My notes on this modern primer on shock by 11 well-known shock experts (shoxperts?). Interesting mix of evidence-base and expert opinion/enthusiasm. Definitely some echophiles amongst them. Definition Life-threatening, generalized, acute circulatory failure associated with inadequate oxygen utilization by cells (dysoxia leading to hyperlactataemia). Pathophysiology Insufficient circulating volume, Pump failure (muscle problem or rhythm problem), Obstruction …
Raghunathan has used some interesting statistics to try and extract the effects of using Saline or Ringer’s lactate in resuscitating sepsis. Elixhauser comborbidities, 5:1 greedy matching, Generalized Estimating Equation models, and “missing-ness” are just a few of the terms I didn’t understand. Nevertheless this appears to be a retrospective study that suggests there’s measurable mortality benefit in using balanced …
LITFL Wessex ICS BottomLine Emcrit
Know your phases and master fluid management
November 22, 2014
The ADQI renal authority turns its attention to fluid strategy in ADQI III’s BJA article. Choose the right fluid balance target for the stage of critical illness: Rescue – first few minutes; generous fluid boluses to treat shock. Obviously, not all patients require this phase. Optimization – few hours; assessment of …
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