
Respiratory Failure Hot Case
Respiratory Failure Hot Case
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Respiratory Failure Hot Case
GENERAL APPROACH Type of renal failure Acute (usually multi-factorial) Chronic (e.g. dialysis dependent) or Acute on Chronic (e.g. post-renal transplant) Causes Pre-renal – hypovolemia, any cause of shock, sepsis, renovascular disease Intra-renal – nephrotoxins, urine for casts + protein, sepsis,…
GENERAL APPROACH Illness requiring ICU admission Pregnancy + Baby Delivery – when or already done INTRODUCTION CUBICLE CTG presence of midwives INFUSIONS PET: MgSO4, phenytoin, hydralazine, GTN pre-term labour: tocolytics, steroids thromboembolism: heparin bleeding: blood products, fluid boluses, TXA cardiogenic…
GENERAL APPROACH Infectious community acquired nosocomial (surgical site, lines, chest, urine, sinusitis) Non-infectious head injury DVT -> PE drug/toxin SIRS (post surgery, trauma, aspiration, pancreatitis) Hypermetabolic syndromes -> thyroid storm-> NMS-> MH-> heat stroke-> phaeo-> liver failure-> burns-> cocaine toxicity->…
GENERAL APPROACH Initial illness and response to treatment Diagnosis correct Organ failures and support for each organ Complications of stay – nosocomial infection… INTRODUCTION CUBICLE number of organs being supported INFUSIONS resuscitation fluid being administered noradrenaline (sepsis) sedation and neuromuscular…
GENERAL APPROACH Cause Treatment (source control) — complete or ongoing? Nutrition — NBM? route? nutritional status? Complications – ACS, fungal sepsis? How to move forward? Important causes intra-abdominal sepsis pancreatitis abdominal trauma perforation (e.g. ulcer, appendicitis, diverticulitis, tumor, obstruction, anastomotic…
Acute Graft Versus Host Disease: major complication of allogeneic haematopoietic stem cell transplantation
Hepatic veno-occlusive disease aka sinusoidal obstruction syndrome (SOS) important complication of stem cell transplantation (SCT) mortality >30%
Erythropoietin (EPO) is an endogenous hormone that stimulates erythrocytosis. Role in critical illness is unclear and is limited by the complications of hematopoietic activation (e.g. VTE)
Procedures and Coagulopathy: many procedures are contra-indicated in the presence of coagulopathy; the degree of acceptable coagulopathy for different procedures is controversial
Haemophagocytic lymphohistiocytosis (HLH) may be inherited (AR; 5 subtypes, aka familial HLH) or acquired; may mimic severe sepsis, consider in apparent sepsis without source
COPD Patient Hot Case