PulmCrit (EMCrit)

Metformin poisoning and lactic acidosis has always been murky.  For years there was debate about whether metformin-induced lactic acidosis exists (short answer:  it obviously does).  However, for an individual patient, it can still be confusing sorting out the contribution of metformin to their critical illness.  A recent re-definition of the condition clarifies things a bit, but substantial confusion persists regarding how to diagnose and treat these patients.  

Recently the concept of extracorporeal CO2 removal has become somewhat popular, with a goal of facilitating ultra low-tidal volume ventilation.  Might there be other means to achieve the same goal?  Let’s start with some basic concepts of mechanical ventilation… Fundamental unanswered questions Permissive hypercapnia refers to the concept of allowing the pCO2 level to increase […]

Emerging evidence shows that there is no such thing as a “penicillin allergy” or “cephalosporin allergy.”  Instead, cross-allergic reactions are restricted to much smaller groups of antibiotics that share greater structural similarity.  This opens the door to using beta-lactam antibiotics safely in patients who have had an allergic reaction to one or more of these drugs.

Preeclampsia is among the most commonly encountered obstetric emergencies.  Definitions and optimal therapies have changed significantly over the past few years.  Although specialists in Obstetrics will invariably be involved in these cases, all resuscitationists need to have a firm grasp of this topic. The optimal therapies for preeclampsia remain controversial.  For example, the International Society […]

Verigene is a nucleic acid micro-array which can be used to provide rapid information about positive blood cultures.  The array detects genetic information which may reveal the genus/species of bacteria and the presence of various resistance genes.