Shock is the next-door neighbor of death. Shock can present in a myriad of different forms, making early recognition challenging. However, early diagnosis is essential. Shock can be caused by a broad differential of serious illnesses. Unlike most differential diagnosis lists, every item on this differential is life-threatening. Fortunately, many causes of shock are reversible […]
Traditionally, vancomycin doses have been adjusted to target a specific trough level. However, it is increasingly clear that the trough level is an inadequate measurement of vancomycin exposure. Furthermore, the practice of waiting until the fourth dose to measure the trough level may expose the patient to days of suboptimal therapy.
Occasionally, the NEJM publishes a scary article that gets a lot of press, but doesn’t pan out to be valid. The recent example is the PESIT study, which seemed to imply that everyone admitted with syncope had PE (don’t worry- they don’t). It looks like NEJM might be at it again, with this week’s review article on the relationship between acute infection and MI.
Initially I wasn’t planning to write a chapter on influenza, because there is precious little evidence regarding ICU management. However, even in the absence of solid evidence, we will be called upon to treat these patients. Currently flu season is afoot, and it looks like it might be a bad one (with a predominance of […]
The importance of avoiding and treating renal failure cannot be overstated. The kidneys are delicate organs, often the first to be injured by systemic hypoperfusion or other insults. Severe renal dysfunction leads to a cascade of badness, promoting the failure of other organs and eventual spiraling into multi-organ failure.1 Alternatively, if we are can defend […]