Coagulopathy in Liver Dysfunction
Coagulopathy in Liver Dysfunction; defined as INR >1.5 due to liver dysfunction; patients are not 'auto-anticoagulated' - they are often in a procoagulant state!
Abnormal LFTs Post Vascular Surgery
CAUSES pre-existing liver disease (+/- exacerbation) drug induced (paracetamol, statins, amiodarone, antibiotics, NSAIDs, beta-blockers, ranitidine, volatiles) ischaemic (post clamping above hepatic artery, thrombosis, embolic, hypotension) surgical injury nutrition (TPN, EN) acalculous cholecystitis transfusion related hepatitis ASSESSMENT History pre-operative liver function…
Fluid administration device flow rates
Rapid fluid administration is potentially life-saving in the resuscitation setting; flow rates achieved depend on the devices used in fluid administration, largely in agreement with Poiseuille's law
Perioperative fluid management
Perioperative fluid management: an adequate and timely replacement of actual losses with appropriate preparations seems to be an ideal primary approach
Global Increased Permeability Syndrome
Global Increased Permeability Syndrome (GIPS) "is characterised by high capillary leak index (CLI, expressed as the ratio of CRP over albumin x 100), excess interstitial fluid and persistent high extravascular lung water index (EVLWI), no late conservative fluid management (LCFM) achievement, and progression to organ failure"
Fluid Therapy Literature Summaries
Fluid Therapy Literature Summaries
Assessing fluid status
Advantages and disadvantages of different methods for assessing fluid status
Albumin
Albumin: colloid solution; 4, 10, 20%; use in the critically unwell is controversial
Albumin versus normal saline
Albumin versus normal saline
Adverse Outcome Template
template for answering on 'adverse outcome' questions in the FCICM exam
Medical futility
"Futility" means the absence of benefit; a consensus definition of medical futility does not exist; ~80% of ICU patients who die do so as a consequence of a decision to withhold or withdraw life support