| The Lightening Thief | When Breath Becomes Air | Sweetness in the Belly | Water for Elephants | Eat, Pray, Love |
|---|---|---|---|---|
|
Norepinephrine
What is the first pressor you start for blood pressure support in septic shock?
|
Berlin Criteria
What is the criteria for categorizing ARDS?
|
Sustained IAP >12mmHg
5-7mmHg
What's the definition of IAH?
What is the normal IAP in critically ill patients? |
Continuous Renal Replacement Therapy
What is CRRT and what does it stand for?
|
4, 4, and 9
How many kcal/g are contained within protein, glucose, and fat?
|
|
Insufficient perfusion and oxygen delivery to organs, causing end organ dysfunction
What is the definition of shock?
|
Pull back the ETT slightly
23M with Rt middle lobe PNA intubated for progressive hypoxemia. After intubation, peak pressure alarm sounds and breath sounds were not heard over the left hemithorax. First response is to:
|
IAP >20mmHg (with or without an APP <60mmHg) that is associated with NEW organ dysfunction
What is the definition of ACS?
|
Abrupt (1-7d) and sustained (>24hrs) decrease in glomerular filtration rate (GFR)
What is acute kidney injury?
|
7-10d
How many days after ICU admission does mortality and hospital LOS start increasing when comparing TPN vs. no nutrition, so we should start TPN?
|
|
Temp <36 or >38
Heart hrate >90 RR >20, or PaCO2 <32 WBC <4 or >12
What is the SIRS criteria?
|
Volume control w/ 6mL/kg TV
From ARDSNet trial
Which of the following decreases mortality in patients with ARDS?
a. intermittent mandatory ventilation w/ 3mL/kg TV b. VC w/ 6mL/kg TV c. PC settings for 12mL/kg TV d. APRV e. High-frequency oscillatory ventilation |
End expiration, in the supine position with the patient either deeply sedated/paralyzed
How should IAP be measured?
|
Prerenal: decreased perfusion, decreased CO, decreased volume, third spacing, ACS
Postrenal: obstructed ureters Intrinsic: glomerular disease, AIN, ATN
What are three categories of AKI, and give an example of each
|
As soon as possible, but ideally within 72hrs
When should you start nutritional support in trauma patients in the ICU?
|
|
Permissive hypotension
Blood products over isotonic crystalloid Early tx of coagulopathy
What are the major tenets of damage control resuscitation?
|
Intubate the patient
What must occur before you insert a Blakemore tube?
|
MAP - IAP
How do you calculate APP?
|
AEIOU - acid-base, electrolyte, ingestion, overload, uremia
What are the indications for dialysis?
|
Hepatic complications - rise in LFTs
Fat overload syndrome Hypoglycemia Electrolyte abnormalities Hyperbilirubinemia Overfeeding
What are possible metabolic complications of TPN? (Name 2)
|
|
Spinal: tx = wait for recovery; occurs at any level
Neuro: tx = pressor + fluids; high >T6 injury
How does the treatment of spinal shock differ from that of neurogenic shock, and what is the physiology behind that?
|
Awake fiberoptic intubation
67F morbidly obese, unexpected extubation in ICU for PNA. Previous intubation was difficult. BP 150/70, HR 110, RR 32, 92% on 100%FM. Best method of obtaining airway?
|
1. Neuromuscular blockade
2. Consider body position 3. Enteral decompression (NG/rectal) 4. Neostigmine for Ogilvie's if present 5. Avoid positive fluid balance 6. Consider paracentesis if large volume of ascites 7. Consider diuretics
Name 5 temporary management strategies for ACS/IAH?
|
I-STUMBLED
isopropyl alcohol, salicylates, theophylline, uremia, methanol, barbiturates, lithium, ethylene glycol, dabigatran/divalproex
What are dialyzable drugs/toxins?
|
Physiologic process that occurs when re-feeding after period of starvation, shifting from use of fat to CHO.
HypoP, hypoK, hypoMg, Na retention, fluid overload.
What is refeeding syndrome? What electrolytes abnormalities are associated with it?
|
Support Us on Ko-fi