Category Archives: Intensive Care

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

BEST OF 2013

Posted on December 30, 2013 by Thomas D

Another year comes to an end. So here’s a selection of posts from 2013. Not sure if it’s the best of ScanCrit 2013, but these are some of the posts that’s gotten the most clicks and discussion, and some we … Continue reading →

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

CLEAR AS CRISTAL

Posted on December 16, 2013 by Thomas D

Just as we were getting used to wearing our smug I-told-you-so grins about how very bad big pharma’s HES crystalloids are, the CRISTAL study comes along, suggesting colloids – even HES – are good for your shocked patients. But are … Continue reading →

Posted in Intensive Care | 2 Comments

PERCUTANEOUS TRACKIES NOT SO SAFE AFTER ALL…

Posted on November 23, 2013 by K

A literature review in crit care reminds me of how ICU percutaneous tracheostomies are potentially dangerous and is associated with significant mortality. This mortality needs to be weighed in when deciding wether to make the hole in the neck or … Continue reading →

Posted in Airway management, Intensive Care | 2 Comments

THERAPEUTIC HYPOTHERMIA – NOT SO COOL

Posted on November 18, 2013 by K

A recent study published in New England Journal of Medicine has created a splash in EM social media. While it acknowledges that temperature control is important, it also suggests therapeutic cooling of cardiac arrest survivors does not work.

Posted in Cardiology, Emergency Medicine, Intensive Care | 6 Comments