“It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgement with respect to particular patients or special clinical situations.” -IDSA/ATS Guidelines 2016 A 73 year old man is admitted from a nursing home for an NSTEMI and is treated on the telemetry [... read more]
The post IDSA Guidelines 2016: HAP, VAP & It’s the End of HCAP as We Know It (And I Feel Fine) appeared first on PulmCCM.
"An' it ain't no use in turnin' on your light, babe, I'm on the dark side of the road ..." -Bob Dylan A 44 year old man with cryptogenic cirrhosis is admitted with large ascites and acute kidney injury. A 50 mL, diagnostic paracentesis reveals 12 PMNs and he is admitted from the emergency department for further [... read more]
The post Intra-abdominal Pressure and Renal Function appeared first on PulmCCM.
“A rising tide lifts all boats.” -John F. Kennedy Two years ago, heart-lung.org went live – a project borne out of my deep interest of the inter-connectedness of the cardiovascular and respiratory pumps. I have been truly amazed and deeply appreciative of the kind words which I have received from around the world; indeed, I [... read more]
The post A Free & Open-Access Hemodynamic Physiology Curriculum appeared first on PulmCCM.
“Doctrine once sown strikes deep its root, and respect for antiquity influences all men.” -William Harvey  The use of hyperoncotic albumin to draw fluid from the interstitial space permeates dark corners of the critical care community. The ‘pull and push’ of 25% albumin followed by furosemide remains somewhat of a cryptic lore – its [... read more]
The post The Revised Starling Principle: Implications for Rational Fluid Therapy appeared first on PulmCCM.
“… it is a tale. Told by an idiot, full of sound and fury, signifying nothing.” Macbeth: Act V, Scene V The results of the ATACH II trial are out; we have even more guidance when managing the blood pressure of hypertensive patients with supratentorial, intra-cerebral hemorrhage of less than 60 cm3 in volume. The question: [... read more]
The post Blood Pressure Goals in Intracerebral Hemorrhage – ATACH II appeared first on PulmCCM.