Practice misalignment occurs in RCTs when randomization disrupts the normal relationship between clinically important characteristics and therapy titration. This can create subgroups of patients within each study arm that receive levels of therapy that are inconsistent with current practices outside of the clinical study and may be harmful
Peer reviewed by Maurice Le Guen OVERVIEW SIGNIFICANCE In adult ICU patients: PATHOPHYSIOLOGY RISK-FACTORS Baseline In ICU ASSESSMENT Clinical presentation Assessment approach Delirium monitoring Tools MANAGEMENT Early recognition Non-pharmacologic treatment Pharmacologic treatment EVIDENCE Treatment Page VJ, et al. 2013 Devlin JW,…
Daily Interruptions of Sedation in Mechanically Ventilated Patients designed to reduce exposure to sedative agents; allow assessment of neurological status; assess readiness for extubation; and reduce duration of mechanical ventilation
High airway pressures are important because they may have adverse effects on the patient; indicate a deterioration of the patient’s condition; indicate an equipment problem that needs to be addressed
OVERVIEW DEFINITION The Berlin Definition (2013) SEVERITY ARDS Severity PaO2/FiO2* Mortality** Mild 200 – 300 27% Moderate 100 – 200 32% Severe < 100 45% *on PEEP 5+; **observed in cohort RISK FACTORS Direct Indirect PATHOPHYSIOLOGY Classical phases Complex interplay:…
Biography Born Kincardine, Canada 1984 – Graduated with MD from the University of Ottawa 1989 – Achieved FRCP Internal Medicine Fellowship from the University of Ottawa 1991 – Achieved FRCP specialisation in haematology at McMaster University 1994 – MSc in…
Tranexamic Acid (TXA): anti-fibrinolytic agent with many uses in preventing haemorrhage that rose to prominence following the CRASH-2 study showing a mortality benefit in trauma patients
Post-intubation hypoxia can be rapidly fatal without early intervention, which requires a structured approach to concurrently identifying and treating the underlying cause
Dabigatran is a direct thrombin inhibitor; It is viewed as a warfarin replacement; It's use is controversial because the management of bleeding complications is difficult and there is no definitive antidote
Respiratory Alkalosis DDx
Respiratory Acidosis DDx
Metabolic acidosis DDx