My dear pulmonologists, I have some bad news.  Santa Claus isn’t real.  Neither is “ARDS.” “ARDS” has traditionally been conflated with a specific histopathological form of lung injury: diffuse alveolar damage (DAD).  Lectures, chapters, and articles typically juxtapose these two entities, promoting the concept that they’re one and the same. But they aren’t. The ability […]

The precise utilization of ABG, VBG, and pulse oximetry remains controversial. Unfortunately, there is little high-level evidence investigating whether these interventions affect patient outcomes (for example, there is precious little evidence to support most of the target values that we’re chasing after). This chapter attempts to explore the strengths, weaknesses, and indications for various techniques. […]

CAR-T cell therapy is rapidly expanding as a miraculous therapy for numerous malignancies.  However, it also causes a variety of unique and severe side-effects, which frequently cause ICU admission.  This chapter explores current approaches to complications including CRS (cytokine release syndrome), HLH (hemophagocytic lymphohistiocytosis), and ICANS (immune effector cell-associated neurotoxicity syndrome).  Updates will be needed […]

Recently, two sets of guidelines for neuroprognostication following cardiac arrest were released – almost simultaneously. In a perfect world, two evidence-based guidelines based on the same evidence would be the same.  But of course, this isn’t actually the case.  The guidelines differ significantly. The Neurocritical Care Society guidelines recommended this general approach:(36949360)  Meanwhile, the Canadian […]

(Blogitorials are short, informal blogs that are written in the spirit of a tweetorial).  Stress hyperglycemia is an everyday occurrence in the ICU, but we hardly know how to treat it. I’ve been waiting years for this topic to be clarified… but I’ve realized that such clarity will probably never be reached. Why? The traditional […]

Steroid is worthless for pneumonia! Wait, a new study shows it’s beneficial! Hang on, a fresh meta-analysis shows that steroid is useless! And wait, here’s a fresh NEJM study showing mortality benefit!! This feels like a roller coaster. What’s going on here? Several factors may explain this: Steroid is beneficial, but only in a subset […]