaneous DepolarisationDSTC Definitive Surgical Trauma CareEAST Eastern Association for the Surgery of TraumaEBM Evidence Based MedicineECD External Cardioverter DefibrillatorECF Extracellular FluidECG ElectriocardiogramECM Extracellular MatrixECoG ElectrocorticographyED Emergency Departmente-DISTRICT European Distance Training Interactive and Collaborative ToolsCiPro for the Civil ProtectionEDRF Endothelium-Derived Relaxing FactorEDV End Diastolic VolumeEDVI End Diastolic Volume IndexEEG ElectroencephalogramEELV End-Expiratory Lung VolumeEF Ejection FractionEGF Epidermal Growth FactorELISA Enzyme-Linked Immunosorbent AssayEMDM European Master in Disaster MedicineEMI Electromechanical InterferenceEMT Electro-magnetic TomographyEP E ProstanoidERK Extracellular Signal-Regulated KinaseESIMC European Society of Intensive Care MedicineESPVR End-Systolic Pressure-Volume RelationshipEUCAST European Committee on Antimicrobial Susceptibility TestingFAC Focal Adhesion ComplexFAK Focal Adhesion KinaseFAST Focused Abdominal Sonograph for TraumaFES Functional Electrical StimulationFEV Forced Expiratory VolumeFFP Fresh Frozen PlasmaFFT Fast Fourier TransformFGF Fibroblast Growth FactorFIESTA Fast Imaging Employing Steady-State AcquisitionFiO2 Fraction of Inspired OxygenFRC Functional Residual CapacityFVC Functional Vital CapacityGA General AnaesthesiaGABA Gamma-Amino-Butyric AcidGAG GlycosaminoglycansGM-CSF Granulocyte-Macrophage Colony Stimulating FactorGNB Gram-Negative BacteriaGR Glucocorticoid ReceptorGSW Gunshot WoundHAP Hospital Acquired PneumoniaHCMV Human CytomegalovirusHDP Hospital Disaster Preparedness
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HDR Host Defence ResponseHES Hydroxyethyl StarchHF Heart FailureHGF Hepatocyte Growth FactorHHS Hypertonic-Hyperoncotic SolutionHMG High Mobility GroupHOC Hypertrophic Obstructive CardiomyopathyHPV Hypoxic Pulmonary VasoconstrictionHR Heart RateHRQOL Health Related Quality of LifeHS Hypertonic SolutionHU Hounsfield UnitI2R Imidazoline 2 ReceptorIATSIC International Association for the Surgery of Trauma
and Surgical Intensive CareICC Intracellular CompartmentICD Internal Cardioverter DefibrillatorICH Intracerebral HaemorrhageICT Isovolumetric Contraction TimeICU Intensive Care UnitIFN-gamma Interferon GammaIGF Insulin-Like Growth FactorIHD Ischaemic Heart DiseaseI-HSA Iodinated Human Serum AlbuminiNO Inhaled Nitric OxideIPM Intraperitoneal MicrodyalisisIRT Isovolumetric Relaxation TimeISE Ion Selective ElectrodeI-SEE Interactive Simulation Exercise for EmergenciesISF International Sepsis ForumISS Interstitial SpaceITBV Intrathoracic Blood VolumeIVS Intravascular SpaceIVT Idioventricular TachycardiaJAK-2 Janus-Activated Kinase 2KGF Keratinocyte Growth FactorLaSRS Late Steroid Rescue StudyLBB Left Bundle BranchLBBB Left Bundle Branch BlockLED Light-Emitting DiodeLIP Lower Inflection PointLIS Locked-in SyndromeLMA Laryngeal MaskLOD Logistic Organ DysfunctionLOS Low Output SyndromeLOS Low Output SyndromeLPS LipopolysaccharideLQTS Long QT SyndromeLV Left VentricularLVAD Left Ventricular Assist Device
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LVEDA Left Ventricular End-Diastolic AreaLVEF Left Ventricular Ejection FractionLVOT Left Ventricular Outflow TractLVP Left Ventricular PacingMAP Mean Arterial PressureMAPK MItogen-Activated Protein KinaseMCGs Multiplayer Computer GamesMCS Mechanical Circulatory SupportMCW Medical College of WinsconsinMD MicrodyalisisMEG MagnetencephalographyMEP Motor Evoked PotentialMEP Motor Evoked PotentialMET Medical Emergency TeamMFI Microvascular Flow IndexMI Myocardial InfarctionMIC Minimum Inhibitory ConcentrationMIF Macrophage Inhibitor FactorMIGET Multiple Inhert Gas Elimination TechniqueMMP Matrix MetalloproteinasesMODS Multiple Organ Dysfunction SyndromeMOF Multiple Organ FailureMONARCS Trial Monoclonal Anti-TNF: A Randomized Controlled Sepsis TrialMPI Mannheimer Peritonitis IndexMPTP Mitochondrial Permeability Transition PoreMRI Magnetic Resonance ImagingMS Molar SubstitutionNCCLS National Committee for Clinical Laboratory StandardsNHE-1 Sodium-Hydrogen Exchanger Isoform-1NIPS Neonatal Infant Pain ScaleNIV Non-Invasive VentilationNLM National Library of MedicineNMDA N-Methyl-D-AspartateNMDAR NMDA ReceptorNMEP Neurogenic Motor Evoked PotentialNNPO Negative Pressure Pulmonary OedemaNO Nitric OxideNPO Neurogenic Pulmonary OedemaNPPV Non-Invasive Positive Pressure VentilationNSAID Non-Steroidal Anti-Inflammatory DrugNSCLC Non-Small Cell Lung CancerNSVT Non-Sustained Ventricular TachycardiaNVEs Networked Virtual EnvironmentsNYHA New York Heart AssociationOLC Open Lung ConceptOLT Orthotopic Liver TransplantationOPS Orthogonal Polarisation SpectralOR Odds RatioPA Pulmonary ArteryPAC Pulmonary Artery Catheters
