PulmCrit (EMCrit)

Acute liver failure is rare, but when it does occur it requires an organized diagnostic and therapeutic approach.  Success often relies upon aggressive support of other organs (e.g. renal failure and management of intracranial hypertension). The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes

Spontaneous bacterial peritonitis is an important consideration for any hospitalized patient with substantial ascites.  Patients can have minimal symptoms.  To complicate matters further, in some cases spontaneous bacterial peritonitis may present with failure of other organs (e.g. hepatic encephalopathy, or disseminated intravascular coagulation leading to gastrointestinal hemorrhage). The IBCC chapter is located 👉 here. The […]

Invasive candidiasis is growing more common in the ICU, as our patients are becoming increasingly complex, with longer stays.  However, most isolation of Candida in the ICU represents colonization rather than infection – so there is a major risk of overdiagnosis resulting in unnecessary medication toxicity and antimicrobial resistance. The IBCC chapter is located 👉 here. […]

We’ve been seeing a lot of decompensated liver disease recently, likely related to increases in alcohol intake due to the COVID pandemic.  Over the next month, several chapters on critical care hepatology be released, exploring how to manage these patients.  We start with hepatorenal syndrome and hepatorenal physiology, because this is often the crux of […]

Cirrhosis causes a derangement of all components of coagulopathy.  Fortunately, these derangements tend to balance one another out (so the best approach is often to merely observe).  However, sometimes imbalances may spin out of control and require aggressive management (e.g. causing hyperfibrinolysis with refractory bleeding). The IBCC chapter is located 👉 here. The podcast & […]