PulmCrit (EMCrit)

Hypertriglyceridemia is responsible for about ~10% of pancreatitis episodes seen in critical care.  The management of this entity is highly variable, due to a lack of high-quality evidence.  Approaches range from extremely aggressive (e.g. plasmapheresis) to more conservative therapy (e.g. subcutaneous insulin).  This chapter attempts to unpack the physiology and evidence underlying this diagnosis, with […]

Fungal infections are becoming common among critically ill patients, as our patient population is increasingly complex and more frequently immunosuppressed.  Traditional curricula often focus on antibacterial agents rather than antifungals, leaving antifungal agents shrouded in a sense of mystery.  Antifungals actually aren’t that tricky though, as there is a very limited number of them. The […]

Enormous attention is committed to the control of pain, with much less being directed to the control of nausea.  However, nausea and vomiting can be even more distressing than pain.  By understanding the receptor pharmacology of various antiemetics, a rational and effective approach is possible. The IBCC chapter is located here. The podcast & comments […]

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 […]