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PAC Pulmonary Artery CatheterPAC Pulmonary Artery CatheterPAE Post Antibiotic EffectPAI Plasminogen Activator InhibitorPAMP Preload-Adjusted Maximal PowerPAOP Pulmonary Artery Occlusion PressurePAP Pulmonary Arterial PressurePAPP Preload-Adjusted Peak PowerPAR Protease-Activated ReceptorPASE Pacing Stress EchocardiographyPC/RSC Posterior Cingulate/Retrosplenial CortexPCA Patient Controlled AnaesthesiaPCM Pulse Contour MethodPCR Polymerase Chain ReactionPCWP Pulmonary Capillary Wedge PressurePDGF Platelet Derived Growth FactorPE Pulmonary EmbolismPEA Pulseless Electrical ActivityPEEP Positive End-Expiratory PressurePEEPi Intrinsic Positive End-Expiratory PressurePET Positron Emission TomographyPGE2 Prostaglandin E2PGF Placental Growth FactorPGI2 ProstacyclinPI Pulsatility IndexPICU Paediatric Intensive Care UnitPIM Paediatic Intex of MortalityPIP Peak Inspiratory PressurePK/PD Pharmacokinetic/PharmacodynamicPKC Protein Kynase CPM PacemakerPMVT Polymorphic Ventricular TachycardiaPNS Peripheral Nervous SystemPOP Postoperative PneumoniaPPHN Persistent Pulmonary Hypertension of the NewbornPPI Pulse Power IndexPPV Pulse Pressure VariationPRAM Pressure Recording Analytical MethodPTHrP Parathyroid Hormone-Related PeptidePTK Protein Tyrosine KynasesPTSD Posttraumatic Stress DisorderPTT Pulse Transit TimePVR Pulmonary Vascular ResistancePWA Pulse Wave AnalysisQOL Quality of LifeRA Regional AnaesthesiarAAV Recombinanta Adeno-Associated VirusRAP Right Atrial PressureRAS Renin-Angiotensin-Aldosterone SystemrAV Recombinant Adenovirus
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RBB Righ Bundle BranchRBC Red Blood CellsRCT Randomised Controlled TrialRDS Respiratory Distress SyndromeREM Rapid Eye MovementsrFVIIa Recombinant Activated Factor VIIarhACP Recombinant Human Activated ProteinRNA Ribonucleic AcidRNAi RNA InterferenceROSC Return of Spontaneous CirculationRPA Rnase Protection AssayRT-PCR Reverse Transcription-Polymerase Chain ReactionRVEDV Right Ventricle End-Diastolic VolumeRVEF Right Ventricular Ejection FractionRVESV Right Ventricle End-Systolic VolumeS Sieving CoefficientSA SinoatrialSAPK Stress-Activated Protein KynaseSBE Standard Base ExcessSCCM Society of Critical Care MedicineSCD-HeFT Trial Sudden Cardiac Death - Heart Failure TrialSCI Spinal Cord InjuredSCLC Small Cell Lung CancerSD Standard DeviatonSDF Sidetream Darkfield ImagingSEP Sensory Evoked PotentialSID Strong Ion DifferenceSIDa Apparent Strong Ion DifferenceSIDe Effective Strong Ion DifferenceSIG Strong Ion GapSIRS Systemic Inflammatory Response SyndromeSISPE Società Italiana Sepsi PediatricaSMART Sensor Modality Assessment and Rehabilitation TechniqueSMS Simple Motif SearchSOFA Sepsis-Related Organ Failure AssessmentSP-D Surfactant Protein-DSPV Systolic Pressure VariationSRE Stretch Response ElementsSSEP Somatosensory Evoked PotentialSSRE Shear Stress Response ElementsSTAT Signal Transducer and Activators of TranscriptionSvO2 Venous Oxygen SaturationSVR Systemic Vascular ResistanceSVT Supraventricular TachycardiaSVV Stroke Volume VariationSWS Slow Wave SleepTAA Thoraco-Abdominal AneurysmTAP Transoesophageal Atrial PacingTCD Transcranial Doppler SonographyTDI Tissue Doppler Imaging
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TDM Therapeutic Drug MonitoringTdP Torsades de PointesTEE Transoesophageal EchocardiographyTF Tissue FactorTFA Trifluoroacetyl HalideTG TriglyceridesTGF Transforming Growth FactorTIMPs Tissue Inhibitors of MetalloproteinasesTMJ Temporomandibular JointTNFR Tumour Necrosis Factor ReceptorTOECV Transoesophageal CardioversionTROICA Thrombolysis in Cardiac ArrestUMLS Unified Medical Languange SystemV/Q Ventilation/Perfusion RatioVAP Ventilator-Associated PneumoniaVAS Ventricular Assist SystemVd Volume of DistributionVEGF Vascular Endothelial Growth FactorVEP Visual Evoked PotentialVEP Virtual Electrode PolarisationVES Ventricular ExtrasystolesVF Ventricular FibrillationVILI Ventilator-Induced Lung InjuryVO2 Oxygen ConsumptionVO2/DO2 Oxygen Consumption/Oxygen DeliveryVP Virtual PatientVR Virtual RealityVT Ventricular TachycardiaVT Tidal VolumeVT/VF Ventricular Tachycardia/FibrillationVV-ECMO Venovenous Extracorporeal Membrane OxygenationVW Vulnerable Window
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