0 Introduction 0 In 1998 Figge reported a strong linear relationship between anion gap and albumin concentration, which has led to the widespread recommendation to correct anion gap for albumin. It was proposed that since albumin is an anion, failing to correct for a low albumin level could allow an anion-gap acidosis to go undetected. […]
Mythbusting: Heparin isn’t beneficial for noninvasive management of NSTEMI
Introduction 0 The use of heparin for noninvasive management of non-ST elevation MI (NSTEMI) is one of the most deeply entrenched myths of modern medicine. Although heparin reduces reinfarction, when it is discontinued there is a rebound in infarction rates. Ultimately, short-term treatment with heparin delays reinfarction without having any sustained benefit. Clinical trials which fail […]
10 Pearls from the Levitan Airway Course
0 Introduction 0 Last week I attended Dr. Levitan’s airway course in Baltimore. It was a teriffic course, which I would recommend to anyone looking to improve their airway management skills. For those of you unable to attend the course, here are some points which were particularly interesting to me. 0 Pearl #10. Respect the […]
Early norepinephrine to stabilize MAP in septic shock
0 Introduction 0 With publication of the PROCESS and ARISE trials, many hemodynamic goals are being disproven. There is a growing tide of nihilism. Should we should just give septic patients a couple bags of fluid, some antibiotics, and hope for the best? 0 Probably not. PROCESS and ARISE have showed us what we can […]
Myth-busting: Lactated Ringers is safe in hyperkalemia, and is superior to NS.
Introduction 0 Several months ago I gave a grand rounds on pH-guided resuscitation which was summarized in this post. This included a discussion that Lactated Ringers (LR) is safe in hyperkalemia. However, myth-busting is hard work. The dogma that LR should be avoided in hyperkalemia continues to replicate, both locally and on twitter. This […]
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