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The book covers vigorously debated controversial topics in the field of critical care medicine over the years. It provides the reader with a balanced approach and guidance based on historical and currently available evidence in dealing with contentious clinical scenarios. The book reviews the most relevant, contemporaneous evidence on each topic and provides practical guidelines for clinical practice.

The book includes chapters that follow a structured approach to controversies related to specific organ systems. The topics covered provide a summary of the most relevant, practice-changing studies in the field of critical care medicine. Each topic describes the basic applied physiology, points of controversy, the evidence base, and summarizes the key points at the end. It includes brief description of landmark studies on each controversial topic.

The book serves as an important clinical guide to practitioners of critical care medicine when confronted with challenging clinical scenarios. Besides, it is a useful source of information to postgraduate trainees in various medical specialties. The topics addressed are among the most widely discussed during postgraduate examinations. It is also relevant for practitioners in general medicine and specialized areas of practice, including pulmonology (respiratory medicine), cardiology, neurology, nephrology, gastroenterology, and surgical specialties.

Controversies in Critical Care

Section 1. Respiratory support in the critically ill  Oxygen: the elixir of life or a double-edged sword?The hypoxic drive: an urban legend?Lung protective ventilation strategies in acute respiratory distress syndrome Non-invasive ventilation in acute hypoxemic respiratory failureHigh-flow nasal cannulaTitration of positive end-expiratory pressure by the bedsideThe role of recruitment maneuvers in acute respiratory distress syndrome Patient self-inflicted lung injuryProne ventilation in acute respiratory distress syndrome Neuromuscular blocking drugs in acute respiratory distress syndrome Ventilator-associated pneumonia: newer outlookIs hypercapnia harmful during lung-protective ventilation Tracheostomy: timing it right Diaphragmatic dysfunction in critical illnessWeaning from mechanical ventilation How to decannulate a tracheostomy Thrombolysis in acute pulmonary embolism 
Section 2. Shock and circulatory support
Steroids in septic shock Hyperlactatemia in sepsis Permissive hypotension in traumaAssessment of volume responsiveness Are we done with early goal-directed therapy? Normal saline vs. balanced crystalloid as resuscitation fluidLiberal vs. conservative fluid resuscitation strategy in septic shock Epinephrine in cardiopulmonary resuscitation Targeted temperature management vs. hypothermia after cardiac arrest 
Section 3. Acute kidney injury and renal replacement therapy

Augmented renal clearance in the critically ill Renal replacement therapy: timing it rightDosing of renal replacement therapyAnticoagulation during renal replacement therapy: heparin vs. citrateContinuous vs. intermittent renal replacement therapy
Section 4. Neurocritical care 
ICP monitoring: does it impact clinical outcomes?Decompressive craniectomy in traumatic brain injurySalt or sugar for the swollen brain?Sedation in critically ill patientsDelirium management in the ICU Corticosteroids in spinal cord injury 
Section 5. Metabolic support in critical illness
Glycemic control in the critically illThiamine and vitamin C critical illness
Section 6. The gut and nutrition 
Abdominal compartment syndromeInterruption of enteral feeds in the ICULocation of feeds: gastric vs. post pyloricEnteral feeds: how early?Permissive underfeeding Enteral vs. parenteral nutrition Stress ulcer prophylaxis in the ICU 
Section 7. Infections and antibiotic therapy 
How to cope multi-drug resistance How early should antibiotics be administered in sepsis?De-escalation of antibiotic therapyAerosolized antibiotics Is procalcitonin level useful in the critically ill?Selective digestive decontamination: helpful or harmful? 
Section 8. Contentious issues in Covid-19 infection
Corticosteroids in Covid-19Interleukin antagonism in Covid-19Anticoagulation strategy in severe Covid-19Vaccine-induced immune thrombotic thrombocytopenia 
Section 9. Organizational challenges in the ICU
The open vs. closed ICU debateCritical incidents in the ICURapid response teams Measuring ICU performance 
Section 10. Coagulopathy and transfusion 
Red cell transfusion thresholds in the critically illTranexamic acid in the bleeding patient  Platelet transfusion in dengue fever Fixed ratio transfusion strategy in trauma 
Section 11. Ancillary issues