How might you answer this oral board examination question? Describe the systemic effect on pH following 2 litres infusion of each of the following solutions: A. normal saline with a pH of 7.0 B. normal saline with a pH of 5.6 C. normal saline with a pH of 4.6. Pick up a bag of [... read more]
The post The Acidity of Normal Saline and the Stewart Approach appeared first on PulmCCM.
The Journal of Intensive Care has newly published a series of sepsis-related organ dysfunction reviews. Additionally, a comprehensive yet concise overview of the cerebral circulation was just disseminated. This summary draws on both of these terrific primary resources as a point-of-departure for discussion of sepsis-associated delirium [SAD]. Cerebral blood flow [CBF] ultimately depends on 1. the [... read more]
The post The Cerebral Circulation and Sepsis-Associated Delirium appeared first on PulmCCM.
Jon-Emile S. Kenny [@heart_lung] As mentioned in part 1, Gattinoni and Quintel have outlined their approach to managing the acute respiratory distress syndrome [ARDS] . They argue that treatment of ARDS should minimize firstly, the mechanical power applied to the lungs – as described in part 1. Secondly, Gattinoni and Quintel note that, in the [... read more]
The post ICU Physiology in 1,000 Words: ARDS – Part 2 appeared first on PulmCCM.
In memory of a kind and gentle soul, I would like to share this brief and basic overview of the genetics of cystic fibrosis [CF]. While CF had been known to be an autosomal recessive gene since 1949 – given its inheritance pattern – it was in 1989 when researchers at the venerable Hospital for [... read more]
The post Review: The Genetics of Cystic Fibrosis appeared first on PulmCCM.
A 66 year old man presents to the emergency department with sudden-onset fevers, chills, and scant hemoptysis. He is hypoxemic, tachypneic and noted to have egophony with focal crackles and wheezing across his right, anterior chest. Further, he is found to be in acute kidney injury and his chest x-ray reveals a bulging fissure sign [... read more]
The post Corticosteroids for Community-Acquired Pneumonia appeared first on PulmCCM.