SYSTEMS

• Cardiology
• Endocrinology
• Gastroenterology
• Hematology & Oncology
• Infectious diseases
• Nephrology
• Neurology
• Obstetrics
• Pulmonology
• Rheumatology
• Toxicology & Temperature

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intro

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• Overview: Guide to supportive care in critical illness
• About this book
• How to create your own IBCC smartphone app 📲

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cardiology

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Arrhythmia

• Atrial fibrillation & flutter
• Bradycardia
  • BRASH syndrome
• Ventricular tachycardia:
  • Monomorphic VT storm
  • Torsade de pointes

Endocarditis

LV failure

• SCAPE (Sympathetic Crashing Acute Pulmonary Edema)
• Cardiogenic shock & severe heart failure
• LV outflow tract obstruction (LVOTO)
• Takotsubo syndrome

Hypertensive emergency

MI

• MI (type I)
• Post-MI complications
• Troponin elevation in non-cardiac critical illness

Pericardial tamponade

Post arrest

• Post-cardiac arrest management
• Neurologic prognostication

RV failure

• Pulmonary embolism (PE)
• Right ventricular failure

Shock

• Undifferentiated shock
• Cardiogenic shock due to LV or BiV failure
• Shock due to RV failure
• Septic shock

Vasopressors

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endocrinology

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Adrenal crisis

Glucose & insulin

• Diabetic ketoacidosis (DKA)
• Hyperglycemic Hyperosmolar State (HHS)
• Glycemic control in the ICU
• Hypoglycemia

Thyroid

• ⬆️ Thyroid Storm
• ⬇️ Decompensated Hypothyroidism

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gastroenterology

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Abdominal compartment syndrome

Biliary

• Acalculous cholecystitis
• Community-acquired biliary sepsis (ascending cholangitis & calculus cholecystitis)

GI hemorrhage

Intestine

• Nausea & antiemetics
• C. difficile
• Motility disorders
  • Gastroparesis
  • Ileus
  • Colonic pseudoobstruction (Oglivie's syndrome)

Liver

• Acute Liver Failure (ALF)
• Acute on Chronic Liver Failure (ACLF)
• Alcoholic hepatitis
• Coagulopathy in liver failure
• Hepatic encephalopathy:
  • In chronic liver failure
  • In acute liver failure
• Hepatorenal syndrome (HRS-AKI)
• Spontaneous bacterial peritonitis (SBP)

Nutrition

• Critical care nutrition
• Gastroparesis
• Refeeding syndrome

Pancreatitis

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heme/onc

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Anemia & transfusion

• Anemia & hemoglobin transfusion targets
• Massive Transfusion Protocol (MTP)
• Sickle cell anemia – acute chest syndrome

Anticoagulation, therapeutic

• Anticoagulant reversal
• Parenteral anticoagulants (heparin, fondaparinux, argatroban, bivalirudin)

Coagulopathy

• Coagulation studies (conventional & TEG)
• Coagulopathy in liver failure
• Disseminated intravascular coagulation (DIC)
  • Purpura fulminans

Malignancy

• Acute promyelocytic leukemia (APL)
• CAR-T cell recipient
• Immune-related adverse events from checkpoint inhibitors
• Tumor lysis syndrome

Thrombocytopenia

• Thrombocytopenia
• Catastrophic Antiphospholipid Syndrome (CAPS)
• Hemophagocytic lymphohistiocytosis (HLH)
• Thrombotic microangiopathies (including TTP and HUS)

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infectious diseases

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General approach

• Allergy to beta-lactam antibiotics
• Antimicrobial:
  • Antibiotics
  • Antifungal agents
• Approach to fever in the ICU
• Septic shock

Specific infections

• Biliary sepsis (ascending cholangitis & calculus cholecystitis)
• Candidiasis
• C. difficile
• COVID-19
• Endocarditis
• Epiglottitis
• Influenza
• Line infection
• Meningitis & encephalitis
• Necrotizing fasciitis
• Pneumonia
  • Aspergillosis, invasive
  • Candidia pneumonia
  • Community-Acquired Pneumonia (CAP)
  • Influenza
  • Pneumocystis jiroveci pneumonia (PJP)
  • Ventilator-associated pneumonia (VAP)
• Spontaneous bacterial peritonitis
• Tickborne illnesses
• Toxic Shock Syndrome
• Urologic
  • Community-acquired urosepsis
  • Catheter-associated UTI (CAUTI)

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nephrology

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Acid-base disorders

• Diagnosis: approach to pH analysis
• Metabolic acidosis
  • AGMA (Anion-Gap Metabolic Acidosis)
  • NAGMA (Non-Anion-Gap Metabolic Acidosis)
• Metabolic alkalosis
• Respiratory acidosis (hypercapnia)
• Respiratory alkalosis (hypocapnia)

Acute kidney injury

• AKI & oliguria
• Hepatorenal syndrome
• Rhabdomyolysis
• Tumor lysis syndrome
• Contrast nephropathy myth

