Spend any time in the NeuroICU and you will encounter an abundance of ADH.
IBCC – Right Ventricular failure due to pulmonary hypertension
Right ventricular failure is extremely common among critically ill patients (e.g., affecting a quarter of patients with ARDS). Unfortunately, this is often overlooked in critical care curricula. We tend to spend lots of time focusing on pulmonary arterial hypertension (which is far more rare), thereby overlooking the everyday conundrum of right ventricular failure. It’s called […]
EMCrit 305 – Post-Cardiac Arrest Hypothermia (or not) – TTM2 Synthesis with Niklas Nielsen and Josef Dankiewicz
The TTM2 trial changes game for post-cardiac arrest management. I am joined today with the study’s authors to discuss this amazing paper.
IBCC – Liberation from invasive ventilation
Liberation from invasive ventilation is one of the most important goals of critical care medicine. Numerous RCTs have improved our understanding of this process, but it remains as much an art as a science. When in doubt, empirical trials of spontaneous breathing and extubation are more accurate than our predictive ability. The IBCC chapter is […]
EMCrit Wee – Breaking News on Fluid Choice and Rate – The BaSICS Trial
BaSICs Trial Results on Fluid Choice and Rate of Administration
PulmCrit Wee – Patient with nonfocal exam and thrombocytopenia
The case: A ~65 year-old human presents to the ICU with a working diagnosis of vasopressor-dependent septic shock. The patient was previously healthy with no significant medical problems or medications. History is notable for mild nonspecific symptoms (chills, nausea, and a headache), with nothing in particular standing out. Physical examination is unrevealing, with the patient […]
IBCC – Respiratory alkalosis & respiratory acidosis
It’s very difficult to write a good chapter about respiratory alkalosis (hypocapnia) or respiratory acidosis (hypercapnia). These states remind me a bit of grand central station, because each encompasses such a broad range of patients with different conditions – who need enormously different treatments. So any discussion of these conditions is by definition a gross […]
EMCrit 304 – Cerebral Venous Thrombosis (CVT)
Atypical headache=SAH w/u right? Except sometimes it is CVT. This is a critical diagnosis to make and to treat properly. Today I interview @caseyalbin on EMCrit 304 – cerebral venous thrombosis
PulmCrit – Is piperacillin-tazobactam safe in patients with penicillin allergy?
Historically it was believed that allergic reactions could be mediated by the core structures. This would imply that a patient could be allergic to all penicillins, all cephalosporins, or even all beta-lactams. That would be hugely problematic, because a patient could simultaneously be allergic to dozens of antibiotics – greatly complicating their management.
EMCrit 303 – A Bounceback Case with Mike Weinstock
A case from the new book by Mike Weinstock and a case of near-death after trauma
IBCC – Neuroprognostication after cardiac arrest
Neuroprognostication following cardiac arrest is one of the most important responsibilities of the ICU team. This process begins as soon as ROSC is achieved, with the avoidance of confounding factors (e.g., sedatives and opioids). An organized, multimodal approach is essential. Incidentally, strategies which are aimed at accurate neuroprognostication will also facilitate early awakening – and as […]
EMCrit 302 – Pain Management Update with Sergey Motov
An update on opioids and pain
IBCC – Subarachnoid Hemorrhage
Subarachnoid hemorrhage remains a challenging disease, with ongoing controversy surrounding several key aspects (including the optimal diagnostic pathway and management of vasospasm). The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes
EMCrit 301 – The Five Fears with Rob Orman (Mind of the Resuscitationist)
We need to carry fear, but we do not need to be afraid…
IBCC – Traumatic Brain Injury (TBI)
Traumatic brain injury is an extremely common problem, which is likely to be encountered in any type of intensive care unit. Management is predominantly supportive, illustrating many principles of neurocritical care. The IBCC chapter is located 👉 here. The podcast & comments are below. Follow us on iTunes
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