August 27, 2018

Choosing Your Initial Settings: I hope you now see what physiologies to consider when setting up the ventilator and your goals for each. If your patient doesn't fit into one of these three categories, then I set up my ventilator as if I was managing a patient who has refractory hypoxemia to maintain a lung protective strategy even if they don't think they have very significant lung disease. Maintaining a lung protective strategy with low tidal volume ventilation has been shown to decrease ventilator induced lung injury and minimize harm, even in patients without refractory hypoxemia and ARDS (1-2).

August 23, 2018

The use of heated and humidified high flow nasal cannula has become increasing popular in the treatment of patients with acute respiratory failure through all age groups.  In part 1 we summarized how High Flow Nasal Cannula (HFNC) works.  In part 2, we will discuss the main indications for its use in adult and pediatric patients.

August 23, 2018

The use of heated and humidified high flow nasal cannula has become increasing popular in the treatment of patients with acute respiratory failure through all age groups.  In part 1 we summarized how High Flow Nasal Cannula (HFNC) works.  In part 2, we will discuss the main indications for its use in adult and pediatric patients.

August 20, 2018

The use of heated and humidified high flow nasal cannula (HFNC) has become increasingly popular in the treatment of patients with acute respiratory failure through all age groups.  I first started using it as a pediatric intensive care fellow, but had little knowledge of how it actually worked.  I noticed a few years after using it successfully in children, mainly with severe bronchiolitis, that we began to use it in the adult intensive care unit as well.  It seems over the past several years many studies have come out reviewing the mechanisms of action as well as its use in a variety of conditions.  In this part we will summarize how it works and for part 2 we will discuss the main indications for its use in adult and pediatric patients.

July 18, 2018

Have you ever heard an entire lecture on sinus tachycardia? Neither have I. It is the most common cardiac dysrhythmia seen in critically ill adults and kids, but it is the least frequently talked about. Sinus tachycardia may not be the sexiest rhythm and we don't think of cardioverting it or giving some new anti-arrhythmic drug, but it is a sign that something may be seriously wrong. To be fair, it’s not the sinus tachycardia we are really worried about, but rather what’s causing the sinus tachycardia that should be our main concern.