Michael R. Pinsky – författare

Dr. Michael Pinsky has assembled an expert team of authors on the topic of Hemodynamic Monitoring. Articles topics include: The interface between monitoring and physiology at the bedside; Defining goals of resuscitation in the critically ill; Minimally invasive hemodynamic monitoring; Bedside ultrasound for the intensivist; Invasive hemodynamic monitoring; Functional hemodynamic monitoring; Using what you get: dynamic physiological signatures of critical illness; and Effect of organizational issues on resuscitation effectiveness.

This book, part of the European Society of Intensive Care Medicine textbook series, teaches readers how to use hemodynamic monitoring, an essential skill for today’s intensivists. It offers a valuable guide for beginners, as well as for experienced intensivists who want to hone their skills, helping both groups detect an inadequacy of perfusion and make the right choices to achieve the main goal of hemodynamic monitoring in the critically ill, i.e., to correctly assess the cardiovascular system and its response to tissue oxygen demands.The book is divided into distinguished sections: from physiology to pathophysiology; clinical assessment and measurements; and clinical practice achievements including techniques, the basic goals in clinical practice as well as the more appropriate hemodynamic therapy to be applied in different conditions. All chapters use a learning-oriented style, with practical examples, key points and take home messages, helping readers quickly absorbthe content and, at the same time, apply what they have learned in the clinical setting. The European Society of Intensive Care Medicine has developed the Lessons from the ICU series with the vision of providing focused and state-of-the-art overviews of central topics in Intensive Care and optimal resources for clinicians working in Intensive Care.

Hemodynamic monitoring is one of the major diagnostic tools available in the acute care setting to diagnose cardiovascular insufficiency and monitor changes over time in response to interventions. However, the rationale and efficacy of hemodynamic monitoring to affect outcome has come into question. We now have increasing evidence that outcome from critical illness can be improved by focused resuscitation based on existing hemodynamic monitoring, whereas non-specific aggressive resuscitation impairs survival. Thus, this book frames hemodynamic monitoring into a functional perspective wherein hemodynamic variables and physiology interact to derive performance and physiological reserve estimates that themselves drive treatment. This philosophy, as well as the limitations and applications of common and evolving hemodynamic measures and their focused use in the care of critically ill patients are discussed, relevant to one underlying truth: No monitoring device, no matter how simple or sophisticated, will improve patient-centered outcomes useless coupled to a treatment which, itself, improves outcome.

Hemodynamic monitoring is one of the major diagnostic tools available in the acute care setting to diagnose cardiovascular insufficiency and monitor changes over time in response to interventions.

This volume presents the latest updates in the basic science and clinical issues associated with coronary circulation and myocardial ischemia. New and clinically relevant aspects of coronary blood flow are reviewed in a four-part structure: (1) The basic physiology of coronary blood flow, its control and dysregulation with atherosclerotic disease. (2) The applied physiological aspects of blood flow and myocardial performance. Important concepts such as pre-conditioning, inflammation and thrombosis and fibrinolysis are addressed within the context of ventricular pump function. (3) The functional assessment of the coronary circulation, going beyond coronary angiography and nuclear scanning to address cutting edge technologies including echocardiographic analysis of tissue blood flow, PET analysis of myocardial viability, rapid nuclear magnetic imaging, and intracoronary ultrasound imaging. (4) Non-thrombotic, anti-thrombotic and thrombolytic therapies for coronary ischemia.

This volume covers the most important aspects of cerebral blood flow (CBF) from bench to bedside. It first defines the basic physiology of CBF, those qualities that make it unique or are shared with other organs and their clinical implications. There follows a section on CBF pathophysiology that explores many of the known and proposed mechanisms of cerebral ischemia in stroke and trauma states. The third section describes the numerous and powerful means available to measure blood flow, tissue function and overall perfusion. These are essential measures if one is to assess the effectiveness of therapies aimed at preventing or reversing cerebral ischemia. The final section describes the interesting and often successful recent clinical trials aimed at preventing or reversing cerebral ischemia. This collection of multicenter trial data and their implications in one volume is unique in this field. This book addresses all the major aspects of CBF from basic issues to clinical practice.

The two previous editions of Applied Physiology in Intensive Care Medicine proved extremely successful, and the book has now been revised and split into two volumes to enhance ease of use.

The two previous editions of Applied Physiology in Intensive Care Medicine proved extremely successful, and the book has now been revised and split into two volumes to enhance ease of use.

This monograph focuses on splanchnic function in health and disease. It represents a distillate of the communication that took place at the First International Symposium of Applied Physiol­ ogy of the Peripheral Circulation, "Splanchnic Circulation: No Longer a Silent Partner." The individual chapters roughly follow the individual presentations and display in durable form the con­ cepts and importance that this symposium achieved. The concept for this annual symposium was the child of An­ tonio Artigas, who not only recruited sponsorship but also Jean­ Francois Dhainaut and me to help with the organization and work. We chose the splanchnic circulation as the peripheral cir­ culatory system to be presented first for many important reasons. Much new information has become available which demon­ strates, as the title of the symposium implies, that splanchnic function has major influence on the overall expression of health and disease in humans. All aspects of splanchnic physiology, it seems, have been rediscovered to be dynamic, important, and complex in their interactions within individual tissues and among remote tissues and organs. It is hoped that after having reviewed this monograph the reader will agree that the splanchnic circula­ tion and its organ systems are emerging as important aspects of critical illness and host-defense homeostasis.

The two previous editions of Applied Physiology in Intensive Care Medicine proved extremely successful, and the book has now been revised and split into two volumes to enhance ease of use.