Archive for category: Critical Care

Targeted Temperature Management in Out-of-Hospital Cardiac Arrest: 33°C or 36°C?

19 Jun
June 19, 2017

Background: In 2002, the New England Journal of Medicine published two studies that changed the management of post-cardiac arrest patients by showing improved outcomes in patients treated with therapeutic hypothermia (32°C-34°C) for at least 24 hours. (Bernard 2002, Hypothermia 2002).  The landscape changed again in 2013 with the publication of the Targeted Temperature Management (TTM) trial […]

Acute Salicylate Toxicity, Mechanical Ventilation, and Hemodialysis

25 May
May 25, 2017

Background: Salicylates are common substances that can be purchased over the counter. They are readily available, and in the setting of an overdose, can be fatal [1]. Initially, as salicylates are metabolized, they can induce a respiratory alklalosis. This is then followed by an anion gap metabolic acidosis. Due to the metabolic derangements induced by […]

The WOMAN Trial: Early TXA in Post-Partum Hemorrhage

22 May
May 22, 2017

Background: Post-partum hemorrhage (PPH) is the leading cause of maternal death worldwide. It is typically defined as > 500 ml of blood loss within 24 hours of giving birth. However, PPH encompasses a broad spectrum of disease from mild oozing over hours to rapid exsanguination and death. The burden of mortality from PPH is shouldered […]

Episode 38 – Do All Submassive PE’s Require Treatment with Thrombolysis?

15 May
May 15, 2017

Background: There has been very little robust evidence published on the long-term outcomes of systemic thrombolysis in acute submassive PE.  Many advocate for the use of systemic thrombolysis to reduce morbidity (complications from chronic pulmonary hypertension) and mortality. The PEITHO trial compared systemic thrombolysis (with tenecteplase + heparin) vs no systemic thrombolysis (placebo + heparin) […]

Peri-Intubation Anaphylaxis

08 May
May 8, 2017

Background: Peri-operative anaphylaxis is an unexpected complication of intubation. The major life threat in anaphylaxis is typically loss of airway, however profound hypotension and circulatory collapse are still possible life threats even in the setting of a protected airway. Peri-operative anaphylaxis is considered an important enough issue to be the subject of the NAP 6 (National Audit […]

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