The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Daily Interruptions of Sedation in Mechanically Ventilated Patients designed to reduce exposure to sedative agents; allow assessment of neurological status; assess readiness for extubation; and reduce duration of mechanical ventilation
High airway pressures are important because they may have adverse effects on the patient; indicate a deterioration of the patient’s condition; indicate an equipment problem that needs to be addressed
OVERVIEW DEFINITION The Berlin Definition (2013) SEVERITY ARDS Severity PaO2/FiO2* Mortality** Mild 200 – 300 27% Moderate 100 – 200 32% Severe < 100 45% *on PEEP 5+; **observed in cohort RISK FACTORS Direct Indirect PATHOPHYSIOLOGY Classical phases Complex interplay:…
Tranexamic Acid (TXA): anti-fibrinolytic agent with many uses in preventing haemorrhage that rose to prominence following the CRASH-2 study showing a mortality benefit in trauma patients
Post-intubation hypoxia can be rapidly fatal without early intervention, which requires a structured approach to concurrently identifying and treating the underlying cause
Dabigatran is a direct thrombin inhibitor; It is viewed as a warfarin replacement; It's use is controversial because the management of bleeding complications is difficult and there is no definitive antidote
Respiratory Alkalosis DDx
Respiratory Acidosis DDx
Metabolic acidosis DDx
Urea (Blood Urea Nitrogen – BUN) is the chief end product of protein metabolism. it is formed in the liver from ammonia and excreted by the kidneys. Urea accounts for 50% of serum non-protein nitrogen Causes of Increased serum urea…
Hypomagnesaemia: Defined as serum magnesium < 0.75 mmol/L; associated with increased ICU mortality common — affects 10-65% of ICU patients
Indications: Evaluate the adequacy of ventilation, acid–base status, and oxygenation. Evaluate the patient’s response to therapy and/or diagnostic evaluation (e.g. oxygen delivery). Monitor severity and progression of a known disease process. Contraindications: Modified Allen test gives a negative result, indicating…