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Table of Contents
2.3.1 Admission Criteria: What About Age
2.3.2 Prognostic Tools for Older ICU Patients
2.3.3 Admission Criteria and Pre-ICU Triage
2.4 What Are the Objectives of ICU Care in Older Patients
2.4.1 Time for Post ICU Geriatric Units
Practical Implications
Conclusion
Take-Home Messages
References
II: Age-Related Physiological Changes
3: Aged-Related Physiological Changes: CNS Function
3.1 Introduction
3.2 CNS Ageing
3.2.1 General Cellular Age-Related Changes in the Brain
3.2.1.1 [beta]-Amyloid and Tau Protein Accumulation
3.2.1.2 Autophagia
Intro
Preface
Contents
Contributors
Abbreviations
I: Introduction: The Very Old ICU Patients
1: The Demography of Ageing and the Very Old Critical Ill Patients
1.1 Introduction: Demography of Ageing
1.2 Diversity Within Europe
1.3 General Health Issues in the Very Old
1.4 ICU Admission of the Very Old
1.5 The Very Old in the ICU
Conclusions
References
2: Objectives of ICU Management for Very Old Patients
2.1 Introduction
2.2 Characteristics of Very Old Patients
2.3 ICU Admission of an Older Patient
3.2.1.3 Oxidative Stress
3.2.1.4 Neuroinflammation
3.2.2 Specific Cellular Type Age-Related Changes in the Brain
3.2.2.1 Neurone
3.2.2.2 Neuroglia
3.2.2.3 Microglia
3.2.2.4 Vascular Unit
3.2.3 Specific Anatomical Age-Related Changes in the Brain
3.2.3.1 Global Age-Related Variations
3.2.3.2 PFC and Dopamine System
3.2.3.3 Hippocampus and Cholinergic System
3.3 Ageing Consequences for CNS Functions
3.3.1 Cognitive Profile
3.3.1.1 Attention
3.3.1.2 Memory
3.3.1.3 Decision Making
3.3.2 Movement
3.3.2.1 Functional Dispersion of Motor CNS Activity
3.3.2.2 Movement and Cognition
3.3.3 Affective and Emotional Aspects
3.3.3.1 Late-Onset Disorders
3.3.3.2 Personality
3.3.3.3 Well-Being Paradox
Practical Implications
Conclusion
Take-Home Messages
References
4: Age-Related Physiology Changes: Cardiovascular Function in the Very Old Critically Ill Patient
4.1 Introduction
4.2 Physiology of Cardiovascular Ageing with Clinical Relevance for Intensive Care
4.2.1 Atria
4.2.2 Ventricles
4.2.3 Myocardium
4.2.4 Valves
4.2.5 The Conduction System
4.2.6 Vascular
4.2.7 Coronary Arteries
4.3 Circulatory Failure: Types of Shock
Practical Implications
Circulatory Monitoring: Particular Aspects in the Elderly
1. Cannulation
2. Invasive and Non-invasive Blood Pressure Measurement
3. Central Venous Pressure (CVP) Measurement
4. Assessment of Cardiac Output
5. Assessment of Fluid Responsiveness
Conclusion
Take-Home Messages
References
5: Age-Related Changes of the Kidneys and their Physiological Consequences
5.1 (Patho)Physiology of Renal Ageing
2.3.2 Prognostic Tools for Older ICU Patients
2.3.3 Admission Criteria and Pre-ICU Triage
2.4 What Are the Objectives of ICU Care in Older Patients
2.4.1 Time for Post ICU Geriatric Units
Practical Implications
Conclusion
Take-Home Messages
References
II: Age-Related Physiological Changes
3: Aged-Related Physiological Changes: CNS Function
3.1 Introduction
3.2 CNS Ageing
3.2.1 General Cellular Age-Related Changes in the Brain
3.2.1.1 [beta]-Amyloid and Tau Protein Accumulation
3.2.1.2 Autophagia
Intro
Preface
Contents
Contributors
Abbreviations
I: Introduction: The Very Old ICU Patients
1: The Demography of Ageing and the Very Old Critical Ill Patients
1.1 Introduction: Demography of Ageing
1.2 Diversity Within Europe
1.3 General Health Issues in the Very Old
1.4 ICU Admission of the Very Old
1.5 The Very Old in the ICU
Conclusions
References
2: Objectives of ICU Management for Very Old Patients
2.1 Introduction
2.2 Characteristics of Very Old Patients
2.3 ICU Admission of an Older Patient
3.2.1.3 Oxidative Stress
3.2.1.4 Neuroinflammation
3.2.2 Specific Cellular Type Age-Related Changes in the Brain
3.2.2.1 Neurone
3.2.2.2 Neuroglia
3.2.2.3 Microglia
3.2.2.4 Vascular Unit
3.2.3 Specific Anatomical Age-Related Changes in the Brain
3.2.3.1 Global Age-Related Variations
3.2.3.2 PFC and Dopamine System
3.2.3.3 Hippocampus and Cholinergic System
3.3 Ageing Consequences for CNS Functions
3.3.1 Cognitive Profile
3.3.1.1 Attention
3.3.1.2 Memory
3.3.1.3 Decision Making
3.3.2 Movement
3.3.2.1 Functional Dispersion of Motor CNS Activity
3.3.2.2 Movement and Cognition
3.3.3 Affective and Emotional Aspects
3.3.3.1 Late-Onset Disorders
3.3.3.2 Personality
3.3.3.3 Well-Being Paradox
Practical Implications
Conclusion
Take-Home Messages
References
4: Age-Related Physiology Changes: Cardiovascular Function in the Very Old Critically Ill Patient
4.1 Introduction
4.2 Physiology of Cardiovascular Ageing with Clinical Relevance for Intensive Care
4.2.1 Atria
4.2.2 Ventricles
4.2.3 Myocardium
4.2.4 Valves
4.2.5 The Conduction System
4.2.6 Vascular
4.2.7 Coronary Arteries
4.3 Circulatory Failure: Types of Shock
Practical Implications
Circulatory Monitoring: Particular Aspects in the Elderly
1. Cannulation
2. Invasive and Non-invasive Blood Pressure Measurement
3. Central Venous Pressure (CVP) Measurement
4. Assessment of Cardiac Output
5. Assessment of Fluid Responsiveness
Conclusion
Take-Home Messages
References
5: Age-Related Changes of the Kidneys and their Physiological Consequences
5.1 (Patho)Physiology of Renal Ageing