Sometimes I encounter basic pharmacokinetic questions that don’t seem to be readily answered in the immediately available literature. I’ve found FOAMed to be a useful way to make sure I’m doing this right (e.g., see a prior discussion of the appropriate loading dose based on intermittent maintenance dosing and half-life here). Today I want to […]
EMCrit Wee – Adaptive Support Ventilation (ASV)
a unique ventilatory mode unfortunately only available on Hamilton vents
EMCrit RACC-Lit Review for June 2024
All the literature goodness for June 2024
PulmCrit: PPIs are safe and effective for GI prophylaxis… the end.
REVISE is the latest multicenter RCT on the use of PPIs for GI prophylaxis in critical illness. I would view this as the triquel following SUP-ICU and PEPTIC. In order to understand REVISE in context, let’s briefly review SUP-ICU and PEPTIC trials, before discussing REVISE. Part I: SUP-ICU (2018) This was a large multicenter RCT […]
PulmCrit: Bilevel Sequence Intubation (BSI) – The new standard
introduction Bilevel Sequence Intubation (BSI) refers to initiation of noninvasive bilevel positive pressure ventilation with a backup rate prior to intubation (either using a BiPAP machine or a full-featured mechanical ventilator). BSI is distinct from traditional rapid sequence intubation (RSI), since BSI involves the delivery of machine-initiated, pressure-controlled breaths following administration of sedation and paralytics. […]
EMCrit Wee – Additional Thoughts on the PREOXI Trial
more on PREOXI
EMCrit 377 – Breaking News – The PREOXI Trial changes everything about Preoxygenation for Intubations in the Critically Ill
the PREOXI trial validates what I have been saying for 15 years about preoxygenation for the critically ill patient
EMCrit Wee – Controlled Automated Reperfusion of the Whole Body (CARL) ECPR / ECLS Yields Amazing Results
Today, we talk about a paper that showed impressive neurologically intact survival for all-rhythms presenting in cardiac arrest, both OHCA and IHCA. It uses a new set of strategies and technologies called CARL. The Paper Treatment of Refractory Cardiac Arrest by Controlled Reperfusion of the Whole Body: A Multicenter, Prospective Observational Study Supplemental Material […]
PulmCrit: MidaKet for procedural sedation in critical illness
intro: the challenge of procedural sedation in critical illness Procedural sedation for critically ill patients is a minefield for several reasons: Patients are already physiologically unstable. Procedures are emergent (a factor widely associated with greater complications). Time constraints often prevent a complete pre-anesthetic evaluation (e.g., medical history and laboratory studies may be unknown). A single […]
EMCrit 376 – Do We Need ETCO2 (Capnography) for Procedural Sedation in the ED? with Sam Campbell (Procedural Sedation 4)
Do we need ETCO2 for PSA in the ED?
CV-EMCrit – Cardiovascular Intensivist Series: Post Cardiopulmonary Bypass Care (CABG) with Trina Augustin
Management of the Post-CABG pt in the ICU
EMCrit 375 – Vasopressors for Early Hemorrhage?
Today we talk about the debate over whether to give vasopressors as part of a balanced resuscitation in early exsanguination…
PulmCrit: Why the new study associating piptazo with increased mortality is wrong
Piperacillin-tazobactam is an antibiotic that a lot of people love to hate. Combine this with the conservatism that often (rightfully) surrounds drug safety, and it creates a lot of volatility. Before going further, we should review some recent history regarding piptazo. In the early 2010’s, a series of retrospective correlational studies found that patients treated […]
EMCrit Wee – Intraosseous Device Burr Holes (Craniotomy) with Marc Grossman
How to do a scary procedure that must get done…
EMCrit 374 – ShadowBoxing – An AMAXimally Sick Patient
An AMAX4 shadowboxing case
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