PulmCrit (EMCrit)

Glycemic control in the ICU is a topic of perpetual controversy.  We’ve come full circle in the past 20 years – beginning with permissive hyperglycemia, then moving to tight control, and finally now moving back to permissive hyperglycemia.  The final answer remains unknown, but in the interim this chapter attempts to muddle through available evidence. […]

Wernicke encephalopathy is important because it’s surprisingly common, potentially debilitating, and fully treatable.  Some patients may present to the hospital due to Wernicke encephalopathy, while many others may develop this while in the ICU as an iatrogenic complication of criical care. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow […]

Valproic acid poisoning is fortunately uncommon.  However, this is a potentially lethal and rather complex intoxication.  Management spans the gamut from decontamination and dialysis, to various metabolic manipulations.  With an aggressive and organized approach, most patients will do extremely well. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us […]

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 […]