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Category CCC

The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.

CCC Critical Care compendium 340

Pyroglutamic Acidosis

Pyroglutamic acidosis is a rare cause of high anion gap metabolic acidosis (HAGMA). When glutathione levels are low, the activity of γ-glutamyl cyclotransferase is increased, resulting in pyroglutamic acid accumulation in glutathione-depleted states
CCC Critical Care compendium 340

D-Lactic acidosis

D-Lactic acidosis aka D-lactic encephalopathy. Rare cause of high anion gap metabolic acidosis (HAGMA), typically occurs in patients short bowel syndrome or following jejuno-ileal bypass surgery
CCC Critical Care compendium 340

Bimanual laryngoscopy

Bimanual laryngoscopy using external laryngeal manipulation (ELM) is the single most practical and effective airway management technique for facilitating intubation during direct laryngoscopy.
Metabolic-Muddle-LITFL-Clinical-340 256

You can beat the feeling

It’s a busy night shift in the ED (as always) and one of the Interns comes to present a case to you. He’s seen a 23 yr old female who has presented with lethargy and weakness. While you're listening to the Intern your phone rings — it's the lab calling to tell you the patient’s potassium is 1.9 mmol/L.
Metabolic-Muddle-LITFL-Clinical-340 256

Hypernatraemia and Acidosis

A 20 year old male presents with 3 days of lethargy and generalised malaise. He is confused and looks very unwell. Can sort out this metabolic muddle?
Metabolic-Muddle-LITFL-Clinical-340 256

Staph Sepsis Acidosis

You are asked to review a 73 year old lady who is in hospital for treatment of septic arthritis affecting a prosthetic right hip joint inserted 5 years earlier.
Metabolic-Muddle-LITFL-Clinical-340 256

Waxing and Waning Weakness

A 50 year old Chinese female presents with severe weakness. She has a history of previous similar episodes that self-resolved. What's going on?
Metabolic-Muddle-LITFL-Clinical-340 256

Could it be renal colic?

Consider a 65 year-old male presenting with right-sided flank pain radiating to the groin. The following CT scan was taken to confirm a presumed diagnosis of renal colic:
CCC Critical Care compendium 340

Does Antivenom Work?

Antivenom is widely used for Australian envenoming syndromes. Antivenoms are generally perceived, by both clinicians and the general public, as highly effective treatments. However, there is little evidence to support this widely held view, in fact, the weight of evidence suggests that some antivenoms are ineffective in clinical practice.