Fluids in Sepsis

What are the effect (good and bad) of positive pressure ventilation on hemodynamics in critically ill patients?  Link to the visuals for this episode: https://bit.ly/venthemodynamics.  Also, checkout Rapid Sequence, our new choose-your-own-adventure resuscitation game at rapidsequence.org (coupon code for ICUedu listeners: ICUEDU2026)

How do you manage the vent in a critical polytrauma patient who is hypoxemic?  Link to the visuals for this episode: https://bit.ly/traumavents.  Also, checkout Rapid Sequence, our new choose-your-own-adventure resuscitation game at rapidsequence.org (coupon code for ICUedu listeners: ICUEDU2026)

When, how, and most importantly WHY we should be using diuretics.  Also, checkout Rapid Sequence, our new choose-your-own-adventure resuscitation game at rapidsequence.org (coupon code for ICUedu listeners: ICUEDU2026)

Acute medical management of valvulopathy.  Part II talks about the pathophysiology and management of stenotic valves: AS and MS.  Check out Rapid Sequence, ICUedu's new education project at rapidsequence.org   Great Core Ultrasound post on POCUS assessment of valvulopathy: https://coreultrasound.com/valves-2/  Additional content and educational resources at ICUedu.org

Acute medical management of valvulopathy.  Part I talks about the pathophysiology and management of regurgitant valves: AI, MR, and TR.  Great Core Ultrasound post on POCUS assessment of valvulopathy: https://coreultrasound.com/valves-2/Additional content and educational resources at ICUedu.org

Updated talk on fluids in sepsis!Access to video version of lecture, supplemental materials & references at: https://www.icuedu.org/fluids-in-sepsis

How can the science of expertise inform our ability to attain excellence in resuscitation?Additional content and educational resources at ICUedu.orgReferences for the papers mentioned in the episode: Kovacs & Croskery. Clinical Decision Making: An Emergency Medicine Perspective. Academic Emergency Medicine, 1999; 6(9): 947-952The Neuroscience of Expertise. Bilalic (2017), Cambridge University PressJeon et al. What does “being an expert” mean to the brain?  Functional specificity and connectivity in expertise.  Cerebral Cortex, 2017; 27(12): 5603-5615Gobet & Simon. Recall of random and distorted chess positions: Implications for the theory of expertise. Memory & Cognition, 1996; 24(4): 493-503 Gold & Ciorciari.  A Review on the Role of the Neuroscience of Flow States in the Modern World. Behav Sci (Basel), 2020;10(9):137

Management approach for electrical storm!For a deep dive into EKGs in wide complex tachycardias, take a look at this awesome lecture by Amal Mattu.References to articles mentioned in the podcast:Cheskes et al. Defibrillation Strategies for Refractory Ventricular Fibrillation. N Engl J Med. 2022 Nov 24;387(21):1947-1956Ortiz et al. Randomized comparison of intravenous procainamide vs. intravenous amiodarone for the acute treatment of tolerated wide QRS tachycardia: the PROCAMIO study. Eur Heart J 2017;38(17):1329-1335Song et al. Association of Dexmedetomidine With New-Onset Atrial Fibrillation in Patients With Critical Illness. JAMA Netw Open 2023;6(4):e239955Wang etc. Effect of Dexmedetomidine on Tachyarrhythmias After Cardiac Surgery: A Systematic Review and Meta-Analysis. J Cardiovasc Pharmacol 2022;79(3):315-324Zhong et al. Dexmedetomidine Reduces Incidences of Ventricular Arrhythmias in Adult Patients: A Meta-Analysis. Cardiol Res Pract 2022;5158362Do et al. Thoracic Epidural Anesthesia Can Be Effective for the Short-Term Management of Ventricular Tachycardia Storm. J Am Heart Assoc. 2017 Oct 27;6(11):e007080Tian et al. Effective Use of Percutaneous Stellate Ganglion Blockade in Patients With Electrical Storm. Circ Arrhythm Electrophysiol. 2019;12(9):e007118Batnyam et al. Safety and Efficacy of Ultrasound-Guided Sympathetic Blockade by Proximal Intercostal Block in Electrical Storm Patients. JACC Clin Electrophysiol 2024;10(4):734-746

ICUedu Physiologically Difficult Airway Pocket Intensivist CardICUedu.org page with video lecture, references, and a downloadable link to key visuals: https://www.icuedu.org/physiologicallydifficultairway

We know what to do with the patient who is sick and hypotensive.  But what about the patient who is sick but not hypotensive?  Or the patient who is hypotensive but not sick?References for the papers mentioned in the podcast on use of midodrine in the ED:Puissant et al (2022). Wait, What? Oral Midodrine Instead of Pressors for Septic Shock? Annals of Emergency Medicine;80(4):S94Zada et al (2024). Midodrine in Early Septic Shock. Critical Care Medicine 52(1):S708Lal et al (2021). Oral Midodrine Administration During the First 24 Hours of Sepsis to Reduce the Need of Vasoactive Agents: Placebo-Controlled Feasibility Clinical Trial. Critical Care Explorations 3(5):e0382Additional content and educational resources at ICUedu.org