Cerebral Salt Wasting
Cerebral Salt Wasting: also now known as renal salt wasting; hyponatraemia not always required to make diagnosis, but often present; cerebral lesion + excess renal loss of Na+ and Cl-; cerebral lesions: SAH, TBI, tumour
SIADH vs Cerebral Salt Wasting
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) versus Cerebral Salt Wasting
Basal metabolic rate
Basal metabolic rate
Cachexia
Cachexia refers to weight loss and skeletal muscle wasting due to illness where the body does not reduce catabolism (unlike the adaptive reduction in protein metabolism that occurs in starvation). Mechanisms not clearly understood
Daily Nutritional Requirements
Daily Nutritional Requirements
Poor Nutrition in ICU
Poor Nutrition in ICU: the establishment of enteral feeding is considered an important goal
Scleroderma
Scleroderma = autoimmune mediated widespread collagenous deposition. Limited form: Calcinosis, Raynauds, Esophageal dysfunction, Sclerodacytaly and Telangiectasia (CREST syndrome)
Systemic Lupus Erythematosus
Systemic Lupus Erythematosus (SLE) = chronic, multi-system disease commonest in young females; wide spread antibodies -> produce tissue damage
Polyangiitis – MPA, GPA, EGPA
Polyangiitis - MPA, GPA, EGPA: similar but different diseases; positive Antineutrophil cytopasmic antibiodies (ANCA); renal histology (focal necrotizing, pauci-immune glomerulonephritis)
Pulmonary Artery Catheter
Pulmonary Artery Catheter aka Swan-Ganz catheter (or 'the yellow snake'); continuous cardiac output monitoring; pulmonary artery pressure and more...
Lactate Clearance versus ScvO2 Monitoring in Severe Sepsis
Resuscitation targets in severe sepsis include: preload, e.g. CVP; afterload, e.g. MAP; tissue oxygen delivery; end point controversial: ScvO2 vs lactate clearance
Procalcitonin
Procalcitonin is the propeptide of calcitonin, a 116-peptide molecule with a molecular weight of 13 kDa. Procalcitonin has been studied as a sepsis biomarker, to help with diagnosing/ ruling out sepsis and to guide the initiation and cessation of antibiotics