Review Article (J Intensive Care Med. 2006 Sep-Oct;21(5):278-86) Vent Stuff ↑ alveolar ventilation (20-40%), ↑ TV, ↑ RR Compensated hypocarbia (Normal 25-32 and normal bicarb 18-21) Mechanical ventilation- need to adjust for PaCO2 30-32 (compensated hypercarbia); no studies show harm with permissive hypercarbia Faster desaturation: ↑ O2 consumption + ↓ function residual capacity + ↑ […]
Cardiothoracic Surgical Intensive Care
best book: Manual of Perioperative Medicine by Bojar Post-CABG what was bypassed? discrete lesion vs. diffuse disease what was the graft material? art vs. vein, pedicle vs. free Looking for MAP 70-80 and DBP>50 First 6 hours, need CI>2.0 Hb 8.0 Fix acidosis CVP is actually a good monitor of RV failure Consider SWAN if […]
Oliguria and Urinary Electrolytes
Post from Nickson on Life in the Fast Lane USES Oliguria UNa+ low (<10mmol/L) – extravascular volume depletion UNa+ high (>20) – tubular damage Hyponatraemia UNa+ low (<10) – extra-renal losses UNa+ high (>20) – renal salt losing states, SIADH, diuretic therapy Fractional excretion of Na+ = 100 x UNa+ x PCr / PNa+ x […]
Neurocritical Care in the ED
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Rapid Response Teams (MERT, RRT)
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Pressure Sores in the ICU
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Nutrition in the Critically Ill Patient
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Palliative Care, End of Life and Advanced Directives
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Family Meetings
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Extracorporeal Corporeal Life Support – ECMO
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Alpha-Stat vs. pH-Stat
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Protein C / Xigris
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Ventilator Associated Pneumonia (VAP)
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Stress Ulcers and GI Prophylaxis
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Renal Replacement Therapy (RRT)
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Multimodal Monitoring
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Optimizing Organ Donors
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Isolation Procedures and Barrier Precautions
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Infections in the Intensive Care Unit
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Diuresis
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DVT Prophylaxis
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Adrenal Disorders and Critical Illness-Related Corticosteroid Insufficiency (CIRCI)
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Neurological Criteria for Death (Brain Death Protocols)
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Abdominal Compartment Syndrome
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Transfusion in the Critically Ill
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Ventilator Induced Lung Injury
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Electrolyte Replacements
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Rounding in the Intensive Care Unit
Fast Hug (Crit Care Med 2005;33:1225) More daily goals Medlist Neuro CV Pulm Renal/Lytes GI ID Endo Heme/Onc Proph/FASTHUG ABCDE AwakeBreathe (Spont)Choice of sedativesDelerium assess and rx Exercise and Early mobility(Crit Care 2010;14:157) ABCDE Bundle On rounds, ask yourself Why was this patient admitted to intensive care […]
Avoiding Common ICU Errors
Summary of Points from the book of the same name
ICU Literature
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Euglycemia in the ICU
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Drains
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Introduction to Critical Care
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Bowel Function and Constipation
Alfred Bowel Protocol Alvimopan: An oral, peripherally acting, µ-opioid receptor antagonist for the treatment of opioid-induced bowel dysfunctionA 21-day treatment-randomized clinical trial Journal of Pain March 2005 Volume 6 Number 3 oral narcan for opioid constipation (Pain 2000;84:105-109) 3-12 mg ngt tid start low to prevent withdrawal observational non-controlled study of […]
Intensive Care Unit Logistics and Design
Guidelines for intensive care unit design (Crit Care Med 2012;40:1586) Rationing of beds: Systematic Review (CCM Volume 32(7) July 2004 pp 1588-1597 Refusal due to no ICU bed availability lead to worse outcomes than pts who got ICU beds (Am J Resp Crit Care Med 2012;185:1081) the ethics of bed rationing (ccm 2006;34(4):958) Leapfrog staffing […]
The Four Most Important Equations in Critical Care
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