Lithium intoxication is a tricky issue, with a variety of different forms which may call for different therapies (acute, chronic, or acute-on-chronic intoxication). To further complicate matters, the pathophysiology of lithium toxicity isn’t understood – particularly, how lithium levels might relate to chronic neurotoxicity (SILENT syndrome). Finally, as is often the case in toxicology, there […]
IBCC chapter & cast – Stress hyperglycemia in the ICU
Glycemic control in the ICU is a topic of perpetual controversy. We’ve come full circle in the past 20 years – beginning with permissive hyperglycemia, then moving to tight control, and finally now moving back to permissive hyperglycemia. The final answer remains unknown, but in the interim this chapter attempts to muddle through available evidence. […]
IBCC chapter & cast – Wernicke encephalopathy
Wernicke encephalopathy is important because it’s surprisingly common, potentially debilitating, and fully treatable. Some patients may present to the hospital due to Wernicke encephalopathy, while many others may develop this while in the ICU as an iatrogenic complication of criical care. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow […]
IBCC chapter & cast – Valproic Acid Intoxication
Valproic acid poisoning is fortunately uncommon. However, this is a potentially lethal and rather complex intoxication. Management spans the gamut from decontamination and dialysis, to various metabolic manipulations. With an aggressive and organized approach, most patients will do extremely well. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us […]
IBCC chapter & cast – BRASH syndrome
BRASH syndrome refers to a vicious spiral wherein hyperkalemia and AV nodal blockers synergize to cause progressive renal failure, bradycardia, shock, and hyperkalemia. The treatment is largely a combination of standard therapies for hyperkalemia and bradycardia. Recognizing this syndrome as a specific entity may help us more fully understand our patients’ physiology, facilitating a more […]
IBCC chapter & cast – Hemophagocytic LymphoHistiocytosis (HLH)
Intensivists have long been struggling with the enigma of hemophagocytic lymphohistiocytosis (HLH). For example, this post from 2016 explores the challenge of dissecting HLH away from septic shock. The COVID pandemic has drawn some attention to the topic, although it’s not clear to what extent COVID might truly reflect HLH. This chapter attempts to lay […]
IBCC chapter & cast – Gastrointestinal hypomotility in critical care
Critical illness leads to a variety of gastrointestinal motility problems (largely due to the constellation of immobility, medications, and metabolic abnormalities). Although these topics don’t generally attract much interest, maintaining adequate bowel motility is essential to avoid iatrogenic harm. The chapter on gastroparesis is located 👉 here. The chapter on ileus is located 👉 here. […]
IBCC chapter & cast – Cerebral Venous Thrombosis
Cerebral vein thrombosis is a neurological emergency with a frequency similar to meningitis. We don’t often think about this, but we probably should. With early diagnosis and appropriate management, outcomes are often very good (making this one of the most treatable forms of stroke). The IBCC chapter is located 👉 here. The podcast & comments […]
IBCC chapter & cast – Hypertriglyceridemic Pancreatitis
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 […]
IBCC chapter & cast – Antifungal agents
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 […]
IBCC chapter & cast – Nausea & antiemetics
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 […]
IBCC chapter & cast – Analgesia for the critically ill patient
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 […]
IBCC chapter & cast – Inhaled Pulmonary Vasodilators
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 […]
IBCC chapter & cast – Hyperosmolar Hyperglycemic State
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 […]
IBCC chapter & cast: Guillain-Barre Syndrome
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 […]
- « Previous Page
- 1
- …
- 7
- 8
- 9
- 10
- 11
- …
- 34
- Next Page »