This chapter gives an overview of how to provide high-quality supportive care to the sickest patients. It summarizes about a dozen chapters within the IBCC. This is intended as a quick guide for folks who don’t work full-time in an ICU (e.g. residents rotating through the unit).
Hyperkalemia is bread and butter critical care medicine. However, the therapeutic approach has changed substantially within the past 5 years. Myths about kayexalate and normal saline have been exposed, allowing more effective therapies to take their place.
Delirium occurs in about half of critically ill patients. Some fairly simple measures may reduce the risk of delirium. When it occurs, delirium is a diagnostic challenge because occasionally it can be a sign of undiagnosed underlying illness. Treatment is challenging, with little evidence to support most of the standard therapies.
Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness. Before jumping into the results of this study, it will help to establish a couple of foundational principles.
High-flow nasal cannula (HFNC) has become popular for the hypoxemic respiratory failure, driven partially by the FLORALI trial.1 Recently, the HIGH trial evaluated the ability of HFNC to reduce mortality among immunocompromised patients with acute hypoxemic respiratory failure.2 HFNC failed to improve mortality or significantly reduce intubation rates. Popular narrative about this trial A common […]