News!

ARDS best practice guidelines came out!

The important thing is to check out the grades of evidence behind each recommendation. There is no real re-invention of the wheel, and most of the suggestions are things we are all doing already….hopefully?!

Site of the month!

We made website of the month with our library!

A meeting worth knowing about!

Check out this meeting, which promises to be a cracker! Hopefully, I am winging my way there to deliver a POCUS talk. But the rumours on the street are that this is one not to miss. Plus, if you haven’t visited Edinburgh…you are missing out!

Click the image to book now!

Papers!

Individualise and it’s more against EGDT

A great article from Monnet et al, discussing the gauntlet the early Rivers studies set for us all; which we all now challenge as NOT gospel.

Is Albumin coming back?!

Perhaps…read this article discussing the recent SWIPE pilot. Interesting…but watch the rather ‘well’ study population used.

Pulmonary Hypertension

A nice review article on pathogenesis and types here.

Let’s make a pancreas!

A great paper discussing the tentative subject if dysglycaemia on the unit and can we automate control!

Epinephrine in cardiac arrest….friend or foe?

A good review in press regarding the various controversies that have recently come to the fore!

Lung US again

A nice supporting paper discussing this useful modality.

What brings them back!?

We don’t want to see our septic patients coming back to the unit on a bungie rope after we have succesfully discharged them! But these are the top reasons why they do. Infographic below as well. Thanks to Jack Iwashyna for these.

AKI and recovery profiling

A nice paper looking at a large cohort of septic and non-septic patients in ICU’s all over the world. We get an interesting profiling of the degree of AKI and relative recovery potentials in patients with sepsis, in particular. Seems AKIN AKI L3 is a bad one to have, even if you recover and downgrade. Also highlights whether we should delay jumping in with RRT in this with AKIN 2…we await STARRT-AKI!

Steroids and muscular weakness!

A paper demonstrating that, no surprise, steroids in septic patients may increase intensive care acquired weakness. These patients are already by remit sitters for the development of this condition, so it was no real surprise this was the case. But, it’s not going to stop us using steroids in septic shock…just might raise awareness we need to stop them and get the physics in EARLIER?

Global Longitudinal strain!

This is a parameter we are talking about more and more on ITU. It may, if you can measure it, offer more from a predictive angle than EF measurement will. It essentially involves speckle tracking. Videos attached below…

POCUS!

Take look at the Appendix!

Thanks to the POCUS Atlas for these brilliant images and guidance on diagnosis of appendicitis via the good old US probe!

TOE Vs TTE in cardiac arrest

Thanks to Manny Singh for this.

Don’t dilate any further!

And certainly don’t put the line in! Thanks to ArunNagdev for this

HOCM and collapse?

Pneumothorax and remedies!

Don’t go too shallow!

Tamponade illustrated

Thanks to TrEMATUS for this as ever.

What’s the cause of renal failure?!

More Butterfly images!

SMA dissection!

Fat, fluid and blood!

Lung like liver!

Retinal detachments

Thanks to Puneet Gupta for these

Blogs!

Heart failure pearls!

Great blog here on some of the pitfalls and pearls of heart failure treatment!

PAMPER us!

TBL pamper us with a look at this paper. In severely injured patients at risk for haemorrhagic shock, does prehospital plasma resuscitation, compared with standard-care resuscitation (not including plasma administration), reduce 30-day mortality?