Hyponatraemia
Hyponatraemia: common problem in ICU (30% of patients have a Na < 134mmol/L). Independent predictor of mortality in ICU
CCC
The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Hypophosphataemia
Hypophosphataemia: Phosphate - important intracellular anion; 85% is stored in bone as hydroxyapapitie crystals, 14% in soft tissues, 1% in blood
Hypokalaemia
Hypokalaemia: the most common electrolyte abnormality in hospitalised patients; mostly caused by drugs and GI disease
Hypocalcaemia
Hypocalcaemia: Reduced intake; redistribution and increased output
Hypernatraemia
Hypernatraemia can be caused by a number of critical illnesses: water depletion (decreased intake, hypotonic fluid loss – renal/non-renal); solute excess (Na+ or other)
Hyperkalaemia Management
Hyperkalaemia is a life-threatening emergency. Basic overview of hyperkalemia management
Hypercalcaemia
Ca2+ exists in the extracellular plasma two states: (1) free ionized state and (2) bound to other molecules (mostly albumin, rest – beta-globulins, phosphate, citrate)
ionized Ca2+ concentration is inversely related to pH -> an increase in pH results in a decrease in ionized Ca2+
Clostridium difficile and PMC
Pseudomembranous colitis (PMC); acute inflammatory disease of colon commonly associated with antibiotic use; C. difficile implicated as a causative organism in 1970’s
Portopulmonary syndrome
Portopulmonary Syndrome is NOT considered contraindication to liver transplantation; affects ~20% of pre-transplant patients; usually due to increased blood flow through the lungs without increased resistance
Cuff Pressure Gauge
Cuff pressure gauge aka cuff manometer; allows safe inflation of the cuff seal of low pressure endotracheal and laryngeal tube cuffs by measuring the cuff pressure
Transplant Patient Hot Case
GENERAL APPROACH Considerations Transplant – liver, heart, lung, heart-lung, bone marrow, renal, pancreatic Phase of care – immediate post op, sepsis, rejection, respiratory failure, renal failure Surgery – graft function, anatomy, anastomoses (leaks and occlusion) Infection – bacterial (early), opportunistic:…
Shock Hot Case
GENERAL APPROACH Find the shock (is it PROVED?) Pump, rate/ rhythm = Cardiogenic – myocardial, valves, rhythm, pericardium, left and right sided (signs: cool peripherally, shut down, bounding pulse, narrow pulse pressure, inotropes, high CVP, low SvO2, low Q, crackles…