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Medical Category: Endocrine, Metabolic, Fluid, and Electrolytes

SCOPE-DKA: Normal Saline vs Plasmalyte in Severe DKA

Background Information:  Diabetic Ketoacidosis (DKA) is a life-threatening complication of diabetes that we frequently encounter in both the emergency department (ED) and intensive care unit (ICU). While intravenous fluid replacement remains one of several cornerstones of therapies, much debate exists ...

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Endocrine, Metabolic, Fluid, and ElectrolytesResuscitation

REBEL Core Cast 63.0 – Adrenal Crisis

Take Home Points Adrenal insufficiency is a life-threatening emergency; recognize early and treat aggressively Hallmark is hypotension refractory to IVF/pressors Suspect in patients with unexplained hypotension and risk factors Prior glucocorticoid therapy History of autoimmune diseases Hyperpigmentation  AIDS or TB ...

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Endocrine, Metabolic, Fluid, and Electrolytes

The BaSICS Trial – Balanced Solution vs 0.9% Saline Solution in Critically Ill Patients

Background: One of the most common treatments in critically ill patients is  the administration of intravenous fluids.  Historically, 0.9% saline has been one of the most common solutions used in resuscitation. In 2015 we saw the publication of the SPLIT ...

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Endocrine, Metabolic, Fluid, and Electrolytes

Dexamethasone vs Methylprednisolone in ICU Patients with COVID19

Background Information: Over one year into the pandemic many therapies to treat COVID-19 have targeted innumerable aspects of the virus. Most recently, the use of corticosteroids to treat the virus’ excessive inflammatory effects has become the front and center of ...

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Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseThoracic and Respiratory

The SALSA Trial: Symptomatic Hyponatremia and Hypertonic Saline

Background: Hyponatremia is one of the most common electrolyte abnormalities seen in clinical practice. Under-correction could lead to cerebral edema, whereas overcorrection could result in osmotic demyelination syndrome (ODS).  The current recommendation is to use hypertonic saline in small, fixed, ...

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Endocrine, Metabolic, Fluid, and Electrolytes

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