A free online resource for Intensive Care Medicine.
An unofficial Fellowship Exam (CICM Part 2) preparation resource.
Deranged Physiologyis a slowly growing archive of discussions and study notes relevant (or if not relevant, then at least interesting) to the practice of intensive care medicine. The content provides an introduction to the fundamental themes in intensive care: mechanical ventilation, vasopressors, electrolyte management, hemodynamic monitoring, dialysis, and so forth. Attention is directed at equipment in intensive care, and there are attempts to revisit interesting pharmacology and physiology. The aim of this resource is to supplement the bedside teaching of senior staff, and to consolidate resources for intensive care trainees in the initial stages of their training.
This is essentially just free water. No anions, no cations. No added buffer, no antimicrobial agent, no artificial colours or preservatives. For flavor, 278mmol of dextrose is added. If you were trying to use this as a source of nutrient, the whole litre would yield 835 kJ, or 198 calories
Also, among his otherwise rather Spartan chapters from Oh's Manual, Rinaldo Bellomo has included a table (pp.545) titled "Drug dosage during dialytic therapy"; given the highly selective nature of the Manual, one can assume that this table is of importance. For fear of copyright-associated repercussions, the table is not reproduced below.
Excellent chapters in Critical Care Nephrology (2009, 2nd ed) exist, but are perhaps too long for the time-poor exam candidate. Some effort has been spent to summarise these into the tables presented below. Additionally, excellent free-to-read articles are available on the intrawebs, containing vast lists of complications.
This is a simple process. You pump anticoagulated blood through a hemoperfusion cartridge. Empirically, it seems a good blood flow rate is about 300ml/min. A rising filter pressure indicates that a clot is forming in the filter.
This chapter is a summary of the pharmacological properties of milrinone. My main focus will be the differences between milrinone and dobutamine. These are the two major old-style inotropes in our arsenal; and there are situations which favour the use of one over the other.