“Half of the time we’re gone but we don’t know where, and we don’t know where ...” -Paul Simon The Case A 42 year old man is admitted with fever, right upper-quadrant pain and jaundice. Over the last few hours he has become progressively confused and hypotensive. He has normal renal function with adequate urine [... read more]
The post Piperacillin-Tazobactam: The Antibiotic You’re Not Administering Correctly appeared first on PulmCCM.
“Rather than love, than money, than fame, give me truth.” -Thoreau The Case A 56 year old man with non-ischemic cardiomyopathy [LVEF 40% and mitral regurgitation] is admitted with severe sepsis due to appendicitis. One month prior to admission, his outpatient cardiologist saw him and noted a dry weight of 88 kg. On admission to the [... read more]
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“Truth is like the sun, its value wholly depends upon our being at a correct distance away from it.” -Hjalmar Söderberg The evening is invigorating; the Stockholm Marathon has been run and cobblestoned cafés, concealed within winding, narrowed side-streets are in the throes of summer’s end. I take a coffee and meander about the Grand [... read more]
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"We do not live in a privileged frame of reference." -Carl Sagan It is a common human experience to feel that one is the exception. Indeed, the study of cosmology has demoted our - once privileged - place in the cosmos. We have fallen from the center of the universe to inhabiting but one planet [... read more]
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A 23 year old woman is admitted with severe abdominal pain following 5 days of profound non-bloody diarrhea and 72 hours of recalcitrant non-bloody emesis. She has lost 7 pounds in this time frame and has been unable to maintain oral hydration. Her eyes are sunken and her vital signs are notable for a heart [... read more]
The post Rising Lactate & the Art of Venous Blood Gas Interpretation appeared first on PulmCCM.