Abdominal mass DDx
We consider the causes of palpable or otherwise detectable mass lesions in the various regions of the abdomen.
Month January 2019
Fever, Friend or Foe?
Paul Young's SMACC talk on 'Fever, friend or Foe?' got some of the most positive feedback ever seen on a speaker's report card. This is his post on the subject of fever in the critically ill, along with the audio and the slides from SMACC.
Temporary Pacemaker Troubleshooting
Temporary Pacemaker Troubleshooting. Problems with pacing: output failure, failure to capture. Problems with sensing: oversensing, undersensing and Pacemaker syndromes
Antibiotic Timing
The mantra for timing of antibiotics for serious infections is 'hit hard, early and appropriately'. Despite the strong biological plausibility of a need for early antibiotics in patients with serious bacterial infections the importance of antibiotic timing is controversial
Pacemakers
Pacemakers are devices that detect the electrical activity of the heart and stimulate it to contract at a faster rate.
Overdrive Pacing
Overdrive pacing = pacing the heart at a higher rate than the native heart rate; VT or VF can result -> always have DC cardioversion available
Pulmonary Hypertension
Pulmonary hypertension (PHT) is present when mean pulmonary artery pressure exceeds 25 mm Hg at rest or 30 mm Hg with exercise. Primary PHT is a relatively rare idiopathic condition; Secondary PHT is usually due to cardiac or respiratory cause
Protective Lung Ventilation
Protective lung ventilation is the current standard of care for mechanical ventilation. It is synonymous with low tidal volume ventilation (4-8 mL/kg) and often includes permissive hypercapnia
Acute Respiratory Distress Syndrome Definitions
definitions of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS) have varied over time. ARDS was first described by Ashbaugh and Petty in 1967 in a case series of 12 ICU patients who shared the common features of unusually persistent tachypnea and hypoxemia accompanied by opacification on chest radiographs and poor lung compliance, despite different underlying causes
Open Lung Approach To Ventilation
The open lung approach (OLA) to ventilation involves increasing the level of Positive End Expiratory Pressure (PEEP) in combination with protective lung ventilation
Airway Pressure Release Ventilation (APRV)
Airway pressure release ventilation (APRV) is inverse ratio, pressure controlled, intermittent mandatory ventilation with unrestricted spontaneous breathing
based on the Open Lung Approach To Ventilation first described by Stock et al 1987
Ventilation Literature Summaries
Ventilation, summaries of key papers from the ventilation literature: NIV; ARDS; Tracheostomy; Weaning