Ch 1: Evaluation and Triage of the Critically Ill Patient

Organ dysfunction that may occur in critically ill animals

Respiratory dysfunction (ARDS, PTE), cardiovascular dysfunction (left ventricular dysfunction, arrhythmias, vasopressor-dependent hypotension), gastrointestinal dysfunction (gastric stasis and ileus, hemorrhagic diarrhea and bacterial translocation), hepatic dysfunction, AKI, coagulation abnormalities (DIC)

How does organ dysfunction occur?

Critical illness can cause significant metabolic derangements and may result in tissue hypoperfusion —> hypoxia —> SIRS —> MODS

Pleural effusion in critical illness can be caused by:

Hypoalbuminemia, right-sided heart failure, PTE, or SIRS and endothelial damage resulting in leakage of fluid.

What are the identified risk factors for ALI and ARDS?

SIRS, sepsis, infection without sepsis, smoke inhalation, near-drowning, severe trauma

PaO2 to FiO2 ratio in ALI

< 300

PaO2 to FiO2 ratio in ARDS

< 200

BG > 300 in patients with severe cardiovascular and/or respiratory dysfunction may indicate:

Severe impairment in tissue oxygen delivery and impending cardiopulmonary arrest.

SIADH

syndrome of inappropriate antidiuretic hormone secretion

SIADH leading to hyponatremia may be identified secondary to:

pneumonia, neoplasia, babesiosis, intracranial disease, or medication administration