Renal Replacement Therapy – help or hindrance?! #FOAMed #FOAMcc

Written by Dr Richard Pertwee (Clinical Fellow ITU) Edited and reviewed by Dr Jonny Wilkinson Renal replacement therapy is a commonly administered treatment in Intensive Care. It is also a therapy / aspect of critical care that creates a large air of confusion amongst many, from nursing staff to medical staff alike. >5% of the... Continue Reading →

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Push them to the (VO2)Max! #FOAMed #FOAMcc

Cardio Pulmonary Exercise Testing (CPEX/CPET) Does your centre have one? We are lucky enough to say we do, and we find the test a very useful discriminator as to whether patients can physiologically 'cope' with the operation ahead of them (normally major surgery). This is relevant to ICU, as there will often be a request... Continue Reading →

Life could be so sweet!!! #FOAMed #FOAMcc

Glycaemic control in Critical Care In the ICU world we obsess and quite rightly, on physiology and correcting what is deranged. There is a vast abundance and ever accumulating bank of research out there focussing on the gold standard...morbidity and mortality and how we can reduce it. As a result we have looked at, to... Continue Reading →

Fluid responsiveness…will your echo help?! #FOAMed #FOAMcc #POCUS

The Conundrum... Your patient is dry....or so the night docs tell you, having had it drummed into them for the past few hours into the morning by the nursing staff. How are you going to sort this, is there a bigger issue with the patient, do they need the magic pressers, just IV fluid.....or, do... Continue Reading →

Volume Overload: Prevalence, Risk Factors, and Functional Outcome in Survivors of Septic Shock #FOAMed

A study carried out in an academic county hospital in the US examined the associations between volume overload on ICU discharge, mobility limitation and discharge to a healthcare facility amongst survivors of septic shock. Septic shock is commonplace in critical care and indeed, its incidence is on the increase. With this however, we are seeing... Continue Reading →

Lactate…is the crystal ball we all need?

So we all hang on this as a prognosticator, as well as a gauge of the state of our patients both on the unit and prior to coming up to us. But should we be focussing on Lactate as much as we think we should? Is it the 'magic bullet' to adequate resuscitation? A bit... Continue Reading →

LEOPARDS…even more dangerous when you’re septic!

Intro... There has been a lot of discussion regarding the LEOPARDS trial on FOAMed recently. Particularly after the ESICM meeting in Milan. The drug Levosimendan was thought to be of some hope in the treatment of sepsis...to better current Vaso/Inotherapy we currently use (starving coronary blood flow, pushing the heart too hard and causing horrendous... Continue Reading →

Paracetamol….you know you want it!

Here's a link to an interesting paper from Oz on paracetamol usage in crit care! Food for thought.......á la statins... What was it looking for Did paracetamol influence outcome of ICU patients? Primary outcome, in-hospital mortality and secondary outcome, ICU mortality. Type Multicenter, retrospective observational study, 17,110 patients. Stats thorough with multi-variate analysis and good... Continue Reading →

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