Airway Management

• Indications for an endotracheal tube

• The compromised airway
• Intrathoracic vs extrathoracic airway obstruction
• Evaluation for airway protection and edema
• Management of post-extubation stridor

• Intubation techniques in unstable patients
• Medicating the hemodynamically unstable patient
• Intubating the patient with closed head or cervical spine injury
• Cuff leaks - evaluation and management

• Timing of tracheostomy

Respiratory Management

Respiratory physiology

• Ventilation perfusion relationships
• Causes of hypoxemia
• Postoperative changes in respiratory function
• PaO2/FIO2 relationships
• Oxygen delivery and consumption

Mechanical ventilation

• Modes of mechanical ventilation - volume vs pressure
• PEEP - indications, systemic effects, contraindications
• Non-invasive mechanical ventilation

Weaning from mechanical ventilation

• Determining patients who are candidates for ventilator weaning
• Use of weaning parameters
• Controversies in weaning modes - AC/SIMV, T-piece trials

Respiratory issues in trauma

• Pulmonary contusion - physiology, management
• Flail chest
• Fat embolism

ARDS

• Diagnostic criteria
• Management - fluid balance, ventilator strategies, steroids
• Oxygen toxicity
• Barotrauma

Fluid Balance in the Surgical Patient

Perioperative fluid management

• Intraoperative fluid balance
• Sources of intraoperative fluid loss
• Postoperative fluid balance � patterns of third spacing and mobilization
• Crystalloid vs colloids

Transfusion therapy

• Optimal hematocrit
• Indications for blood products
• Albumin controversies

Electrolyte and Acid-base disorders

• Acid base balance, compensatory mechanisms
• Renal failure- diagnostic criteria, management, indications for dialysis, renal replacement techniques

Hemodynamic monitoring

Pulmonary artery catheters

• Use of hemodynamic monitoring data, limitations of data, waveform recognition
• Complications of catheters

Hemodynamic mangement

• Management of hypertension
• Management of tachyarrhythmias
• Inotropic agents
• Vasopressor agents
• Recognition and management of shock states

Infectious diseases

• Sources of infection in the ICU patient
• Management of fever in the ICU
• Sinusitis
• Preventive measures
• Antibiotic management, empiric coverage, rotation of antibiotics
• Management of central lines in the ICU patient

Nutritional support

• Enteral vs parenteral nutrition
• Uses of indirect calorimetry

Neurosurgical concepts

Closed head injury, intracranial pressure

• Basic concepts of cerebral hemodynamics
• Management of elevated intracranial pressure
• Concepts of cerebral perfusion pressure

Cerebral aneurysms

• Complications of aneurysmal rupture
• Management of cerebral vasospasm
• Timing of aneurysmal clipping

Cervical spine injuries

• Respiratory pathophysiology
• Hemodynamic management
• Steroids in spinal cord injury
• Timing of spine stabilization

Radiology in the ICU

• Limitations of plain films
• Proper placement of tubes, central lines
• Recognition of pulmonary collapse
• Use of CT scans in the ICU patient

Recommended reading:

• Anesthesiology Resident�s Guide to Learning in the Intensive Care Unit, 1999 ASCCA
• The ICU Book, Marino, 1998