Category Archives: Intensive Care

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 | 5 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 | 1 Comment

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 | 1 Comment

THE BOTTOM LINE

While we at ScanCrit were thinking about what a great idea it would be, The Bottom Line just went ahead and did it. And they’re still doing it: Making a library of the key articles and most important trials in … Continue reading

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DEATH TO THE YELLOW CATHETER OF DEATH

It’s not news but I recommend you read Paul E Marik’s review of the Pulmonary Artery Catheter (PAC) from Annals of Intensive Care 2013. Basically he tears the whole thing apart, writes an obituary and suggest we make it a … Continue reading

Posted in Cardiology, Intensive Care | Leave a comment

STEWART’S ACID TRIP

Acid-base calculations. The ones that make my head hurt. Every time I read up on it, I seem to almost grasp it and get a deeper understanding – which slips away slightly after a week or two. And a few … Continue reading

Posted in Anesthesia, Emergency Medicine, Intensive Care | 2 Comments

COPD ICU MORTALITY

In intensive care, we are often called to deal with marginal or crashing COPD patients. Often, we end up intubating them. Then, in the morning rounds there always seems to be at least one passive-aggressive (†) colleague in the back, shaking … Continue reading

Posted in Airway management, Intensive Care | 1 Comment

ELECTROLARYNX – TALK WHILE INTUBATED

For awake, intubated patients a great frustration is the inability to speak. A great little report in NEJM shows a novel use of the electrolarynx – that little device some laryngectomised patients hold to their neck to produce robot sounding … Continue reading

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