Serum Chloride Levels in Critical Illness – The Hidden Story

Serum Chloride Levels in Critical Illness – The Hidden Story

Chloride is the principal anion of the extracellular fluid and vital for both serum electroneutrality and acid-base homeostasis. The aim of this review is to investigate the relevance of dyschloremia in the critically... read more

Hemodynamic Monitoring – The Why, When, Which and What

Hemodynamic Monitoring – The Why, When, Which and What

Although the need to properly assess and monitor the hemodynamic status of a critically ill patient appears self-evident, the plethora of information in the published literature over the past two decades has resulted in complexity... read more

Possible Link Between Splanchnic Circulatory Changes and Exhaled CH4

Possible Link Between Splanchnic Circulatory Changes and Exhaled CH4

The aim of this study was to explore the possible link between splanchnic circulatory changes and exhaled CH4 in an attempt to recognize intestinal perfusion failure. Methane (CH4) breath test is an established diagnostic... read more

Hemodynamic Impact of Oxygen Desaturation During Tracheal Intubation Among Critically Ill Children With Cyanotic and Noncyanotic Heart Disease

Hemodynamic Impact of Oxygen Desaturation During Tracheal Intubation Among Critically Ill Children With Cyanotic and Noncyanotic Heart Disease

Oxygen desaturation was more commonly observed during tracheal intubation in children with cyanotic versus noncyanotic heart disease. However, hemodynamic tracheal intubation associated event rates were similar. In both groups,... read more

Measuring Cardiac Output at the Bedside

Measuring Cardiac Output at the Bedside

The purpose of this review is to review the importance of cardiac output (CO) or stroke volume (SV) measurement and to discuss the various methods (devices) used in determination of CO. Bedside cardiac output measurement... read more

TPTD Techniques in the Hemodynamically Unstable Patient

TPTD Techniques in the Hemodynamically Unstable Patient

Transpulmonary thermodilution (TPTD) devices invasively measure not only cardiac output but also several other hemodynamic variables estimating cardiac preload, cardiac preload, systolic function, the lung oedema and systolic... read more

Venous Doppler and Veno-Cardiac Coupling

Venous Doppler and Veno-Cardiac Coupling

Concepts have been clanging around my head since I participated in Philippe Rola's sedulous Hospitalist & Resuscitationist Conference in Montreal. Initially, the abstractions of ventriculo-arterial coupling, Guytonian physiology... read more

Metabolic sepsis resuscitation: the evidence behind Vitamin C

Metabolic sepsis resuscitation: the evidence behind Vitamin C

Sepsis resuscitation generally focuses on hemodynamics. Rivers of ink have been spilled writing about oxygen delivery and fluid responsiveness. This is clearly important, but it's possible that our focus on easily... read more

Vasopressors and Inotropes for Shock Syndromes

Vasopressors and Inotropes for Shock Syndromes

Vasopressors and inotropes are cornerstones in the management of shock syndromes. Understanding vasopressors' receptor activity and resultant pharmacological response enables clinicians to select the ideal vasopressor(s)... read more

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Effect of Single-Dose Dexmedetomidine on Intraoperative Hemodynamics and Postoperative Recovery during Pediatric Adenotonsillectomy

Premedication of dexmedetomidine at the dose of 1 μg/kg in children undergoing adenotonsillectomy resulted in favorable effect on intraoperative hemodynamics, significant decrease in postoperative EA without causing any... read more

Study of the Effects of Epinephrine on Cerebral Oxygenation and Metabolism During Cardiac Arrest and Resuscitation by Hyperspectral Near-Infrared Spectroscopy

Study of the Effects of Epinephrine on Cerebral Oxygenation and Metabolism During Cardiac Arrest and Resuscitation by Hyperspectral Near-Infrared Spectroscopy

Epinephrine administration by bolus resulted in transient improvements in cerebral oxygenation and metabolism, whereas continuous epinephrine infusion did not, compared with placebo. Future studies are needed to evaluate... read more

Hypotensive Response to IV Acetaminophen in Pediatric Cardiac Patients

Hypotensive Response to IV Acetaminophen in Pediatric Cardiac Patients

In isolation of other medication, a hemodynamic response to IV acetaminophen has a higher prevalence in critically ill children with cardiac disease than previously thought and justifies controlled studies in the perioperative... read more

Validation and Critical Evaluation of the Effective Arterial Elastance in Critically Ill Patients

Validation and Critical Evaluation of the Effective Arterial Elastance in Critically Ill Patients

In critically ill patients, effective arterial elastance may be reliably estimated at bedside. We support the use of this validated estimate of effective arterial elastance when coupled with an index of left ventricular contractility... read more

Artificial Liver Support in Acute and Acute-on-Chronic Liver Failure

Artificial Liver Support in Acute and Acute-on-Chronic Liver Failure

Liver support systems such as MARS and TPE may temporarily improve systemic hemodynamics and the degree of encephalopathy. However, TPE is the only procedure that improves survival in patients with ALF. The role of TPE in... read more

A Trial of Goal-oriented Hemodynamic Therapy in Critically Ill Patients

A Trial of Goal-oriented Hemodynamic Therapy in Critically Ill Patients

Hemodynamic therapy aimed at achieving supranormal values for the cardiac index or normal values for mixed venous oxygen saturation does not reduce morbidity or mortality among critically ill patients. A total of 10,726 patients... read more

Angiotensin II For Septic Shock Treatment

Angiotensin II For Septic Shock Treatment

Angiotensin II has been studied for many years and has consistently shown to increase MAP. This medication adds a new mechanism of action to the vasopressor arsenal that is already used for septic shock. Angiotensin II should... read more

Lactate-Guided Resuscitation Only Encourages Over-Resuscitation and Downstream Harms

Lactate-Guided Resuscitation Only Encourages Over-Resuscitation and Downstream Harms

The Centers for Medicare and Medicaid Services and the Surviving Sepsis Campaign both rushed to offer guidance on the appropriate management strategies for patients presenting with septic shock. In both cases, a lactate-guided... read more