GENERAL APPROACH Infectious community acquired nosocomial (surgical site, lines, chest, urine, sinusitis) Non-infectious head injury DVT -> PE drug/toxin SIRS (post surgery, trauma, aspiration, pancreatitis) Hypermetabolic syndromes -> thyroid storm-> NMS-> MH-> heat stroke-> phaeo-> liver failure-> burns-> cocaine toxicity->…
GENERAL APPROACH Initial illness and response to treatment Diagnosis correct Organ failures and support for each organ Complications of stay – nosocomial infection… INTRODUCTION CUBICLE number of organs being supported INFUSIONS resuscitation fluid being administered noradrenaline (sepsis) sedation and neuromuscular…
GENERAL APPROACH Cause Treatment (source control) — complete or ongoing? Nutrition — NBM? route? nutritional status? Complications – ACS, fungal sepsis? How to move forward? Important causes intra-abdominal sepsis pancreatitis abdominal trauma perforation (e.g. ulcer, appendicitis, diverticulitis, tumor, obstruction, anastomotic…
Acute Graft Versus Host Disease: major complication of allogeneic haematopoietic stem cell transplantation
Hepatic veno-occlusive disease aka sinusoidal obstruction syndrome (SOS) important complication of stem cell transplantation (SCT) mortality >30%
Erythropoietin (EPO) is an endogenous hormone that stimulates erythrocytosis. Role in critical illness is unclear and is limited by the complications of hematopoietic activation (e.g. VTE)
Procedures and Coagulopathy: many procedures are contra-indicated in the presence of coagulopathy; the degree of acceptable coagulopathy for different procedures is controversial
Haemophagocytic lymphohistiocytosis (HLH) may be inherited (AR; 5 subtypes, aka familial HLH) or acquired; may mimic severe sepsis, consider in apparent sepsis without source
COPD Patient Hot Case
Cardiac Arrest Survivor Hot Case
Burns Patient Hot Case
Cryoprecipitate is prepared by thawing fresh frozen plasma (FFP) between 1°C and 6°C and recovering the precipitate
The cold-insoluble precipitate is refrozen.