Electrolytes

• Sodium
  • Hypernatremia
  • Hyponatremia
• Potassium
  • Hypokalemia
  • Hyperkalemia
  • BRASH syndrome
• Calcium
  • Hypocalcemia
  • Hypercalcemia
• Magnesium
  • Hypomagnesemia
  • Hypermagnesemia
• Phosphorous
  • Hypophosphatemia
  • Hyperphosphatemia

Fluids & diuretics

• Fluid selection & pH-guided resuscitation
• Deresuscitation: Dominating the diuresis

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neurology

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General

• Approaches to problems:
  • Delirium
  • Stupor & Coma
  • ICP elevation
  • Brain death
  • Neuro emergencies in pregnancy
• Diagnostics
  • EEG
  • Neuro exam & lesion localization
  • Neuroimaging
  • Neuro-ultrasonography
• Therapeutics
  • Analgesia and sedation
  • Antiemetics

Anoxic brain injury

• Management of the post-cardiac arrest patient
• Neuroprognostication after anoxic brain injury

Effects on other organ systems

• Central (neurogenic) fever
• Takotsubo (stress) cardiomyopathy
• Neurogenic pulmonary edema

Infectious diseases

• Approach to CNS infection
• Sites of infection
  • Meningitis/encephalitis
  • Brain abscess
  • Spinal Epidural Abscess (SEA)
• Specific pathogens
  • Viruses
  • Neurological complications of COVID
  • Fungi
  • Unusual bacteria & mycobacteria
  • Parasites & prions

Inflammatory

• Autoimmune encephalitis
• Acute demyelinating disorders

Movement disorders

• Movement disorders
• Baclofen withdrawal & toxicity
• Catatonia
• Serotonin Syndrome
• Malignant hyperthermia
• Neuroleptic Malignant Syndrome

Neuromuscular weakness

• Neuromuscular disorders & generalized weakness
• Guillain-Barre Syndrome (GBS)
• Myasthenic crisis
• Rhabdomyolysis

Neurosurgery

• External Ventricular Drain (EVD)
• Post-craniectomy management & complications

Oncological

• Neuro-oncology emergencies
• ICANS (CAR-T cell toxicity)
• Leptomeningeal carcinomatosis

Seizures

• Convulsive status epilepticus
• EEG & Ictal-Interictal Continuum (IIC)
• Nonconvulsive status epilepticus (NCSE)

Spinal Cord

• Spinal cord disorders
• Spinal Epidural Abscess (SEA)
• Traumatic Spinal Cord Injury (SCI)

Toxic / metabolic

• Alcohol withdrawal
• Wernicke encephalopathy
• (More on toxicology 👇 below)

Traumatic

• Traumatic Brain Injury (TBI)
• Paroxysmal sympathetic hyperactivity (PSH)
• Spinal Cord Injury (SCI)

Vascular

• Occlusion
  • Acute Ischemic Stroke (AIS)
  • Cerebral Venous Thrombosis (CVT)
  • Cervical artery dissection (carotid & vertebral)
• Hemorrhage
  • Intracranial hemorrhage
  • Subarachnoid hemorrhage (SAH)
• Vascular tone abnormality
  • PRES (Posterior Reversible Encephalopathy Syndrome)
  • RCVS (Reversible Cerebral Vasoconstriction Syndrome)

Appendix

• Index of the IBNCC
• About the IBNCC

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obstetrics

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• Neurological emergencies in pregnancy
• Preeclampsia & HELLP syndrome
• Thrombotic microangiopathy in pregnancy

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pulmonology

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General 🫁

• Approaches to common problems
  • 🔜 Approach to pulmonary infection
  • ARDS
  • CO2 abnormality: Hypercapnia and Hypocapnia
  • 🔜 DPLD (diffuse parenchymal lung disease)
  • 🔜 Eosinophilic lung disease
  • Hemoptysis and DAH (diffuse alveolar hemorrhage)
  • SCAPE (Sympathetic Crashing Acute Pulmonary Edema)
• Diagnostics
  • 🔜  Diagnosis in pulmonology
  • ABG, VBG, and pulse oximetry
  • Capnography and end-tidal CO2
  • Diagnosis of acid-base disorders
  • 🔜  Pulmonary function tests (PFTs)
• Radiology
  • 🔜 Approach to thoracic imaging
  • 🔜 Atelectasis
  • 🔜 Cavitary lung disease
  • Consolidation
  • 🔜 Cystic lung disease
  • 🔜 Distribution of abnormalities
  • GGO (ground glass opacification)
  • 🔜 Lymphadenopathy
  • 🔜 Nodular patterns
  • 🔜 Reticular patterns
• Therapeutics
  • Extubation
  • Inhaled pulmonary vasodilators
  • Noninvasive respiratory support (CPAP, BiPAP, HFNC)
  • 🔜 Lung transplantation

Airway disorders 🫁

• 🔜 Upper airway disease
  • Vocal cord dysfunction
  • 🔜 Aspiration
• 🔜 Bronchiectasis & 🔜 Cystic fibrosis
• 🔜 Bronchiolitis
• 🔜 Asthma & Critical asthma exacerbation
• 🔜 COPD & Critical COPD exacerbation

