
Antimicrobial Dosing and Kill Characteristics
Dosing is different to non-critically ill patients
Different antimicrobials have different kill characteristics, which can be demonstrated on a concentration vs time graph for antibiotic activity

Dosing is different to non-critically ill patients
Different antimicrobials have different kill characteristics, which can be demonstrated on a concentration vs time graph for antibiotic activity

See RCH Melbourne Guidelines:

ILCOR = International Liaison committee on Resuscitation = conglomerate of resuscitation councils worldwide. Changes in 2010

Reviewed and revised 24 May 2014 OVERVIEW MECHANISM OF ACTION TOXICOKINETICS RISK ASSESSMENT CLINICAL FEATURES Effects include: Complications INVESTIGATIONS (Guided by clinical assessment) Laboratory tests MANAGEMENT Resuscitation Supportive care and monitoring Decontamination Disposition References and Links Journal articles

Renal replacement therapy: Fluid Management

Ethanol (ethyl alcohol) is an aliphatic alcohol, C2H5OH. The primary effect of ethanol is CNS depression, which is additive with other CNS depressants

High-dose Insulin Euglycaemic Therapy (HIET) is primarily used in the therapy of severe calcium channel blocker toxicity. HIET can also be used for severe beta blocker toxicity and potentially other toxicities/ presentations requiring inotropic support

Sympathomimetic syndrome with potential for life-threatening vascular complications (ischemia, dissection and haemorrhage). Note: ecstasy is also associated with hyponatraemia

End-stage renal failure has multiple implications for ICU management

Fluid responsiveness is an increase of stroke volume of 10-15% after the patient receives 500 ml of crystalloid over 10-15 minutes (as defined by Paul Marik). The definitive test for fluid responsiveness is a Fluid challenge

Drug withdrawal in ICU is more common than generally appreciated.

Haemoperfusion: Renal replacement therapy (RRT) using an adsorbent cartridge to remove circulating toxins