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A blog on anaesthesia, intensive care and emergency medicine. In-hospital and outside. Mostly focusing on the critically ill patient. Written by two Scandinavian senior anaesthetic registrars turned consultants.
This is our way of keeping log of articles and interesting things we come across in our work and on the internet. Should any of you out there stumble across this blog and find it useful then all the better.
Please leave comments or questions if you have any. The best way to keep learning is to keep the conversation going.
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Category Archives: Intensive Care
Iloprost is a powerful vasodilator, but I have never seen it used as an intravenous infusion to improve general microcirculation in septic shock, like in this interesting, albeit very small, case series from Intensive Care Med. In septic shock, one … Continue reading
We know that hypothermia in sepsis is associated with increased mortality but other than that we tend to see fever in sepsis as something bad. We tend to perceive sepsis patients as more sick the more the temperature is elevated. We then … Continue reading
We have been concerned about hyperoxaemia for a long time. Numerous studies have documented how supranormal O2-concentrations are harmfull in critical illness. Unfortunately, as far as I can tell anyway, ICU practice hasn’t changed much. We deal with hypoxia straight away, but otherwise we leave … Continue reading
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
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
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.
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.
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
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