Exposures

• 🔜 Aspiration
• 🔜 Drug-induced lung disease
• EVALI (E-cigarette or vaping associated lung injury)
• Fat emboli syndrome
• 🔜 Pneumoconiosis

Infectious 🫁

• Clinical infectious syndromes
  • 🔜 Approach to pulmonary infection
  • CAP (community acquired pneumonia)
  • 🔜 HAP (hospital acquired pneumonia)
  • VAP (ventilator associated pneumonia)
  • 🔜 Lung abscess
• Bacteria
  • 🔜 Bacteria
  • 🔜 Atypical bacteria
  • 🔜 Nocardia
  • 🔜 Actinomycosis
• Mycobacteria
  • 🔜 Tuberculosis
  • 🔜 Non-tuberculous mycobacteria
• Fungi
  • Pneumocystis
  • 🔜 Cryptococcus
  • Endemic mycoses
    • 🔜 Blastomycosis
    • 🔜 Histoplasmosis
    • 🔜 Cocciodomycosis
  • Mold
    • Aspergillosis, invasive
    • 🔜 Mucormycosis
  • Candida
• Viral
  • COVID-19
  • Influenza
  • 🔜 Other viruses

Interstitial lung diseases 🫁

• Approach:
  • 🔜 Approach to diffuse parenchymal lung disease (DPLD)
  • 🔜 Acute exacerbation of ILD
• 🔜 Amyloidosis
• 🔜 CT-ILD (connective tissue-related ILD)
• 🔜 DAD (diffuse alveolar damage)
• 🔜 DIP (desquamative interstitial pneumonitis)
• 🔜 Eosinophilic lung disease
  • Acute Eosinophilic Pneumonia (AEP)
• 🔜 GLILD (granulomatous & lymphocytic ILD)
• 🔜 HP (hypersensitivity pneumonitis)
• 🔜 IgG4-related lung disease
• 🔜 IPF (idiopathic pulmonary fibrosis)
• 🔜 LIP (lymphocytic interstitial pneumonia)
• 🔜 Lipoid pneumonia
• 🔜 NSIP (nonspecific interstitial pneumonia)
• OP (organizing pneumonia)
• 🔜 PAP (pulmonary alveolar proteinosis)
• 🔜 PAM (pulmonary alveolar microlithiasis)
• 🔜 PPFE (pleuroparenchymal fibroelastosis)
• 🔜 RBILD (respiratory bronchiolitis ILD)
• 🔜 Sarcoidosis

Malignant 🫁

• 🔜 Lung cancer
• 🔜 Lymphoproliferative disorders
• 🔜 Pulmonary complications from malignancy

Neuromuscular weakness 🫁

• Neuromuscular disorders
• Guillain-Barre Syndrome (GBS)
• Myasthenic crisis

Pleural 🫁

• 🔜 Pleural effusion
• Air:
  • 🔜 Pneumomediastinum
  • 🔜 Pneumothorax & bronchopleural fistula

Vascular 🫁

• Pulmonary embolism
  • 🔜 Diagnosis of PE & tx of low-risk PE
  • Submassive/massive PE
• Pulmonary hypertension
  • 🔜 Pulmonary hypertension
  • RV failure
• Pulmonary vasculitis & Diffuse alveolar hemorrhage
• 🔜 Pulmonary AVMs & other vascular abnormalities
• Sickle cell acute chest syndrome
• 🔜 Superior vena cava syndrome (SVCs)

Other 🫁

• 🔜 Pulmonary manifestations of systemic diseases
• 🔜 Pregnancy-related respiratory disease
• 🔜 Sleep-disordered breathing

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rheumatology

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Allergy

• Allergy to beta-lactam antibiotics
• Anaphylaxis
• Angioedema

Inflammatory

• Catastrophic Antiphospholipid Syndrome (CAPS)
• Hemophagocytic lymphohistiocytosis (HLH)
• Pulmonary vasculitis

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tox & temp

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Basic toxicology

• Approach to the poisoned patient
• Dysthermias:
  • Hyperthermia
  • Hypothermia

Common intoxications & withdrawals

• Acetaminophen
• Alcohol et al.
  • Alcohols, toxic (ethylene glycol & methanol)
  • Alcohol withdrawal
  • Wernicke encephalopathy
• Anticholinergics
• Baclofen withdrawal & toxicity
• Beta-blockers
• Bupropion
• Calcium channel blockers
• Carbon monoxide
• Digoxin
• Lithium
• Local Anesthetic Systemic Toxicity (LAST)
• Malignant hyperthermia
• Metformin-associated lactic acidosis (MALA)
• Methemoglobinemia
• Neuroleptic Malignant Syndrome (NMS)
• Opioid
  • Opioid intoxication
  • Opioid withdrawal & buprenorphine
• Salicylate
• Serotonin Syndrome
• Sodium channel blockers
• Sympathomimetics
• Tricyclic antidepressants
• Valproic Acid