Egyptian Board Critical Care key terms

The plateau airway pressure minus the applied positive end-expiratory pressure during controlled ventilation; it reflects the cyclic stretch imposed on aerated lung and rises when tidal volume is excessive relative to lung size.

The airway pressure measured during an end-inspiratory pause, when gas flow has stopped and alveolar pressure equilibrates with the proximal airway; it estimates the static distending pressure of the respiratory system.

Positive alveolar pressure that persists at end-expiration because the next breath begins before the lung has emptied, typically from high respiratory rate, airflow obstruction, or a short expiratory time; it reduces effective triggering and can cause hypotension.

A ventilation strategy using small tidal volumes (about 6 mL/kg predicted body weight), limited plateau and driving pressures, and adequate PEEP to reduce ventilator-induced injury in acute respiratory distress syndrome.

A transient increase in airway pressure intended to reopen collapsed alveoli, followed by sufficient PEEP to keep them open; benefit must be weighed against barotrauma and hemodynamic compromise.

Placing a ventilated patient face down for prolonged periods, usually 12 to 16 hours daily, to improve oxygenation and survival in moderate-to-severe acute respiratory distress syndrome; requires careful airway and pressure-injury precautions.

The difference between maximum and minimum pulse pressure over a respiratory cycle, expressed as a percentage of the mean; a dynamic marker of fluid responsiveness that is reliable only in fully controlled ventilation with a regular rhythm and adequate tidal volume.

The likelihood that a patient will increase stroke volume meaningfully after a fluid bolus; dynamic measures such as stroke volume variation or passive leg raising estimate it better than static pressures or single volume estimates.

A bedside test in which the legs are raised from a semi-recumbent position to shift blood toward the heart; a rise in stroke volume or cardiac output suggests fluid responsiveness without giving any fluid.

Circulatory failure caused by inadequate cardiac output despite adequate filling, producing tissue hypoperfusion; common causes include acute myocardial infarction, severe arrhythmia, and decompensated cardiomyopathy.

Oxygen saturation of blood in the pulmonary artery, reflecting the balance between whole-body oxygen delivery and consumption; a low value suggests inadequate cardiac output or anemia, while a high value may indicate shunting or impaired extraction.

The decline in blood lactate concentration over time during resuscitation; failure to clear lactate suggests ongoing hypoperfusion or another source, and it is used to judge response to therapy in shock.

Sepsis with persistent hypotension requiring vasopressors to maintain mean arterial pressure and a raised lactate despite adequate fluid resuscitation, reflecting profound circulatory and cellular dysfunction.

Narrowing empirical broad-spectrum therapy once culture results and the clinical picture allow, reducing resistance pressure and drug toxicity while preserving adequate treatment of the identified pathogen.

A peptide precursor that rises in bacterial infection and falls with resolution; it can support decisions to shorten antibiotic courses but must be interpreted with the clinical context and is unreliable in some conditions.

An irregularly irregular supraventricular rhythm with absent P waves and a fast ventricular rate that can impair filling and cause hypotension or ischemia; management depends on stability and precipitating illness.

Delivery of a direct-current shock timed to the QRS complex to terminate a tachyarrhythmia with a pulse, used when the rhythm causes instability such as hypotension, ischemia, or altered mentation.

An unsynchronized high-energy shock delivered to a patient in ventricular fibrillation or pulseless ventricular tachycardia; unlike cardioversion, timing to the QRS is unnecessary because no organized rhythm exists.

The bundle after return of spontaneous circulation: targeted temperature management, avoidance of hypotension and hypoxia, treatment of the precipitating cause, and neuroprognostication after adequate observation.

Controlled cooling, or active prevention of fever, for a defined period after cardiac arrest or in selected neurocritical illness, aiming to limit secondary brain injury while avoiding shivering and hemodynamic instability.

The pressure inside the rigid skull, normally kept low by cerebrospinal fluid and blood volume regulation; sustained elevation reduces cerebral perfusion and can cause herniation.

Mean arterial pressure minus intracranial pressure; it drives blood flow to the brain, so management of elevated intracranial pressure often targets maintaining an adequate perfusion pressure.

Use of hypertonic saline or mannitol to draw water out of brain tissue and lower intracranial pressure in acute cerebral edema or raised pressure, with monitoring of sodium and osmolality.

An abrupt decline in kidney function, recognized by a rising serum creatinine or falling urine output over hours to days, classified by stage to guide fluid, drug, and dialysis decisions.

Extracorporeal removal of solutes and fluid in kidney failure, delivered continuously or intermittently; continuous therapy is preferred when hemodynamic instability makes intermittent sessions poorly tolerated.

Metabolic acidosis with an elevated calculated anion gap, indicating accumulation of unmeasured acids such as lactate, ketones, or toxins; the gap helps narrow the differential and monitor therapy.

A metabolic emergency of insulin deficiency with ketone production, high anion gap acidosis, and dehydration; treatment requires fluids, insulin, potassium replacement, and correction of the precipitating cause.

Severe hyperglycemia with profound dehydration and high serum osmolality but little ketosis; it occurs mainly in older patients with type 2 diabetes and carries high mortality.

Acute cortisol deficiency causing hypotension unresponsive to fluids and vasopressors, often with hyponatremia, hyperkalemia, and hypoglycemia; it requires immediate glucocorticoid therapy after or alongside blood sampling.

Serum sodium below the normal range, reflecting a disturbance of water balance; severity and rate of onset determine whether hypertonic saline is needed for neurologic symptoms.

A preplanned, balanced delivery of red cells, plasma, and platelets with rapid laboratory and clinical feedback for hemorrhagic shock, aiming to limit crystalloid and correct coagulopathy early.

Deliberately accepting a lower-than-normal blood pressure during active hemorrhage, before bleeding is controlled, to avoid dislodging clots; it is unsuitable for patients with traumatic brain injury.

An integrated approach to severe trauma combining hemorrhage control, minimal crystalloid, balanced blood products, permissive hypotension, and correction of hypothermia, acidosis, and coagulopathy.

Poisoning by methanol, ethylene glycol, or similar alcohols that produce toxic metabolites and a high anion gap acidosis with an osmolal gap; treatment includes blocking metabolism and sometimes dialysis.

A drug-induced hyper-serotonergic state with altered mentation, autonomic instability, and neuromuscular hyperactivity such as clonus; it is a clinical diagnosis managed by stopping the agent and supportive care.

A clinical situation in which mask ventilation, supraglottic placement, laryngoscopy, or intubation is expected to be difficult or has failed; it requires a preformed plan and early call for help.

Tracheal intubation after a sedative and a neuromuscular blocker given in quick succession to minimize aspiration risk, with preoxygenation, careful hemodynamic preparation, and a rescue plan.

Use of a camera-equipped blade to view the glottis on a screen, often improving visualization in difficult anatomy and allowing an assistant to guide cricoid or external laryngeal manipulation.

An acute fluctuating disturbance of attention and awareness common in critically ill patients; it is associated with worse outcomes and is detected with validated bedside tools rather than impression alone.

Generalized muscle weakness developing during critical illness, from disuse, inflammation, and metabolic derangement; it prolongs ventilation and rehabilitation and is diagnosed clinically after other causes are excluded.

An ethical standard in which a surrogate decides as the patient would have decided, based on known values and preferences, rather than on what the surrogate believes is best.

A written or documented statement of a patient's treatment preferences, or the naming of a decision-maker, used to guide care when the patient loses capacity.

A judgment that an intervention cannot achieve the intended physiologic goal or meaningful benefit; it is ethically contested and should prompt shared decision-making rather than unilateral withdrawal.