OVERVIEW Organisms Bacteria-> Gram +ve’ cocci (staphylococci, streptococci)-> Gram –ve bacilli (E.coli, Klebsiella, Pseudomonas aeruginosa) Fungi (Candida) Viruses Parasites Complex interaction between inciting microbe host immune response inflammatory pathway coagulation pathway LPS = lipopolysaccharideTRAF6 = TNF receptor-associated factor 6NIK =…
Corticosteroids are widely used in patients with refractory septic shock, as well as other selected causes of shock. Despite numerous trials, the role of corticosteroids in septic shock remains a controversial issue... still!
ECMO support has potential implications for pharmacotherapy in the critically ill, the significance of which are poorly defined; Pharmacokinetic effects of ECMO vary with different drugs and drug characteristics
Acalculous cholecystitis: pathophysiology: bile stasis + increased viscosity c/o fever, dehydration, no enteral feeding -> CCK induced gall bladder contraction with wall ischaemia
Hemihepatectomy: major surgery; perioperative mortality = 3%; usual indication = metastatic colorectal adenocarcinoma or cholangiocarcinoma
There are various systems available for scoring trauma severity. Some are based on anatomical descriptions of injuries, some on physiological parameters and others use combined data. No ideal trauma scoring system is currently available
Trauma Literature Summaries: Tranexamic acid (TXA) for traumatic haemorrhage; Steroids for acute spinal injury
Urinalysis (UA) is used as a screening and/or diagnostic tool to detect substances or cellular material in the urine associated with metabolic disorders, renal dysfunction or urinary tract infections (UTI)
Pyloric Stenosis is a medial emergency that requires urgent fluid resuscitation and resolution of biochemical abnormalities. Definitive surgical treatment can then be undertaken to restore enteral nutrition.
The Septic Child
There is concern that sedatives and anaesthetic agents may have harmful effects on the developing brain
Selective Lung Ventilation involves the isolation of one lung from the other allowing independent ventilation. Usually performed with a double lumen tube (DLT); alternatives are the use of a univent tube or an endobronchial blocker