PulmCrit (EMCrit)

It’s impossible to get through a single shift in the ICU without encountering several patients experiencing pain.  Controlling pain is easy – but controlling pain while limiting collateral side-effects can be a challenge.  Anesthesiologists have pioneered the best approaches here, which often involve multimodal combinations of various medications carefully titrated to effect.  Although intensivists may […]

Inhaled pulmonary vasodilators are generally quite safe.  They offer a variety of physiologic benefits to patients with cardiopulmonary failure, including improved oxygenation and right ventricular function.  Unfortunately, like so many interventions in critical care, there is a dearth of large, multi-center RCTs proving patient-centered benefit.  This chapter attempts to sift through available evidence, in efforts […]

Hyperosmolar Hyperglycemic State (previously known as “Hyperosmolar Hyperglycemic Nonketotic Syndrome” and, before that, “Hyperosmolar Hyperglycemic Nonketotic Coma”) is a bit of a slippery animal.  Despite being redefined several times, the precise definition remains elusive.  This may cause it to be over-diagnosed in anyone with severe hyperglycemia.  The treatment likewise remains a bit controversial, with different […]

Guillain-Barre Syndrome is the most common cause of acute-onset neuromuscular weakness requiring ICU admission.  COVID-19 appears to be one trigger of Guillain-Barre Syndrome, so this might be even more common in the coming months.  There isn’t much high-quality evidence regarding respiratory support in Guillain-Barre Syndrome, particularly when intubation is indicated.  Consequently, it’s important to use […]

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