Where are we on Fluids on 2022?
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PulmCrit Wee – Follow-up Bamlanivimab study unmasks statistical chicanery
Whether or not you have any interest in bamlanivimab, you should read this post as an amusing example of shoddy statistics being published in top journals. background & general landscape of the two trials The BLAZE-1 trial involved randomizing patients within three days of testing positive for COVID-19 to one of four arms: placebo, 700 […]
Hyperosmolar hyperglycemic state (HHS)
CONTENTS Rapid Reference 🚀 Pathophysiology Definition & diagnosis Evaluation Treatment Overview Step #1 – Volume resuscitation Step #2 – Insulin Step #3 – Water repletion Rhabdomyolysis Podcast Questions & discussion Pitfalls pathogenesis of hyperosmolar hyperglycemic state (HHS) HHS is often triggered by an acute stressor, which increases levels of cortisol and catecholamines (thereby reducing insulin […]
We are Complicit – A glimpse into the current state of Severe Sepsis/Septic Shock Quality Measures
Don’t read this unless you want to be annoyed
PulmCrit: New ARDS guidelines reveal a shambolic state of affairs
Within the past year, two major societies have released guidelines on ARDS: the ATS (American Thoracic Society) and the ESICM (European Society of Intensive Care Medicine). Don’t be fooled by their names – both of these organizations are fundamentally international in scope. Some authors on the ATS document were from Europe, and similarly some authors […]
PulmCrit – Central venous oxygen saturation: signal or noise?
Recently a few cases at Genius General have arisen where cvO2% was misleading. Specifically, the cvO2% was elevated despite cardiogenic or hemorrhagic shock. This post will attempt to explore why this might occur.
StaS Maneuver: Changing out a Non-Intubating Laryngeal Airway
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“The Adventure of the Dancing Men”
The illustrious Cardinal Commendoni suffered sixty epileptic paroxysms in the space of 24 hours, under which nature being debilitated and oppress’d he at leangth sank, and died. His skull being immediately taken off, I found his brain affected with a disorder of the hydrocephalous kind. -Gavassetti, 1586 The […]
PulmCrit- All 2nd line conventional anti-epileptics are equally good… or equally bad?
The management of generalized convulsive status epilepticus remains in perpetual status controversius. There is consensus that the front-line agent should be a benzodiazepine, but little agreement beyond that. The much-awaited ESETT trial is a multi-center RCT comparing three anti-epileptic agents for ongoing status epilepticus (levetiracetam, fosphenytoin, and valproate). This trial will be the highest-quality evidence […]
CC Nerd-The Case of the Uncertain Surrogate
I’ve often wondered if the devastating outcomes observed in patients presenting in status epilepticus (SE), are far more influenced by the underlying etiology inciting this seizure activity than the time it takes us to control this neurological outburst. And while the HYBERNATUS study does not directly address this question, it does allow for some interesting […]
PulmCrit Wee – The meaning of nocturnal extubation is 42
What should intensivists do at night? Should they sleep at home or remain dutifully in the hospital? Should they extubate patients or just maintain the status quo until 7 AM?
EEMCrit conference supplemental reading
Welcome to the supplemental reading around my talks at the EEMCrit Conference. If you have any unanswered questions or discussion points, feel free to comment. It would probably be ideal to comment within the comments section of the relevant blog, but you can put them below too. (1) LR vs. NS for hyperkalemia The initial […]
EEG interpretation and ictal-interictal continuum
CONTENTS When & how long to monitor EEG: Indications for EEG monitoring in the ICU Duration of EEG monitoring Basics EEG leads Background pattern Reactivity Paralysis to eliminate artefacts EEG in encephalopathy/coma Beta coma Alpha coma Theta coma Delta coma Spindle coma Seizures Epileptiform discharges Seizures BIRDs – Brief Potentially Ictal Rhythmic Discharges 🐥 Ictal-Interictal […]
PulmCrit wee- Five ways to improve live-tweeting at conferences
For generalists such as myself, there’s almost always a conference of interest going on somewhere in the world. In the normal course of events, I would miss 99.9% of them. However, twitter makes it possible for me to gain some insight from all of them. However, conference tweeting is far from perfect. A large conference […]
EMCrit 336 – Team NeuroEMCrit’s Critical Neuro Cases – Part 2
SAH and Hypoxic Encephalopathy
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