Background: Saline (0.9% sodium chloride) has historically been one of the most common intravenous fluids administered in critically ill adults. However, the supraphysiologic chloride concentration can cause hyperchloremia, metabolic acidosis, renal vasoconstriction and alter immune function. There is nothing normal ...
Background: Recently there have been some observed trends in decreasing susceptibility among Strep pneumoniae isolates to antimicrobials used to treat community acquired pneumonia (CAP) (Resistance to oral penicillin and macrolides for Strep pneumoniae & macrolides and fluoroquinolones for Staph aureus). ...
Take Home Points End stage liver disease patients have fragile baseline physiology. Minor insults can have profound effects Always start with the basics – large bore IV lines SBP give 3rd generation cephalosporin + albumin in severe disease Upper ...
Background: In 2016, Paul Marik published a study in Chest demonstrating a decrease in hospital mortality of 32% for sepsis patients treated with vitamin C, thiamine and hydrocortisone. The Marik protocol(as it has come to be known), entails IV ...
Background: The IOTA trial, was a systematic review and meta-analysis of 25 RCTs enrolling 16,000 patients with sepsis, critical illness, stroke, trauma, MI, cardiac arrest, and/or emergency surgery. In this review it was found that liberal use of O2 resulted ...
Background Information: Therapeutic hypothermia is the use of targeted temperature management to reduce neurologic sequelae resulting from the severe ischemia-reperfusion injury that occurs during cardiac arrest primarily from shockable rhythms.1 Although a mainstay treatment in the Advanced Cardiac Life Support ...
Background: Septic shock is the most severe form of sepsis. It is characterized by vasodilation and increased capillary permeability leading to hypotension and tissue hypoxia. The initial treatment of septic shock includes early identification, intravenous fluids when necessary, appropriate broad-spectrum ...
REBEL Core Cast 21.0 – ECG in Syncope Click here for Direct Download of Podcast
Background: Peri-intubation cardiovascular collapse (shock, cardiac arrest or death) is an all too common complication of airway management in critically ill patients seen in up to 25% of patients (Jaber 2010, Umobong 2018). The causes for collapse are numerous and ...
Background: Despite minimal high-quality supporting evidence (Seymour 2017, Liu 2017, Ferrer 2014, Sterling 2015), regulatory bodies have pushed for benchmark times for administration of antibiotics in patients with sepsis. While most clinicians would agree that in patients with septic shock ...
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