PulmCrit (EMCrit)

Thyroid storm is a bit of a zebra.  It can mimic a variety of common conditions (e.g. sepsis, delirium, heart failure).  Unfortunately, if you’re not looking for it, you probably won’t find it.   Once identified, an organized multimodal treatment regimen will generally get the job done.  But be careful – these patients may have varying physiology, so blindly following the same rubric for every single patient isn’t the answer.

Thrombocytopenia is extremely common in critical illness.  It’s generally a consequence rather than a cause of illness, predicting increased mortality.  However, we must remain alert for cases where serious hematologic disease is afoot.  The major concern here is the ever-looming possibility of heparin-induced thrombocytopenia and thrombosis (HITT).  This chapter explores thrombocytopenia and provides an evidence-based […]

The use of an inhaled pulmonary vasodilator is a logical strategy for stabilization of PE patients (especially nitric oxide, which may be depleted in this situation). Previously inhaled nitric oxide has only been supported by case series.

We spend a lot of time obsessing over the finer details of critical care:  which fluid is best?  which vasopressor is best?  will another liter of fluid help?  These details are important, but for a septic patient something more important than any of these details is choosing the right antibiotic(s).  In septic shock, source control and […]

Shock is the next-door neighbor of death.  Shock can present in a myriad of different forms, making early recognition challenging.  However, early diagnosis is essential.  Shock can be caused by a broad differential of serious illnesses.  Unlike most differential diagnosis lists, every item on this differential is life-threatening.  Fortunately, many causes of shock are reversible […]