Is diastolic worse than systolic dysfunction in sepsis?
Septic myocardial dysfunction is a well recognised contributor to shock in sepsis but for many of us we assume this […]
Acute Med, All Updates, ICU, Resus, Ultrasound
shock
Acute Med, All Updates, ICU, Resus
Thrombolytic Therapy in Unstable Patients with PE
Most of us would give strong consideration to giving thrombolytics to patients with massive pulmonary embolism (PE), which is in […]
All Updates, ICU, Kids
Passive leg raise predicted fluid responsiveness in kids
Passive leg raising (PLR) is a great ‘free reversible fluid challenge’ to see if a shocked or hypotensive patient is […]
All Updates, ICU, Resus
Non-invasive BP in shock
In the management of the shocked patient, we sometimes get a little fixated on the need for an arterial line. […]
All Updates, PHARM, Resus
The REAL Shocked Patient
I promised to put some summary notes on the site for those who attended my talk on ‘The REAL Shocked […]
Acute Med, All Updates, ICU, Resus
Vasopressin – what it does and doesn't do
The current Surviving Sepsis campaign guidelines recommend that vasopressin should not be administered as the initial vasopressor in septic shock, […]
Acute Med, All Updates, ICU, Resus
Circulatory support in cardiogenic shock
An editorial1 reviewing options for circulatory support in patients with cardiogenic shock argues that traditional inotrope therapy may be replaced […]
Acute Med, All Updates, ICU, Resus
Xigris withdrawn
Pharmaceutical company Eli Lilly has announced the withdrawal of its severe sepsis drug activated protein C, or drotrecogin alfa (proprietary […]
Acute Med, All Updates, ICU, Resus
'Cryptic shock' important but not always very cryptic
Patients with severe sepsis and an elevated lactate who appear to be normotensive had a mortality similar to those presenting […]
All Updates, ICU, Resus
Delta CVP with PEEP and fluid responsiveness
I’ve been (and remain) critical of the use of CVP to determine ‘filling status’ or more accurately volume-responsiveness, even using […]