ICU Rounds

Starting Surgery Rotation: How to Pre-Round and Present on Rounds

Splitting a Ventilator: Multipatient Ventilation for COVID?

Prone Ventilation for ARDS (COVID-19)

ARDS and Mechanical Ventilation / COVID-19 Care

ICU Care of Coronavirus (COVID-19)

Colloids: Details and Myths

Colloids function as essential tools in intensive care by exerting osmotic pressure to maintain intravascular volume, yet common misconceptions persist regarding their definition and clinical application. While albumin serves as a primary colloid by remaining in solution to pull water into the circulatory system, whole...

Random Serum Cortisol Levels are misleading

Adrenal insufficiency in critically ill patients is frequently misdiagnosed due to an over-reliance on total serum cortisol levels, which fail to account for the physiological impact of protein binding. Cortisol exists primarily in protein-bound forms, with only 10% circulating as biologically active free cortisol. Con...

EARLY use of Tranexamic Acid may improve survival from bleeding in trauma

Pediatric IVC diameter determination with ultrasound

Takotsubo Cardiomyopathy

Takotsubo's cardiomyopathy, also known as transient left ventricular apical ballooning syndrome, presents as a reversible form of left ventricular dysfunction that frequently mimics acute myocardial infarction. Patients often exhibit ST-segment elevation, elevated cardiac enzymes, and potential cardiogenic shock, yet c...

Necrotizing Soft Tissue Infection (NTSI)

The podcast addresses the increasing occurrence of soft tissue infections, emphasizing the critical need for rapid treatment to minimize morbidity and mortality. It explores potential reasons for the rise in cases, including more virulent organisms, increased media attention, and the growing number of chronically ill o...

Different Cardiac Output Monitors & Physiology

The podcast explores the physiological principles behind cardiac output monitors and their utility in critical care. It emphasizes understanding what a monitor truly measures, its reliance on specific physiological conditions, and its limitations under pathological conditions. The discussion questions the traditional f...

Lactic Acidosis - Type B

The podcast explores Type B lactic acidosis, differentiating it from Type A, which results from inadequate oxygen delivery. Type B is categorized into B1 (underlying diseases), B2 (drugs and toxins), and B3 (inborn metabolism errors). Examples of B1 include renal and hepatic failure, diabetes, and malignancies, with sp...

Lactate Acidosis - Type A

The podcast addresses lactic acidosis, clarifying its nature, measurement, and application in patient resuscitation. It emphasizes that lactate serves as a tool to gauge oxygen kinetics, where shock occurs when oxygen demand surpasses delivery, potentially affecting individual organs. The discussion covers the metaboli...

Endotracheal tube cuff leaks and self-extubations

The podcast addresses the management of orally intubated patients in the ICU experiencing a significant cuff leak. It emphasizes a thoughtful approach over hasty decisions, prioritizing airway patency. The discussion covers assessing endotracheal tube positioning via X-ray or bronchoscopy and methods for safe repositio...

Pulmonary Embolus

Smoke Inhalation Injury

Smoke inhalation represents a critical, multi-faceted injury involving thermal damage, asphyxiation, and delayed toxic lung complications. While the initial 24 to 48 hours often present as a deceptive "honeymoon period," severe pulmonary dysfunction frequently emerges thereafter due to the sloughing of epithelial cells...

Propofol Related Infusion Syndrome

Propofol Infusion Syndrome (PRIS) represents a rare but potentially fatal complication associated with the administration of propofol, characterized by acute refractory bradycardia progressing to asystole. This clinical state often manifests alongside metabolic acidosis, rhabdomyolysis, hyperkalemia, and cardiac dysfun...

Wedge: Everyone elses favorite Swan number

The podcast delves into the complexities of using pulmonary artery catheters, specifically focusing on the wedge pressure measurement. It argues that the wedge, often misunderstood, shouldn't be the sole determinant in clinical decisions due to inter- and intra-patient variability in cardiac compliance. The discussion ...

SVO2 My favorite Swan Number

The podcast focuses on understanding and interpreting the mixed venous saturation of oxygen (SvO2) as measured by a pulmonary artery catheter. It emphasizes that while the utility of PA catheters is debatable, the SvO2 value provides critical information about oxygen delivery and consumption in critically ill patients....