We obsess with diuresis in our critically ill patients with positive fluid balances. But are we doing a dis-service? The focus should perhaps be on natriuresis...but how? The evidence is out there suggesting a positive fluid balance is detrimental to overall outcomes in ICU. I talk on the JICS mix below: https://youtu.be/faX9Zerio3o See also my... Continue Reading →
There are many reasons for a raised lactate. Identify the cause and then you will know if you need to do anything about it. Hint - it's usually not IV fluids. Lactate-CCNDownload
Fluid-guideline-ICU-CCN-1Download
Hypernatraemia is an independent predictor of mortality. DOI: 10.1093/ndt/gfm831. It is completely avoidable. This downloadable 1 page guide outlines causes, diagnosis and treatment. Hypernatraemia-guidelineDownload
Hyponatraemia can be confusing to diagnose and treat. Here it is all on 1 page! Hyponatraemia-guideline-3Download
IV fluid policy Written by: Dr Jonny Wilkinson– Consultant in ITU and Anaesthesia and NICE IV Fluid Lead Dr Lisa Yates – Clinical Fellow in ITU Additions from Dr Ashley Miller (@icmteaching). Legal pre-amble! I would like to point out to everyone before we go any further on here, that the IV fluid guideline discussed below... Continue Reading →
What does it do?! Albumin has loads of physiological effects: Regulating colloid osmotic pressure Binding and transporting drugs and hormones in the blood Antioxidant properties Nitric oxide modulation Maintenance of microvascular integrity Buffering Particularly relevant in critically ill patients. We also know that low serum albumin levels, commonly found in the critically ill, may... Continue Reading →
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... Continue Reading →
Another edition and loads to talk about, as ever. Let's crack on...lots to click on and catch up on at your leisure. I hope you enjoy it. News! CCR 19 is coming!! Get booking here Is this for real?! At first, I thought this was an April fool...then realised its May! Exciting potential to... Continue Reading →
Another fortnightly trawl of the best of the best in infographs, POCUS images, blogs, research and much more. Again, showcasing some of the fabulous stuff the world of #FOAM has to offer. There is loads here, so scroll and click on what interests you and don't be bamboozled by stuff that doesn't! Best wishes as... Continue Reading →
It never ceases to amaze me what is out on Twitter! A wealth of POCUS with some fabulous images, some really interesting infographs, trials, reviews and resources. I have done my usual trawl to try to snapshot what I see as the best of the lot this week. Sit down, caffeinate and digest.... Big News!!... Continue Reading →
A final happy Christmas to you all! This episode features loads of POCUS images, many of which you have kindly shared over Twitter. Thanks to all concerned and I have acknowledged you where I can. There is also a lot on flu, ARDS, OOHCA, less is more in sepsis and our usual run of infographics... Continue Reading →
I wanted to present a graphical snapshot of this meeting for you all. What you see first of all are my graphics, produced as I followed the meeting on Twitter and interacted with a lot of you who were kind enough to share things with us all. Following mine, you will see Aoife's, then the... Continue Reading →
There is a lot to say, but I've tried to be as concise as possible. Having just met with our medical director this afternoon to discuss this, it is a red hot topic. He certainly had absolutely no opposition towards anything I was discussing with him...an engaging session, from which we are going to ensure... Continue Reading →
What was it about?! The aim of this sixth edition meeting is to review recent advances in fluid management, and hemodynamic and organ function monitoring in the critical care setting in a comprehensive manner for intensivists, anaesthesiologists and emergency physicians as well as interested internists and surgeons. However the meeting will deal with any broad... Continue Reading →
Here we go again...the latest trawls and highlights of the FOAM world. A big thanks to all concerned...we have credited most, but certainly not forgotten all! Loads to see, so click away, follow and enjoy! Meeting of note Please take some time to go through this case report and answer the questions therein. This promises... Continue Reading →
There's been a small lapse...trips to Italy and all! So here we are back with some snappy #FOAMed #FOAMcc #POCUS finds and the usual trawl of the Twittersphere! In other news! Apparently we hit the dizzy heights of no. 17 amongst the top critical care sites online! Thanks to you all for clicking and... Continue Reading →
Here we go again! More trawling and mouse clicking for you all. Here are links and chats about all I see as the best of the bunch this week out there where access is free and open! To come... First ED post from Dan Weston Part 3 of the Fluid series with Manu Malbrain New... Continue Reading →
Loads of action this week. But here is a pick of some of the best of FOAM / POCUS. Click the pics to go to the linked articles. JW General Papers ARDS and its after effects...beyond the trial info! Frailty...not just mortality!! I think this is very poignant. We quote mortality when putting patients... Continue Reading →
Before we go any further with this post, please do join us for this amazing meeting: Programme Register here Submit your Abstract here Abstract It is imperative to acknowledge that there are four main indications for fluid therapy. The United Kingdom’s National Institute for Health and Care Excellence (NICE) recently provided a complete set... Continue Reading →
