background There has long been debate about exactly how to design a spontaneous breathing trial. If the trial is made too easy, then patients would be extubated before being ready (leading to re-intubation). Alternatively, if the trial is too hard, that would prolong mechanical ventilation beyond the point of being beneficial. The figure above shows […]
Based on this polling data, 42% of you will hate this chapter. It’s a good thing I’m not running for president. Seriously though, fluid selection remains controversial. This chapter presents an approach which makes sense physiologically and is supported by a substantial amount of animal and human data.
by Jeff Lapoint “I was not proud of what I had learned, but I never doubted that it was worth knowing.” Hunter S. Thompson I don’t know why I’ve been identifying with the works of Hunter S Thompson of late. It’s not because the political times seem eerily similar to that of 1972, nor because […]
Hypercalcemia isn’t a particularly common cause of critical illness, but when encountered this requires immediate treatment. Fortunately, advances in the treatment for hypercalemia have clarified how to do this safely and definitively. Forced diuresis with furosemide has largely fallen by the wayside, simplifying fluid and electrolyte management. The cornerstone of therapy is generally simultaneous initiation of calcitonin and an IV bisphosphonate.