There probably isn’t much to say about ARDS that hasn’t been said in some form within the past couple years. We’ve debated continually about the optimal approach to this syndrome, in the absence of much solid evidence (the only large, multi-center RCT which has been replicated in ARDS was ACURASYS – and it failed to […]
Here is a 10-minute video I made for the Cooper Critical Care Conference. It explores some basic & useful concepts about hypoxemia physiology, including how to apply this at the bedside. The algorithms in the video aren’t intended to be strictly followed, but rather merely as general conceptual schemas. related For more information about the […]
Right ventricular failure is extremely common among critically ill patients (e.g., affecting a quarter of patients with ARDS). Unfortunately, this is often overlooked in critical care curricula. We tend to spend lots of time focusing on pulmonary arterial hypertension (which is far more rare), thereby overlooking the everyday conundrum of right ventricular failure. It’s called […]
An Opportunity, a Change, a Request, & an Amazing Upgrade Hi There Emcritters: For over a dozen years, I have been putting out Resuscitation and Acute Critical Care education on the EMCrit podcast. And you have been the best audience in the imaginable universe. Together, we have reached a crossroads–the time has come for a […]
Liberation from invasive ventilation is one of the most important goals of critical care medicine. Numerous RCTs have improved our understanding of this process, but it remains as much an art as a science. When in doubt, empirical trials of spontaneous breathing and extubation are more accurate than our predictive ability. The IBCC chapter is […]
The case: A ~65 year-old human presents to the ICU with a working diagnosis of vasopressor-dependent septic shock. The patient was previously healthy with no significant medical problems or medications. History is notable for mild nonspecific symptoms (chills, nausea, and a headache), with nothing in particular standing out. Physical examination is unrevealing, with the patient […]
It’s very difficult to write a good chapter about respiratory alkalosis (hypocapnia) or respiratory acidosis (hypercapnia). These states remind me a bit of grand central station, because each encompasses such a broad range of patients with different conditions – who need enormously different treatments. So any discussion of these conditions is by definition a gross […]
Historically it was believed that allergic reactions could be mediated by the core structures. This would imply that a patient could be allergic to all penicillins, all cephalosporins, or even all beta-lactams. That would be hugely problematic, because a patient could simultaneously be allergic to dozens of antibiotics – greatly complicating their management.