PulmCrit (EMCrit)

Hyperkalemia is bread and butter critical care medicine.  However, the therapeutic approach has changed substantially within the past 5 years. Myths about kayexalate and normal saline have been exposed, allowing more effective therapies to take their place.  

Delirium occurs in about half of critically ill patients.  Some fairly simple measures may reduce the risk of delirium.  When it occurs, delirium is a diagnostic challenge because occasionally it can be a sign of undiagnosed underlying illness.  Treatment is challenging, with little evidence to support most of the standard therapies.

Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness.  Before jumping into the results of this study, it will help to establish a couple of foundational principles.

High-flow nasal cannula (HFNC) has become popular for the hypoxemic respiratory failure, driven partially by the FLORALI trial.1  Recently, the HIGH trial evaluated the ability of HFNC to reduce mortality among immunocompromised patients with acute hypoxemic respiratory failure.2  HFNC failed to improve mortality or significantly reduce intubation rates. Popular narrative about this trial A common […]

Most patients in the ICU will become anemic.  This chapter explores prevention, evaluation, and treatment of anemia in the ICU.  Causes of new-onset anemia in the ICU are distinct from the causes of anemia seen in the outpatient clinic, so the approach should be appropriately tailored to the critical care environment.