PulmCrit (EMCrit)

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 […]

Critical illness leads to a variety of gastrointestinal motility problems (largely due to the constellation of immobility, medications, and metabolic abnormalities).  Although these topics don’t generally attract much interest, maintaining adequate bowel motility is essential to avoid iatrogenic harm. The chapter on gastroparesis is located 👉 here. The chapter on ileus is located 👉 here. […]

Cerebral vein thrombosis is a neurological emergency with a frequency similar to meningitis.  We don’t often think about this, but we probably should.  With early diagnosis and appropriate management, outcomes are often very good (making this one of the most treatable forms of stroke). The IBCC chapter is located 👉 here. The podcast & comments […]