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Rebel Category: REBEL Crit

The CLASSIC Trial: IV Fluid Restriction in Septic Shock

Background: The Surviving Sepsis Campaign guidelines recommend an initial fixed volume of 30mL/kg of IDEAL body weight within the first 3 hours of resuscitation (weak recommendation, low-quality evidence). [2].  Additionally, the Surviving Sepsis Campaign Guidelines state there is insufficient evidence …

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Endocrine, Metabolic, Fluid, and ElectrolytesInfectious DiseaseResuscitation

Impella Devices 101

Now that I am working up in the ICU, one of the devices that I am frequently coming across is the Impella device.  This is not something we get much training on downstairs in the ED.  Below is a summary …

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Cardiovascular

The Dirty Epi Drip and IV Flow Rates

Recently, I put out a video on the dirty epi drip (YouTube and TikTok) and in that video I discuss the use of this modality when in a pinch (i.e. can’t get push-dose pressors and/or a pump is not available …

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Resuscitation

Effect of Intra-Arrest Transport and eCPR on Neurologic Outcomes in Refractory OHCA

Background Information: Refractory out of hospital cardiac arrest (OHCA) is defined as prolonged cardiac arrest and cardiac arrest without return of spontaneous circulation (ROSC). In addition to an already morbid condition, the chances of these patients surviving drops below 5% …

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CardiovascularNeurologyResuscitation

Andexanet Alfa Vs. Four-Factor PCC: Is Andexanet Alfa Worth The Hype?

Background: Oral factor Xa inhibitors (FXi) have been associated with major and fatal bleeding events, including intracranial hemorrhage (ICH). In randomized controlled trials, both rivaroxaban and apixaban are associated with ICH at rates that range from 0.1 to 4% (Agnelli …

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Hematology and OncologyNeurologyTrauma

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