Best 2022 Clinical Cases in Intensive Care Medicine

Series EditorsMaurizio Cecconi is Head of Department Anaesthesia and Intensive Care Units, IRCCS Istituto Clinico Humanitas, Rozzano (MI), Italy and Professor of Anaesthesia and Intensive Care, Humanitas University, Pieve Emanuele (MI), Italy. His main fields of research are haemodynamic monitoring, haemodynamic optimisation and physiology of the critically ill patient. He has published extensively and has specific interest in haemodynamic monitoring and fluid management of the critically ill.Daniel De Backer is Professor of Intensive Care at the Université Libre de Bruxelles, Brussels, Belgium Head of Intensive Care Departments of CHIREC Hospitals (Brussels and Braine l’Alleud-Waterloo). His main fields of investigation are severe sepsis, organ dysfunction, acute circulatory failure and its treatment (in particular vasoactive agents), haemodynamic monitoring, hepato-splanchnic circulation and microcirculatory disorders. Volume EditorsDavid Pérez-Torres is a Consultant in Intensive Care Medicine at Hospital Universitario Río Hortega, in Valladolid (Spain), his home town. He is a member of multidisciplinary work teams such as the Antimicrobial Stewardship Team and the ECMO Team. His areas of specialization include severe infections and sepsis, immunology in critical illness, ARDS and ECMO, haemodynamics and critical care ultrasound, AKI and renal replacement therapy. He is passionate about critical care research and has contributed to diverse projects in this field. David is an active member of the NEXT Committee and the Social Media & Digital Content Committee of the European Society of Intensive Care Medicine (ESICM). María Martínez-Martínez is an intensivist in Vall d’Hebron University Hospital in Barcelona (Spain). She is part of the ECMO retrieval team and has a strong interest in the treatment and support of severe acute respiratory failure, including lung transplantation and ECMO. Her areas of research are respiratory infections, early mobilisation and long-term outcomes of critically ill patients. She is a member of the NEXT Committee and the E-learning subcommittee of the European Society of Intensive Care Medicine. Stefan J Schaller is currently the deputy clinical director of the Department of Anesthesiology and Operative Intensive Care Medicine (CVK/CCM) at Charité – Universitätsmedizin Berlin, Germany. After his medical degree in Graz, Austria, he finished his residency in anaesthesiology, followed by a specialisation in intensive care medicine at the Technical University Munich. During that time, he also did a postdoctoral research fellowship at Harvard Medical School in Boston, USA investigating intensive care unit acquired weakness in an animal model. Back in Munich he continued research focusing on early rehabilitation, frailty, and long-term outcome of critically ill patients.Clinically he worked as attending at the interdisciplinary intensive care unit in Munich until he was appointed professor in Berlin in 2019. He is involved in ESICM and currently the chair of the NEXT committee till October 2022.

• Part I. The best clinical cases in severe infections and sepsis.- Principles and management of sepsis.- Endocarditis in an HIV patient. Infection in an immunocompromised patient, the perfect costume in which to hide.- Intraabdominal sepsis. Portal and mesenteric vein thrombosis as first presentation of myeloproliferative disease in a young woman.- Skin or soft tissue sepsis. Necrotizing fasciitis.- Complicated intraabdominal sepsis. Fournier’s gangrene secondary to perforated retrocaecal appendicitis: a turbulent and prolonged ICU admission.- Septic shock and complications. The use of venous-venous extracorporeal membrane oxygenation in a patient with severe acute respiratory distress syndrome and multiple organ failure due to septic shock.- Viral infections in the ICU.- HIV. Respiratory insufficiency in an HIV patient.- Herpesviridae. Severe varicella zoster virus reactivation after SARS-CoV-2 vaccination in an immunocompetent patient.- Herpesviridae. A young man with acute liver failure and hemolysis.- Influenza. Challenges in Infection Management in the Immunocompromised Patient.- SARS-CoV-2. Organizing pneumonia treated with high dose methylprednisolone in an adolescent with Covid-19 pneumonia under extracorporeal circulation.- Severe infections in the ICU.- Parasitic infections. Severe malaria in the ICU.- Parasitic infections. Dyspnea, oedema, and abdominal distention.- Mucormycosis. An unusual cause of intracranial hemorrhage: cerebral mucormycosis.- Fungal infections. A Case of Gastroparesis and Candidemia secondary to Gastric Ischemia.- Wrap-up.- Part II. The best clinical cases in respiratory medicine.