Catecholamine excess, or 'sympathetic overload', may be harmful in critically ill patients, including those with septic shock. Catacholamine excess is associated with specific conditions such as Takotsubo cardiomyopathy
Pulmonary Artery Catheter (PAC) Literature Summaries
OVERVIEW a life threatening time-critical emergency pulmonary artery rupture caused by inflation of the pulmonary artery catheter (PAC) balloon during ‘wedging’ (measurement of the pulmonary artery occlusion pressure) some experts advise against measuring PAWP because of the risk of pulmonary…
Troubleshooting Pulmonary Artery Catheter measurement
PAOP or PAWP is pressure within the pulmonary arterial system when catheter tip ‘wedged’ in the tapering branch of one of the pulmonary arteries
in most patients this estimates LVEDP thus is an indicator of LVEDV (preload of the left ventricle)
USES measurement of oxygenation saturation from mixed venous blood (SvO2) in the pulmonary artery requires Pulmonary Artery Catheter insertion in most clinical settings DESCRIPTION measures the end result of O2 consumption and delivery METHOD OF INSERTION AND/OR USE O2 flux…
Central venous oxygen saturation (ScvO2) surrogate for SvO2 thus provides a surrogate measure of oxygen flux, reflecting the balance between oxygen delivery (DO2) and consumption (VO2).
SvO2 vs ScvO2: used as a measure of the adequacy of total body O2 delivery; can be both displayed continuously
EGDT: Within 6 hours of presentation to the Emergency Department intensive monitoring of specific circulatory parameters with the aggressive management of 5 key parameters to specified targets to optimise oxygen delivery to tissues.
AGENTS CLINICAL FEATURES INVESTIGATIONS SPECIFIC MANAGEMENT AND TRIGGERS FOR INTERVENTION Cyanide Carbon monoxide Methaemoglobinaemia References and Links
Paracetamol overdose is the most common cause of fulminant hepatic failure in the USA (39% of cases). Paracetamol-induced hepatotoxicity is defined as a peak elevation in hepatic transaminases (ALT or AST) > 1000 IU/L in the context of paracetamol overdose
Fulminant Hepatic Failure = rapid onset of encephalopathy in conjunction with hepatic synthetic failure.