Outline the strengths and limitations of the current Surviving Sepsis Campaign Guidelines, using examples to illustrate your points.

A 42-year-old male is admitted to ICU following a cadaveric orthotopic liver transplant for end-stage liver disease secondary to alcohol-induced cirrhosis.

With respect to thromboelastography and haemostasis:

You are called to review a 55-year-old female following difficult, prolonged surgery for clipping of a left middle cerebral artery aneurysm. She returned to the ICU intubated, ventilated and with an external ventricular drain (EVD) in situ three hours earlier.

You have been called to the Emergency Room to review a previously well adult male who has sustained a penetrating injury to the root of the neck.

A 35-year-old female with no known previous medical history presents to the emergency department with a decreased conscious level.

List four assessments of the RIGHT ventricle that can be made on transthoracic echocardiography; List four clinical signs of right heart failure

A 42-year-old male is admitted to your intensive care day 4 post induction chemotherapy for acute promyelocytic leukemia (AML-M3). The patient was initially treated with idarubicin and all-trans retinoic acid (ATRA).

Critically evaluate the role of non-invasive ventilation (NIV) in critically ill patients.

Critically evaluate the role of monitoring blood lactate levels in the critically ill.

A 76-year-old female is admitted to the ICU following elective aortic and mitral valve replacement. Trans- oesophageal echo assessment at the end of surgery showed an ejection fraction of 20%. Her preoperative creatinine was 340 μmol/L. Total bypass time was 240 minutes.

Critically evaluate the role of corticosteroids in the management of severe community-acquired pneumonia.