The LITFL Critical Care Compendium is a comprehensive collection of pages concisely covering the core topics and controversies of critical care.
Physiotherapists are part of the multidisciplinary ICU team. The traditional focus of treatment has been the respiratory management of both intubated and spontaneously breathing patients. Evidence of the longstanding physical impairment suffered by survivors of intensive care has resulted in physiotherapists re-evaluating treatment priorities to include exercise rehabilitation as a part of standard clinical practice
The Intensive Care Unit (ICU) ward round consists of scheduled discussions in which healthcare providers review clinical information and develop care plans for critically ill patients
Preload = initial myocardial fibre length prior to contraction; determined by anything that effects ventricular volume at the end of diastole
Pericarditis = inflammation in the pericardium
Features that distinguish Pulmonary Embolus from Right Ventricular Infarction
Pericardial disease
Syncope is transient, self-limited loss of consciousness with an inability to maintain postural tone that is followed by spontaneous recovery. Such an event without loss of consciousness is often termed “presyncope”. Underlying cause is often not found in the emergency department (~50%)
pCO2 gap is a surrogate for cardiac output; pCO2 gap = PcvCO2 - PaCO2; pCO2 gap >6 mmHg suggests a persistent shock state that may be amenable to fluid resuscitation +/- intrope support; a “ScvO2-cvaCO2gap-guided protocol” has been proposed to guide the management of septic shock
Lung volume reduction surgery is performed on a high risk population with an associated mortality of 5-10%. The goal of the operation is to eliminate the most diseased areas of lung to reduce overall lung volume and improve respiratory mechanics
Chylothorax occurs when chyle from the thoracic duct empties into the pleural space. Chyle is a milky white fluid with a high concentration of triglycerides, chylomicrons, and white blood cells. Pseudochylothorax is pleural fluid that mimics true chylous pleural effusion in appearance but lacks the biochemical criteria for chylothorax; usually due to a longstanding pleural effusion
Vasoplegia Post Cardiopulmonary Bypass. Common; results from a bypass-induced SIRS response, but other causes of vasodilation (e.g. drugs, sepsis) can also contribute
Post-Pericardotomy Syndrome = febrile illness secondary to an inflammatory reaction involving the pleura + pericardium.