CICM First Part key terms

The volume of oxygen transported to the tissues each minute, calculated as cardiac output multiplied by arterial oxygen content. It reflects the balance between circulation and oxygenation and is a key target in shock resuscitation.

The rate at which tissues take up and use oxygen per minute. It is estimated from the difference between arterial and venous oxygen content multiplied by cardiac output, and rises with fever, sepsis and increased metabolic demand.

The oxygen saturation of blood sampled from the pulmonary artery, representing the oxygen remaining after tissue extraction. A low value suggests inadequate oxygen delivery or increased demand, while a high value may indicate impaired extraction.

A state of inadequate tissue perfusion causing cellular hypoxia and organ dysfunction, classified as hypovolaemic, cardiogenic, distributive or obstructive. Diagnosis relies on clinical signs, lactate and perfusion markers rather than blood pressure alone.

The average arterial pressure across the cardiac cycle, approximated as diastolic pressure plus one third of the pulse pressure. It drives organ perfusion and is a common target for vasopressor therapy in critical illness.

An end product of anaerobic glucose metabolism that accumulates when oxygen delivery is inadequate or when catecholamine-driven metabolism increases. Serial measurement guides resuscitation and predicts outcome in shock and sepsis.

Life-threatening organ dysfunction caused by a dysregulated host response to infection. It is identified clinically by a rise in organ dysfunction scores and managed with prompt antimicrobials, source control and careful fluid resuscitation.

Sepsis with persisting hypotension requiring vasopressors to maintain mean arterial pressure despite adequate fluid resuscitation, together with elevated lactate. It carries high mortality and demands rapid source control and organ support.

A drug that constricts blood vessels to raise systemic vascular resistance and blood pressure. Noradrenaline is first line in most distributive shock; these agents are given by controlled infusion with close haemodynamic monitoring.

An acute inflammatory lung injury causing bilateral opacities and severe hypoxaemia not fully explained by cardiac failure. Management emphasises lung-protective ventilation with low tidal volumes, limited plateau pressures and cautious fluid balance.

The airway pressure maintained at the end of expiration during mechanical ventilation, which keeps alveoli open and reduces collapse. It improves oxygenation but can impair venous return and cause barotrauma at excessive levels.

The difference between plateau pressure and applied positive end-expiratory pressure during mechanical ventilation. It reflects the cyclic stretch imposed on aerated lung and is associated with mortality in acute respiratory distress syndrome.

Placing a ventilated patient face down to improve oxygenation and survival in moderate to severe acute respiratory distress syndrome. It redistributes ventilation, reduces lung compression by abdominal contents and requires careful pressure-area and line care.

A transient increase in airway pressure used to reopen collapsed alveoli during mechanical ventilation. It may improve oxygenation but carries risks of hypotension and barotrauma, and evidence for improved survival is limited.

An abrupt decline in kidney function detected by a rise in creatinine or fall in urine output. Causes are prerenal, renal or postrenal, and management focuses on restoring perfusion, avoiding nephrotoxins and treating complications.

Techniques such as haemodialysis or continuous filtration that remove waste products and fluid when native kidney function fails. Continuous modalities are preferred in haemodynamically unstable patients because they cause less rapid fluid and solute shifts.

Breakdown of skeletal muscle releasing myoglobin and intracellular contents into the circulation. It causes hyperkalaemia, raised creatine kinase, acute kidney injury and compartment syndrome, and is treated with aggressive fluid resuscitation.

A serum potassium concentration above the normal range that risks fatal cardiac arrhythmia. Emergency treatment combines membrane stabilisation with calcium, intracellular shift using insulin and glucose, and removal via diuretics or dialysis.

An acute fluctuating disturbance of attention and cognition common in critically ill patients. It is associated with longer ventilation and higher mortality, and is managed by treating causes, orientation strategies and cautious sedative use.

A validated score from minus five to plus four describing a patient's level of sedation and agitation. It guides titration of sedatives and is used alongside delirium screening to monitor brain function in intensive care.

The use of drugs to reduce awareness, anxiety and discomfort in ventilated or agitated patients. Modern practice favours light, targeted sedation with daily interruption to shorten ventilation and reduce delirium.