- Principles and management of ARDS.- ARDS secondary to near-drowning. Drowning in seawater.- ARDS treatment in a patient with another condition. The use of inhaled nitric oxide for acute respiratory distress syndrome in a patient with a subarachnoid hemorrhage.- Post-partum ARDS. Postpartum ARDS in a Patient with Suspected Amniotic Fluid Embolism after Complicated Childbirth.- Airway complications. Management of a non-traumatic tracheal lesion in severe tracheobronchomalacia.- Bronchopleural fistula. Post COVID-19 bronchopleural fistula treated with “closed-lung” minimal ventilation and ECCO2R.- Weaning from mechanical ventilation. Antipsychotic-induced respiratory dyskinesia in a patient with severe SARS-CoV2 pneumonia.- Pulmonary embolism in the ICU.- Diagnosis of pulmonary embolism. An Uncommon Cause of Pulmonary Embolism.- Right ventricular failure in pulmonary embolism. The forgotten chamber: When in trouble, go back to basics.- Mechanical circulatory support in pulmonary embolism. VA-ECMO for resuscitation of cardiac arrest after pulmonary embolism in brain stem intracranial hemorrhage.- Wrap up.- Part III. The best clinical cases in cardiovascular medicine.- Principles and management of rhythm disturbances. Overview of cardiac arrest.-Arrhythmias. Electrical storm in a COVID-19 patient.- Antiarrhythmic drugs. A case of near-fatal chronic digoxin toxicity.- Cardiac arrest. Pediatric out-of-hospital cardiac arrest on the soccer pitch – how implementation of digital solutions into the chain of survival can help with a favorable outcome.- Principles and management of heart failure and cardiogenic shock.- Differential diagnosis of shock. A 60- year old woman with gastrointestinal bleeding in hemorrhagic shock- an unexpected shift in shock etiology.- Cardiogenic shock. Seizure-associated takotsubo cardiomyopathy complicated by cardiogenic shock and successfully treated with levosimendan.- Cardiogenic shock. Cardiogenic shock due to reversed Takotsubo syndrome associated with E-cigarrete or vaping product use-associated lung injury (EVALI).- Ivabradine as an alternative to beta-blockade in Takotsubo cardiomyopathy: case report.- Myocarditis. Novel immunotherapy and mechanical cardiac support in myocarditis: A case report.- Peripartum cardiomyopathy. Peripartum cardiomyopathy- Diagnostic and therapeutic challenge.- Perioperative cardiovascular critical care. Impact of perioperative veno-arterial extracorporeal membrane oxygenation on outcome in a patient with impaired cardiac function undergoing open thoracoabdominal penetrating aortic ulcer repair.- Wrap-up.- Part IV. The best clinical cases in neurocritical care and severe trauma.- Principles and management of subarachnoid hemorrhage.- Respiratory complications of SAH. Systemic complications of subarachnoid hemorrhage.- Cardiovascular complications of SAH. Neurogenic stunned myocardium in subarachnoid hemorrhage.- Principles and management of severe trauma and bleeding.- Traumatic brain injury and rhabdomyolysis. Continuous renal replacement therapy management in a patient with severe traumatic brain injury and rhabdomyolysis-associated acute kidney injury.- Post-traumatic cardiac tamponade. Delayed post-traumatic tamponade: the end of the tunnel.- Pelvic trauma. Polytrauma patient with refractory shock.- Abdominal and pelvic bleeding control strategies. Resuscitative endovascular balloon occlusion of the aorta (REBOA) in a patient with exsanguinating penetrating torso trauma. A clinical case.- Principles and management of hemorrhagic shock.- Hemothorax. Massive Hemothorax Of Extremely Rare Cause.- Spleen rupture. An Unusual Cause of Syncope.- Transfusion complications. Blood transfusion triggered posterior reversible encephalopathy syndrome.- Wrap-up.- Part V. The best clinical cases in severe endocrine and metabolic disorders.- Endocrine and metabolic disorders in the ICU.- Diabetes ketoacidosis. New onset diabetes with diabetic ketoacidosis after SARS-CoV-2 infection in adult critically ill patient.- Porphyria. Acute Intermittent Porphyria: A challenging diagnosis and treatment.- Cyanide poisoning. Arterialization of venous blood.- Wrap-up.- Part VI. The best clinical cases in severe inflammatory disorders.- Inflammatory disorders in the ICU.- Systemic capillary leak syndrome. In case of severe hemoconcentration and hypovolemic shock, also think of zebras: a case of systemic capillary leak syndrome.- Haemophagocytic lymphohistiocytosis. Haemophagocytic lymphohistiocytosis in a critically ill adult with asymptomatic post-acute COVID-19.- Miastenia gravis. The approach to a patient with a myasthenic crisis in an intensive care unit.- Adult-onset Still's disease. A usual presentation of an unusual case.- Wrap-up.