Category Archives: Intensive Care

DEATH TO THE YELLOW CATHETER OF DEATH

Posted on July 27, 2014 by K

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

Posted on July 14, 2014 by Thomas D

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

Posted on June 11, 2014 by K

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

Posted on April 27, 2014 by Thomas D

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 →

Posted in Intensive Care | Leave a comment

THE MOTTLING SCORE

Posted on April 19, 2014 by K

Several methods have been developed for identifying and quantifying microcirculatory dysfunction in septic shock. We can measure buccal, sublingual and subcutaneous microcirculatory CO2-levels. Near infrared spectroscopy (NIRS) measures microcirculatory hemoglobin saturation. Sidestream dark field (SDF) imaging directly visualises the microcirculation. … Continue reading →

Posted in Emergency Medicine, Infectious diseases, Intensive Care | Leave a comment

SEPSIS PROGRESS

Posted on April 8, 2014 by K

The PROCESS and SEPSISPAM studies were serious blows to protocol EGD therapy in sepsis. With all the other dead ends we pursued (activated protein C, colloids, intensive insulin therapy, cortisone and what not) it is tempting to think that little … Continue reading →

Posted in Infectious diseases, Intensive Care | Leave a comment

PRESSOR DOSES AND PROGNOSTICS

Posted on March 11, 2014 by K

Just a short post. In fact, I am writing these first two sentences just to make the post somewhat longer. Anyway, a paper in Journal of Critical Care makes vasopressor infusion doses less abstract. The authors correlate adrenaline and noradrenaline … Continue reading →

Posted in Intensive Care, Uncategorized | 6 Comments

HYPOTHERMIC INFECTIONS

Posted on February 25, 2014 by Thomas D

Adding to the discussion on therapeutic hypothermia or just avoiding hyperthermia in cardiac arrest patients after ROSC, there’s a new systematic review slash meta-analysis on infection rates in hypothermic vs normothermic patients. Prolonged therapeutic hypothermia shows an increased risk of … Continue reading →

Posted in Emergency Medicine, Intensive Care | Leave a comment

β-BLOCKER IN SEPSIS – A TRIAL

Posted on January 28, 2014 by Thomas D

A small study with patients randomised to standard ICU sepsis therapy, or ICU sepsis therapy with beta blockage. We’ve written about the potential for β-blockage in sepsis earlier. This is the first clinical trial. It shows much better survival for … Continue reading →

Posted in Intensive Care | 9 Comments

NO COUNTRY FOR OLD MEN

Posted on January 13, 2014 by Thomas D

What does ICU do to old patients? How does the elderly popuplation do after critical illness? One thing is that we can often get them through the initial surgery/treatment and even through ICU, but the total burden of illness can … Continue reading →

Posted in Intensive Care | Leave a comment