Tag: hypertension
Pediatric Hypertension and Hypertensive Emergencies: Recognition and Management in the Emergency Department
Pediatric hypertension generally presents to the ED in 2 forms: (1) the otherwise asymptomatic child with elevated blood pressure, and (2) the child with a true hypertensive emergency. This issue provides recommendations... read more
Incidence, Severity, and Detection of Blood Pressure Perturbations after Abdominal Surgery
Intraoperative and postoperative hypotension are associated with myocardial and kidney injury and 30-day mortality. Intraoperative blood pressure is measured frequently, but blood pressure on surgical wards is usually measured... read more
Management of Pediatric Severe Traumatic Brain Injury
This article provides an algorithm of clinical practice for the bedside practitioner based on the available evidence, treatment protocols described in the articles included in the 2019 guidelines, and consensus that reflects... read more
Overuse of troponin? A comprehensive evaluation of testing in a large hospital system
Troponin assays are integral to the diagnosis of acute myocardial infarction (AMI), but there is concern that testing is over utilized and may not conform to published guidelines. We reviewed all testing performed at 14 hospitals... read more
Predicting AKI using urinary liver-type fatty-acid binding protein and serum N-terminal pro-B-type natriuretic peptide levels in patients treated at medical cardiac ICUs
Urinary L-FABP and serum NT-proBNP levels on admission are independent predictors of acute kidney injury (AKI), and when used in combination, improve early prediction of AKI in patients hospitalized at medical cardiac intensive... read more
Plasma Volume, Tissue Oedema, and the Steady-state Starling Principle
The Michel–Weinbaum steady-state Starling principle has important consequences for clinical practice. The hope that biophysical intravascular colloid therapy with albumin or plasma substitutes can deliver plasma volume... read more
Ultrasound Non-invasive Measurement of Intracranial Pressure in Neurointensive Care
Of the studied ultrasound nICP methods, ONSD is the best estimator of Intracranial Pressure (ICP). The novel combination of ONSD ultrasonography and vTCD of the straight sinus is a promising and easily available technique... read more
Pheochromocytoma Diagnosis
Pheochromocytoma is a catecholamine-producing tumor that originates from chromaffin cells of the adrenergic system, most commonly in the adrenal medulla. There are two main steps in the diagnosis of pheochromocytoma: biochemical... read more
The Elevated Troponin: What else besides ACS could cause troponin elevation?
The increased troponin used to be a straight ticket to the cardiology service. Now, the picture isn't so clear. What do you need to consider in the patient with elevated troponin? Cardiac troponins consist of three proteins:... read more
Resuscitation of Pulmonary Hypertension and RV Failure
A guide to the initial emergency department management of patients with pulmonary hypertension and right ventricular failure. It is very rare for my to write about pathophysiology, but understanding the pathophysiology of... read more
Emergency Management of Intracerebral Hemorrhage – The Golden Hour
There is a kind of self-fulfilling prognostic pessimism when it comes to Intracerebral Hemorrhage. And this pessimism sometimes leads to less than optimal care in patients who otherwise might have had a reasonably good outcome... read more
Johns Hopkins Investigators Unravel Biological Roots of Pulmonary Hypertension
Working with cells that line the innermost layer of the blood vessels, Johns Hopkins investigators say they have made a leap forward in understanding the underlying biology behind pulmonary hypertension, a dangerous type... read more
Intra-Abdominal Hypertension Is More Common Than Previously Thought
Intra-abdominal hypertension is common in both surgical and nonsurgical patients in the intensive care setting and was found to be independently associated with mortality. Despite prior reports to the contrary, intra-abdominal... read more
Association Between Continuous Hyperosmolar Therapy and Survival in Patients with TBI
Intracranial hypertension (ICH) is a major cause of death after traumatic brain injury (TBI). Continuous hyperosmolar therapy (CHT) has been proposed for the treatment of ICH, but its effectiveness is controversial. We compared... read more
R.E.B.E.L. EM – Fluid Responsiveness and the Six Guiding Principles of Fluid Resuscitation
Fluid resuscitation is a crucial aspect of emergency and critical care. Since the advent of the concept of early goal-directed therapy, we have placed a huge emphasis on aggressive fluid resuscitation in patients with severe... read more
Hospitalist Tackles Chronic Disease With Food Pharmacies
Before January 2017, Rita Nguyen, MD, was "pretty much like any other academic hospitalist," she says. In the hospital, she could provide excellent care to patients, but once they were discharged, many didn't have the necessary... read more
The Iatrogenic Potential of the Physician’s Words
Some of the information that physicians convey to their patients can inadvertently amplify patients' symptoms and become a source of heightened somatic distress, an effect that must be understood by physicians to ensure optimal... read more
