petulantskeptic + medicine   15

ICU Physiology in 1000 Words: Blood Pressure | Jon-Emile S. Kenny | PulmCCM | 03 February 2019
If we assume that the decay from peak systole is mono-exponential, it takes roughly 5 time constants for a distensible structure to return to its baseline state of deformation. A time constant is the product of compliance and downstream resistance. Therefore, a poorly compliant aorta [e.g. old, unhealthy, high volume], coupled with a low downstream resistance [e.g. vasodilator, sepsis, high metabolic demands] will radically reduce the decay-time from systole to diastole. If this is coupled with a long duration of diastole [e.g. beta-blocker], then the final diastolic pressure can be quite low
medicine 
14 days ago by petulantskeptic
Biggles FRCA | Grant Hutchison | The Oikofuge | 31 December 2015
First published in Today’s Anaesthetist Vol.13 No.4 July/August 1998. "The whole point of a plane is that it is designed to fly, and if it’s not working properly then you don’t take it off the ground. Human beings, in contrast, are not designed to be anaesthetized, and are often not working properly when the occasion arises. They are also rather poorly provided with back-up systems and spares, and frequently have long histories of inadequate servicing. So if giving an anaesthetic is like flying a plane, then this must be what flying a plane is like."
medicine 
october 2018 by petulantskeptic
Could the Furosemide Stress Test clarify resuscitative goals? | Josh Farkas | PulmCrit | 16 July 2018
The furosemide stress test (FST) is a protocolized furosemide challenge, which has been shown to predict whether patients are likely to progress towards advanced AKI and dialysis.
medicine 
july 2018 by petulantskeptic
pH-guided fluid resuscitation & BICAR-ICU | Josh Farkas | PulmCrit | 27 June 2018
The fact that bicarbonate appears to be clinically beneficial further bolsters the concept that NAGMA is detrimental. Essentially, the BICAR-ICU trial is the flip side of the SMART and SALT-ED trials.
medicine 
june 2018 by petulantskeptic
Methylene Blue Infusions | Steve Curry | Tox and Hound | 22 June 2018
Continuous Methylene Blue Infusions for Treating Recurrent Methemoglobinemia
medicine 
june 2018 by petulantskeptic
Doctor—your septic patients have scurvy! | Paul Marik | Critical Care | 29 January 2018
"About 40% of the patients in their ICU with septic shock have serum levels of vitamin C supporting a diagnosis of scurvy (<11.3 u/mol/l). The remainder of their patients with sepsis are likely to have hypovitaminosis C (serum level < 23 u/mol/l). Half of their nonseptic ICU patients also have hypovitaminosis C."
medicine 
february 2018 by petulantskeptic
Myth-busting: Lactated Ringers is safe in hyperkalemia, and is superior to NS | Josh Farkas | PulmCrit | 29 September 2014
The myth that LR should be avoided in hyperkalemia is not only incorrect, it is probably backwards. For a hyperkalemic patient in renal failure, LR should be preferred over NS. LR has been proven to produce lower potassium levels en vivo.
medicine 
february 2018 by petulantskeptic
BILEVEL-APRV | Duncan Chambler | The Bottom Line | 26 January 2018
The reported benefits of APRV are clinically significant and the conduct of the trial is reasonable enough to conclude the results are probably valid
medicine 
january 2018 by petulantskeptic
Less is More: The New paradigm in Critical Care | Paul Marik | iSepsis | 26 December 2017
List of all the studies which have shown less or none of something to be beneficial to ICU patients.
medicine 
january 2018 by petulantskeptic

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