PulmCrit (EMCrit)

Stupor and coma can be a challenging presentation, because it has a broad differential filled with very severe diseases.  An organized approach is essential.  One core feature of that approach is the coma neurologic examination, which remains central to the evaluation even in the era of abundant CT and MRI scanning. The IBCC chapter is […]

COVID will eventually lead to many improvements in our approach to critical illness.  I’ve been hoping that one of these would be an improved understanding of venous thromboembolism (VTE) prophylaxis, but perhaps that was overly optimistic. We provide VTE prophylaxis to nearly every patient in the ICU.  Consequently, even tiny changes in our VTE prophylaxis […]

Acute Eosinophilic Pneumonia is rare, but it definitely happens.  It typically causes relatively rapid-onset ARDS, frequently leading to mechanical ventilation.  Prompt recognition is critical, because AEP responds beautifully tosteroid therapy. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes  

Acute on Chronic Liver Failure (ACLF) refers to decompensated cirrhosis causing failure of at least two organs (e.g. hepatic encephalopathy, hepatorenal syndrome, shock, or respiratory failure).  It may be useful to conceptualize these patients as having ACLF (rather than, for example, hepatic encephalopathy plus hepatorenal syndrome), because this provides a more accurate global understanding of […]

A fresh preprint reveals the results of combining three trials to evaluate therapeutic anticoagulation among severe COVID patients (defined as patients requiring high flow nasal cannula, noninvasive ventilation, intubation, vasopressors, or inotropes).  Patients were randomized to therapeutic anticoagulation versus thromboprophylaxis per usual care guidelines.  REMAP-CAP also simultaneously randomized some patients to receive aspirin as well.  […]