A viral lower respiratory infection of infants, most often caused by respiratory syncytial virus, producing wheeze, crackles and feeding difficulty. Management is supportive with oxygen, hydration and respiratory support; routine bronchodilators are not recommended.

Pauses in breathing lasting more than twenty seconds, or shorter pauses with bradycardia or desaturation, in preterm infants due to immature respiratory control. Caffeine citrate is first-line treatment alongside cardiorespiratory monitoring.

The structured approach to supporting a newborn who does not breathe adequately at birth, using warming, airway positioning, inflation breaths and, if needed, chest compressions and drugs. Delayed cord clamping and team briefing improve outcomes.

Inhalation of meconium-stained amniotic fluid around birth, causing airway obstruction, chemical pneumonitis and persistent pulmonary hypertension. Management includes suction of visible airway obstruction, oxygen and ventilatory support.

Failure of the pulmonary vascular resistance to fall after birth, causing right-to-left shunting and severe hypoxaemia. Treatment includes oxygen, inhaled nitric oxide, optimising lung recruitment and inotropic support.

A selective pulmonary vasodilator delivered by inhalation that improves oxygenation in pulmonary hypertension by dilating ventilated lung regions. It is used in persistent pulmonary hypertension of the newborn and right heart failure, with monitoring for methaemoglobinaemia.

Heated, humidified oxygen delivered at high flow through nasal prongs, providing modest positive pressure and improving comfort. It is widely used in infants with bronchiolitis and in adults with hypoxaemic respiratory failure.

Respiratory support delivered through a mask or interface without an artificial airway. It reduces work of breathing and intubation rates in selected patients, but requires a cooperative patient and close monitoring for failure.

A tool combining vital signs and clinical observations to detect deteriorating children on wards and trigger escalation. It standardises communication and aims to identify deterioration before cardiac arrest or unplanned intensive care admission.

A group of clinicians who attend to deteriorating ward patients when triggered by warning scores or staff concern. The team assesses, stabilises and arranges escalation, aiming to prevent cardiac arrest and unplanned intensive care admission.

An anaesthetic technique for patients at risk of aspiration, using a fast-acting induction agent and neuromuscular blocker with minimal delay between drug administration and tracheal intubation, often with cricoid pressure.

A clinical situation in which trained personnel experience difficulty with mask ventilation, supraglottic device placement, laryngoscopy or intubation. It is managed with pre-planned algorithms, alternative devices and early declaration of a failed airway.

Pharmacological paralysis of skeletal muscle produced by drugs that block transmission at the neuromuscular junction. In anaesthesia and intensive care it facilitates intubation and ventilation, and requires sedation and peripheral nerve monitoring.

A genetic susceptibility to volatile anaesthetics and depolarising muscle relaxants causing uncontrolled muscle metabolism, hyperthermia, rigidity and hyperkalaemia. Treatment is dantrolene with supportive cooling and correction of metabolic derangement.

Chemical injury to the lungs from inhalation of gastric contents, causing cough, hypoxaemia and bilateral infiltrates shortly after the event. Management is supportive with airway protection and oxygen; antibiotics are reserved for infection.

A method allowing patients to self-administer small doses of analgesic, usually opioid, within programmed limits. It improves pain control and satisfaction while requiring monitoring for sedation and respiratory depression.

The triad of reduced consciousness, pinpoint pupils and respiratory depression caused by excessive opioid effect. It is reversed with naloxone titrated to breathing, with monitoring for recurrent sedation as the antidote wears off.

Combining analgesic drugs and techniques with different mechanisms to improve pain relief and reduce individual drug doses and side effects. Typical components include paracetamol, non-steroidal agents, local anaesthetic blocks and opioids.

A metabolic emergency of insulin deficiency causing hyperglycaemia, ketonaemia and metabolic acidosis. Management requires fluids, insulin infusion, potassium replacement and treatment of the precipitating cause, with careful monitoring for cerebral oedema.

Acute severe cortisol deficiency presenting with hypotension, vomiting, hyponatraemia and hyperkalaemia, often triggered by illness. Treatment is immediate parenteral hydrocortisone with fluid resuscitation and correction of electrolytes.

The coordinated effort to restore circulation and breathing after cardiac arrest through chest compressions, ventilation and defibrillation when indicated. High-quality compressions, minimal interruptions and early defibrillation determine survival.