PulmCrit (EMCrit)

Septic shock is perhaps the defining illness of medical intensive care.  As such it is an enormously broad and controversial topic.  This chapter attempts to provide a unified and straight-forward approach.  However, every physicians has a different approach to septic shock, so it’s impossible to claim that this is the best approach. There will doubtless […]

Like so many things in critical care, angioedema is difficult to research since it is uncommon, heterogeneous, and emergent.  As such, we have relatively little high-quality evidence regarding this disease (and the high-quality evidence that we do have is largely restricted to pharma-sponsored trials of new and insanely expensive pharmaceuticals).  This chapter attempts to create […]

In 2015 I wrote this post on ACEi-induced angioedema.  I still think it was a pretty good post (particularly for 2015), but it’s become increasingly clear recently that the post was fundamentally flawed.  Let’s try to straighten this out.  old model of bradykinin-mediated angioedema This is a conceptual model of how bradykinin-mediated angioedema occurs.  Several […]

The timing of basal insulin administration in DKA has been controversial for years.  I posted the following poll on twitter recently to get a sense of current opinion on this: So, it seems that the majority of people are using traditional management (wait for the anion gap to close, give basal insulin, then shut off […]

Severe hemoptysis is a true challenge.  Due to the rarity of this condition, there is little high-quality data on it.  So you can’t become a hemoptysis whisperer by reading books.  Unfortunately, due to the rarity of the condition it’s also difficult to accumulate clinical experience.