Intraoperative recurrent laryngeal nerve identification is sometimes difficult in reoperative cervical dissection or operation for inflammatory thyroid disorders. Three modalities have been described to intraoperatively assess nerve function: vocal cord visualization with fiberoptic bronchoscopy or direct laryngoscopy, electromyelographic surveillance of arytenoid muscle function, and cord function assessment with an electromyelogram-electrode endotracheal tube. Our study focused on patients requiring cervical dissection for thyroid or parathyroid disease in which intraoperative recurrent laryngeal nerve function was monitored by nerve stimulation with a concentric bipolar probe. Impulses were tracked via a specialized electrode-bearing endotracheal tube with signal transduction to a recording monitor. No operative nerve injuries occurred in the patients of our study group. This surveillance technique's several advantages include use of standard intubation techniques with no increase in operative time, nerve stimulation tracings that are quantifiable and reproducible with production of a permanent record, and less subjectivity due to observer variability. We believe these factors make the electromyelogram-electrode endotracheal tube approach to intraoperative recurrent laryngeal nerve assessment the optimal technique.
as acid-base and fluid and electrolyte disorders. A focused review of the relevant pharmacology is presented in two chapters. The essential techniques and principles of hemodynamic and respiratory monitoring, arrhythmia control, airway management, and mechanical ventilation are reviewed cogently and comprehensively. Discussions of ventilatory support address an extensive array of issues from initiation of mechanical ventilation to its discontinuation, including practical problems and complications, various modalities, and weaning techniques. The authors emphasize the contemporary understanding of ventilatory management and refer extensively to the relevant literature. In the section on transfusion medicine, the authors discuss transfusion thresholds in light of the available medical evidence. The first section is rounded out with chapters on intensive care imaging, general supportive care, quality improvement, and cost control. The second section of the book, "Medical and Surgical Emergencies," includes discussions of a wide range of topics involving clinical syndromes and events encountered in the intensive care practice. The chapter on sepsis provides an excellent synopsis of the current medical knowledge and clinical practice. The discussion of acute kidney injury includes an excellent and useful review of the modes of renal replacement therapy. The infectious complications of critical illness are an increasingly recognized and studied complication of the intensive care unit. The discussions of intensive care unit-related infection, including ventilator-associated pneumonia and catheter-related bloodstream infections, are terrific synopses of these areas. Each chapter begins with a list of key points. The book is consistently illustrated with essential figures, graphs, and tables. Each chapter concludes with a succinct list of the key references. Critical Care Medicine: The Essentials is aptly titled. The authors present an eminently concise and readable text. Medical students, residents, and fellows will love this book because it summarizes state-of-the-art practices concisely and in a manner that is not available from other sources. Nonintensivist anesthesiologists will find it a lucid, thoughtful, highly informative explication. However, they might also be frustrated by the paucity of images in the chapter on imaging, which discusses newer modalities and the key findings associated with important diagnoses. For other readers who are interested in more detailed, exhaustive reviews, I recommend seeking one of the tomes of critical care-or they may wish to sate their appetites with offerings from the peer-reviewed literature. As an introduction to critical care, however, it is my belief that this text is without equal. A copy should be present in every anesthesia and intensive care library.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2025 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.