Intracranial hemorrhage is a fairly common problem, which spans the gamut from mild to life-threatening. Most therapies haven’t been shown to work, so management mostly consists of high-quality neuro-supportive care. The IBCC chapter is located here. The podcast & comments are below. Follow us on iTunes
IBCC chapter & cast – Catastrophic antiphospholipid syndrome (CAPS)
Catastrophic antiphospholipid syndrome (CAPS) is a truly rare cause of multi-organ failure. It is usually not considered as a diagnostic possibility, leading it to be mis-diagnosed as septic or cardiogenic shock. Awareness of this condition and various red flags suggesting its presence might facilitate earlier diagnosis and therapy. The IBCC chapter is located here. The […]
IBCC chapter & cast – Fever workup in the ICU
Familiarity breeds contempt. Fever is so common in the ICU, that we often don’t put much thought into these workups. Just culture everything, right? Well, not really. Excessive cultures frequently lead to false-positive results (representing colonization), which serve only to misdirect attention away from the actual problem. Meanwhile, inadequate attention to the physical examination and […]
IBCC chapter & cast: Catheter-Associated Urinary Tract Infection (CAUTI)
Catheter-associated urinary tract infection (CAUTI) is supposedly one of the most common causes of nosocomial infection. However, it’s dubious to what extent it is truly a disease. It’s increasingly clear that the vast majority of cases of “CAUTI” are likely merely asymptomatic bactiuria, which has been mis-diagnosed as infection (leading to unnecessary treatment and iatrogenic […]
IBCC chapter & cast – Sickle Cell Acute Chest Syndrome
Sickle cell disease affects 100,000 people in the United States and far more internationally. One of the most dangerous manifestations of the disease is acute chest syndrome, which involves a vicious cycle of erythrocyte sickling and respiratory failure. Acute chest syndrome can be a presenting feature upon hospital admission, it can arise as a complication […]
IBCC chapter & cast – Epiglottitis
The hard part about playing chicken is knowing when to flinch – Bart Mancousco, The Hunt for the Red October Epiglottitis is often a game of chicken. The great majority of adult patients don’t require intubation, so the best management for them is steroid and antibiotic (plus close observation and the ability to intubate if […]
IBCC chapter & cast – Pneumocystis Jirovicii Pneumonia
Pneumocystic Jirovicii Pneumonia (previously Pneumocystic Carinii Pneumonia) remains an important opportunistic infection in critical care. Improved treatment for HIV has reduced the frequency of PJP due to AIDS, but meanwhile the development of increasingly sophisticated immunosuppressive regimens for other patient populations has increased the incidence of non-HIV PJP. New diagnostic tests are improving our ability […]
PulmCrit – Dexamethasone & COVID – a study in immunopathology, evidence-based medicine, and ourselves
Early in the COVID epidemic, it became clear that the virus often causes a cytokine storm, leading to immunopathological organ damage. The first major study to suggest benefit from steroid in COVID was a retrospective study by Wang et al. released in early March, which found reduced mortality among COVID patients with ARDS who were […]
IBCC chapter & cast – Vocal cord dysfunction
Vocal cord dysfunction is a masquerader of life-threatening pathologies (most notably asthma and anatomic upper airway obstruction). Vocal cord dysfunction itself is not dangerous, but if not properly diagnosed it may lead to considerable iatrogenic harm (e.g. multiple unnecessary intubations for “asthma”). On the flip side, incorrect diagnosis of vocal cord dysfunction is also dangerous, […]
IBCC chapter & cast – Invasive pulmonary aspergillosis
Invasive pulmonary aspergillosis was traditionally conceptualized as a rare infection restricted to profoundly immunocompromised patients. However, over the past decade, it’s become increasingly clear that invasive aspergillosis can also occur as a nosocomial superinfection among patients who aren’t immunocompromised (especially following influenza). This opens a can of worms regarding how to sift out colonization versus […]
PulmCrit Wee – Multicenter RCT evaluating ruxolitinib (a JAK inhibitor) for COVID-19
Janus kinases (JAKs) are named after Janus, the Greek god of beginnings, gates, transitions, and duality. They’re named after Janus because they contain a mirror-image structural element. However, given their role within the immune system as a multi-functional gateway for cytokine systems, the name seems apt. The cytokine storm induced by COVID-19 has received considerable […]
IBCC chapter & cast – Refeeding syndrome
Refeeding syndrome is a slippery topic. It’s probably more common than we recognize, often running underneath the radar (the constellation of electrolyte and clinical abnormalities can easily masquerade as another problem, such as alcohol withdrawal). However, there is essentially no prospective evidence on how to prevent or treat it. Indeed, there is no clear consensus […]
IBCC chapter & cast – Takotsubo’s Cardiomyopathy
Takotsubo’s cardiomyopathy may be perceived as a zebra, but it is extremely common in the ICU (as a secondary consequence of endogenous stress and exogenous catecholamines). With increasing recognition, Takotsubo cardiomyopathy is also noted to underlie ~1-2% of patients presenting with chest pain and a similar fraction of cath lab activations. The IBCC chapter is […]
PulmCrit: Remdesivir 5-day vs. 10-day trial raises some red flags?
So, Gilead’s first RCT on remdesivir was just published, and it’s very interesting.1 Gilead’s, you say? Yep. The study was designed, monitored, analyzed, and written by Gilead: Before getting into the study, let’s take a moment and think about what Gilead’s first RCT could look like. Gilead knows more about remdesivir than anyone (they built […]
IBCC chapter & cast – Parenteral anticoagulants
Anticoagulation is ubiquitous in critical care. Considering the use of DVT prophylaxis, the majority of critically ill patients will receive some form of anticoagulation during their ICU stay. Anticoagulants are potentially high-risk medications, with relatively narrow therapeutic windows. Thus, it’s important to understand the pharmacology of various agents to select and monitor anticoagulation optimally. The […]
- « Previous Page
- 1
- …
- 8
- 9
- 10
- 11
- 12
- …
- 34
- Next Page »