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

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cardiology

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Arrhythmia

• Atrial fibrillation & flutter
• Bradycardia
  • BRASH syndrome
• Ventricular tachycardia:
  • Monomorphic VT/VF 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)
• RV failure due to pulmonary hypertension

Shock

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

Vasopressors

⇒ more cardiology at PulmCrit

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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

⇒ more endocrinology at PulmCrit

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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
• Hepatorenal syndrome
• Spontaneous bacterial peritonitis

Nutrition

• Critical care nutrition
• Gastroparesis
• Refeeding syndrome

Pancreatitis

• Acute pancreatitis
• Hypertriglyceridemic pancreatitis

⇒ more gastroenterology at PulmCrit

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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)
• 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)

⇒ more heme/onc at PulmCrit

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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)

⇒ more infectious diseases at PulmCrit

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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

⇒ more nephrology at PulmCrit

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neurology

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General

• Approaches to common problems
  • Delirium
  • Stupor & Coma
  • Status epilepticus
  • ICP elevation
  • Brain death
• Therapeutics
  • Analgesia for the critically ill patient
  • Antiemetics
  • Sedating the intubated patient

Anoxic brain injury

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

Infectious / inflammatory

• Autoimmune encephalitis
• Meningitis & viral encephalitis

Neuromuscular weakness

• Myasthenic crisis
• Guillain-Barre Syndrome (GBS)

Toxic / metabolic

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

Traumatic

• Traumatic Brain Injury (TBI)
• Paroxysmal sympathetic hyperactivity

Vascular / hypoperfusion

• Acute Ischemic Stroke (AIS)
• Cerebral venous thrombosis
• Hemorrhage
  • Intracranial hemorrhage
  • Subarachnoid hemorrhage (SAH)
• Vascular tone abnormality
  • PRES (Posterior Reversible Encephalopathy Syndrome)
  • RCVS (Reversible Cerebral Vasoconstriction Syndrome)

⇒ more neurology at PulmCrit

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obstetrics

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• Preeclampsia & HELLP syndrome
• Thrombotic microangiopathy in pregnancy

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pulmonology

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General

• Diagnostics
  • Capnography and end-tidal CO2
  • Diagnosis of acid-base disorders
• Approaches to common problems
  • ARDS
  • Hemoptysis
  • Respiratory acidosis (hypercapnia)
  • Respiratory alkalosis (hypocapnia)
• Therapeutics
  • Extubation
  • Inhaled pulmonary vasodilators
  • Noninvasive respiratory support (CPAP, BiPAP, HFNC)

Airway disorders

• Asthma
• COPD exacerbation
• Vocal cord dysfunction

Cardiovascular & Pulmonary vascular

• PE (submassive & massive)
• RV failure due to pulmonary hypertension
• SCAPE (Sympathetic Crashing Acute Pulmonary Edema)
• Sickle cell acute chest syndrome

Infectious

• Aspergillosis, invasive
• Candidia pneumonia
• Community-Acquired Pneumonia (CAP)
• COVID-19
• Influenza
• Pneumocystis jiroveci pneumonia (PJP)
• Ventilator-associated pneumonia (VAP)

Inflammatory & interstitial lung diseases

• Acute Eosinophilic Pneumonia (AEP)
• Diffuse alveolar hemorrhage & pulmonary vasculitis

Neuromuscular weakness

• Guillain-Barre Syndrome (GBS)
• Myasthenic crisis

⇒ more pulmonology at PulmCrit

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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

⇒ more rheumatology at PulmCrit

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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
• 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

⇒ more toxicology at PulmCrit