EMCrit Project

BRASH syndrome refers to a vicious spiral wherein hyperkalemia and AV nodal blockers synergize to cause progressive renal failure, bradycardia, shock, and hyperkalemia.  The treatment is largely a combination of standard therapies for hyperkalemia and bradycardia.  Recognizing this syndrome as a specific entity may help us more fully understand our patients’ physiology, facilitating a more […]

Intensivists have long been struggling with the enigma of hemophagocytic lymphohistiocytosis (HLH).  For example, this post from 2016 explores the challenge of dissecting HLH away from septic shock.  The COVID pandemic has drawn some attention to the topic, although it’s not clear to what extent COVID might truly reflect HLH.  This chapter attempts to lay […]

Critical illness leads to a variety of gastrointestinal motility problems (largely due to the constellation of immobility, medications, and metabolic abnormalities).  Although these topics don’t generally attract much interest, maintaining adequate bowel motility is essential to avoid iatrogenic harm. The chapter on gastroparesis is located 👉 here. The chapter on ileus is located 👉 here. […]

Cerebral vein thrombosis is a neurological emergency with a frequency similar to meningitis.  We don’t often think about this, but we probably should.  With early diagnosis and appropriate management, outcomes are often very good (making this one of the most treatable forms of stroke). The IBCC chapter is located 👉 here. The podcast & comments […]

Hypertriglyceridemia is responsible for about ~10% of pancreatitis episodes seen in critical care.  The management of this entity is highly variable, due to a lack of high-quality evidence.  Approaches range from extremely aggressive (e.g. plasmapheresis) to more conservative therapy (e.g. subcutaneous insulin).  This chapter attempts to unpack the physiology and evidence underlying this diagnosis, with […]