CONTENTS Introduction Early brain death is (still) death Prognostic value of historical information Confounding factors & hypothermia Timing & serial evaluation Prognostic tests Neurological examination EEG EEG background Findings superimposed on the background Myoclonus SSEPs (Somatosensory evoked potentials) CT scan Qualitative CT scan Quantitative CT scan MRI Neuron-specific enolase Multimodal prognostication Related topics Delayed post-hypoxic […]
Search Results for: acid base
EMCrit 296 – The French Connection, Part 1 – Resuscitation Geography, Logistics, & Ergonomics
A new series on the philosophy and psychology of resuscitation…
The New Elaine Bromiley Videos
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Bronchiolitis
CONTENTS Constrictive bronchiolitis: Bronchiolitis obliterans Epidemiology Clinical presentation Radiology Pulmonary function tests Bronchoscopy Diagnostic criteria Treatment DIPNECH (diffuse idiopathic pulmonary neuroendocrine cell hyperplasia) Cellular bronchiolitis: Aspiration bronchiolitis Diffuse panbronchiolitis Infectious bronchiolitis ➡️ RBILD (Respiratory bronchiolitis interstitial lung disease) ➡️ Follicular bronchiolitis ➡️ Questions & discussion abbreviations used in the pulmonary section: 2 ABPA: Allergic bronchopulmonary aspergillosis […]
PulmCrit – Myth-busting the conditional nephrotoxicity of piperacillin-tazobactam
Most medical myths arose decades ago, prior to the era of modern evidence-based medicine. When investigating the origin story of those myths, we wind up reading grainy old papers from the 1950s. Surely, we think, such myths wouldn’t arise today – not in our shiny, interconnected, science-based, hyper-argumentative medical world. Unfortunately, new myths do continue […]
Understanding lactate in sepsis & Using it to our advantage
Introduction with a case 0 Once upon a time a 60-year-old man was transferred from the oncology ward to the ICU for treatment of neutropenic septic shock. Over the course of the morning he started rigoring and dropped his blood pressure from 140/70 to 70/40 within a few hours, refractory to four liters of crystalloid. […]
Thrombocytopenia
CONTENTS Rapid Reference 🚀 Overview & definition Differentials Overall classification of thrombocytopenia in the ICU Clinical clues & specific situations Investigation of thrombocytopenia Platelet transfusion Additional comments on specific causes of thrombocytopenia: Drug-induced immune thrombocytopenia (D-ITP) Transfusion related thrombocytopenia Heparin-Induced Thrombocytopenia Podcast Questions & discussion Pitfalls approach to thrombocytopenia in critical illness ✅ investigations (more) […]
Immune-related adverse events from checkpoint inhibitors
CONTENTS Rapid reference 🚀 Introduction to checkpoint inhibitors Core principles of immunotherapy-related adverse events Immune-related adverse events in the ICU Specific organ-system involvement Cardiac Pneumonitis Colitis Hepatitis Nephritis Endocrine Neurologic Hematologic Dermatologic Podcast Questions & discussion Pitfalls basic tests to consider in critically ill patient s/p checkpoint inhibitor (more) Labs: CBC with differential, electrolytes. Coagulation […]
Hypophosphatemia
CONTENTS Rapid Reference 🚀 Phosphate physiology Symptoms Phosphate level Causes of hypophosphatemia Investigation of etiology Treatment Podcast Questions & discussion Pitfalls phosphate basics 99% of phosphate is present within cells. Symptoms from phosphate deficiency result from intracellular phosphate deficiency. Unfortunately, we can measure only extracellular phosphate levels. This creates some variability among patients with hypophosphatemia: […]
Sarcoidosis
CONTENTS Basics Epidemiology Pulmonary sarcoidosis Clinical presentation Radiographic staging (Scadding stage) Chest CT scan Lymphadenopathy ➡️ Nonfibrotic parenchymal abnormalities Fibrotic parenchymal abnormalities Necrotizing sarcoid granulomatosis Pulmonary function tests Reduced DLCO Restriction Obstruction Pleural involvement Pulmonary hypertension Large airway involvement Treatment of pulmonary sarcoid Approach to sarcoidosis patient with cardiopulmonary deterioration Extrapulmonary sarcoidosis Skin Erythema nodosum […]
PulmCrit- Ketamine for alcohol withdrawal?
Recent publications have explored the role of ketamine in alcohol withdrawal. Ketamine undoubtedly has some outstanding properties, which make it well suited for this task. The challenge is integrating ketamine into a unified, coherent treatment strategy.
Thoracic Radiology – Septal thickening & reticular patterns
CONTENTS Septal thickening Nodular septal thickening Crazy paving Fibrosis (including honeycombing) Questions & discussion abbreviations used in the pulmonary section AE-ILD: Acute exacerbation of ILD 📖 AIP: Acute interstitial pneumonia (Hamman-Rich syndrome) 📖 ANA: Antinuclear antibody 📖 ANCA: Antineutrophil cytoplasmic antibodies 📖 ARDS: Acute respiratory distress syndrome 📖 ASS: Antisynthetase Syndrome 📖 BAL: Bronchoalveolar lavage […]
Approach to CNS infection
CONTENTS Infectious disease history Clinical syndromes Blood tests to consider Lumbar puncture (LP) Test to obtain & opening pressure Normal CSF & CSF patterns Specific CSF tests: CSF erythrocytes CSF differential cell count CSF protein CSF glucose CSF lactate CSF microarray (e.g., BioFire) Lumbar puncture & coagulopathy Specific risk groups Patients status post transplantation Patients […]
PulmCrit – Awake Proning for COVID-19
Recently, many on twitter have been engaged in a furious debate about how to ventilate patients with COVID-19. Is it ARDS or not? High PEEP or low PEEP?… As an intensivist, these issues are near and dear to my heart. However, the truth is that humble methods to keep patients off invasive ventilation altogether are […]
Antibiotics
CONTENTS commonly used antibiotics Aminoglycosides Ampicillin & Ampicillin-Sulbactam Aztreonam Carbapenems (meropenem & ertapenem) Cephalosporins Cephalosporin G1: cefazolin Cephalosporin G3: ceftriaxone Cephalosporin G3: ceftazidime Cephalosporin G4: cefepime Cephalosporin G5: ceftaroline Clindamycin Daptomycin Doxycycline Fluoroquinolones Linezolid Macrolides (Azithromycin, Clarithromycin) Metronidazole Nafcillin Nitrofurantoin Penicillin G Piperacillin-Tazobactam Rifampin Tigecycline Trimethoprim-Sulfamethoxazole Vancomycin specific pathogens Antibiogram & 1st line agents by […]
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