PulmCrit (EMCrit)

For centuries, medical experts practiced bloodletting for a variety of ailments. This was widely believed to rid the body of evil humors. When patients didn’t respond well, this was believed to reflect an inadequate or delayed bloodletting. Practitioners competed to see who could partake in the most rapid and aggressive bloodletting.

Hepatic encephalopathy is a common cause of ICU admission, as well as a common complication of ICU admission for other indications (e.g. gastrointestinal hemorrhage).  At first the intubated patient with hepatic encephalopathy may seem a bit bewildering (will they ever wake up??).  However, an organized and aggressive strategy combined with some patience is generally sufficient […]

introduction The neutrophil/lymphocyte ratio (NLR) has been gaining increasing attention across many fields of medicine within the past five years.  Currently, there are 2,230 publications about this in PubMed, mostly within the past few years.  This post will attempt to create a framework for understanding this ratio. overview definition & physiology The NLR is simply […]

Background Kimberly Blumenthal and colleagues at the Massachusetts General Hospital have been performing groundbreaking work on beta-lactam allergies.  Their work forms the foundation for much of the IBCC chapter on beta-lactam allergies (you might want to read it before this post, but if you don’t have time, a one-minute synopsis is below). One fundamental technique […]

Before writing this chapter I though I understood rhabdomyolysis fairly well.  I had treated many cases, read about it in a few books, and heard a lecture or two on it.  However, writing this chapter has forced me to realize that I didn’t really understand rhabdo well at all.  This disease is generally poorly understood, […]