Category Archives: Intensive Care

STILL NO EVIDENCE FOR PPI IN ICU

We believe that the ICU-patients, especially ventilated patients, are prone to having stress ulcers and one of the components of the daily ICU drill is to ensure that the patient is on ulcer prophylactics. We do this despite how the … Continue reading






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SHOCK LIVER AFTER CARDIAC ARREST

Interesting paper in AJEM. Hypoxic hepatitis (HH), ‘shock liver’, is defined as an increase in serum aminotransferase levels (20 times the upper normal level) after respiratory or circulatory failure. It is commonly seen in critical illness and after cardiac arrest. In … Continue reading






Posted in Cardiology, CPR, Intensive Care, Uncategorized | Leave a comment

BP MANAGEMENT IN BRAIN BLEEDS

There´s a nice Best BET mini review in EMJ April 2016. The authors ask if it is safe and beneficial to control hypertension in the acute/hyperacute phase (~<6h from presentation) in patients with acute intracerebral haemorrhage.






Posted in Emergency Medicine, Intensive Care, Neurology, Prehospital Medicine, Uncategorized | 1 Comment

LUNG US AND BNP

A small study in Ann Intensive Care reminds me that lung ultrasound is  good at detecting heart failure and differentiating against other causes of acute dyspnoea.






Posted in Emergency Medicine, Intensive Care, Ultrasound | Leave a comment

OWN THE O.G.

Passing the orogastric tube can be difficult or sometimes impossible. Unfortunately a lot of patients really need their OGs and in a time-critical scenario you don’t want to spend too much time struggling with it. Here is a simple trick a senior … Continue reading






Posted in Airway management, Anesthesia, Emergency Medicine, Intensive Care, Prehospital Medicine, Uncategorized | 8 Comments

PERIPHERAL NORADRENALINE

Peripheral noradrenaline (or norepinephrine), or any peripheral pressor, is shunned in many centers. High doses can cause gangrene. If extravasated, it can cause tissue necrosis. But is this a big risk? Also, weighing against the risks of CVC or delayed … Continue reading






Posted in Anesthesia, Emergency Medicine, Intensive Care | 8 Comments

EGDT IS DEAD, LONG LIVE EGDT

And so the EGDT trilogy is complete. The results of the ProMISe trial was published, after we’ve recently had the results from the ARISE and ProCESS trials. They all compared EGDT (Early Goal-Directed Therapy) to “standard care”. And they were … Continue reading






Posted in Emergency Medicine, Infectious diseases, Intensive Care | 5 Comments

ECMO – MIXING IT UP

ECMO is all the rage, and ScanCrit is a fanatical believer. However, ECMO has its problems and challenges. The challenge we’ll look into here, is choosing between VV or VA ECMO – sometimes the choice is straightforward, other times not. … Continue reading






Posted in ECMO, Intensive Care | 2 Comments

AVOID THE OXYGEN REFLEX

We’ve been waiting for the AVOID study, since we mentioned it a few years ago in another post on the harm of excessive oxygen. AVOID (Air Versus Oxygen in Myocardial Infarction). Now, it’s out. As expected, it shows that unnecessary … Continue reading






Posted in Cardiology, Emergency Medicine, Intensive Care | 31 Comments

I AM THE RESURRECTION

If you make a study on interventions on dead people, you don’t expect much. Well, the Alfred in Melbourne did such a study – and got a resurrection rate of over 50%! Their intervention group was people in refractory cardiac … Continue reading






Posted in Cardiology, ECLS, ECMO, Emergency Medicine, Intensive Care | 3 Comments