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REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension

RebelEM

REBEL Cast Ep116: The CLOVERS Trial – Restrictive vs Liberal Fluids in Sepsis-Induced Hypotension Click here for Direct Download of the Podcast Paper: The National Heart, Lung and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network. Liberal: 14.9% Estimated Difference: -0.9%; 95% CI 04.4

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REBEL Core Cast 117.0 – Infections of Pregnancy

RebelEM

REBEL Core Cast 117.0 – Infections of Pregnancy Click here for Direct Download of the Podcast Urinary Tract Infection/Pyelonephritis Epidemiology: Occurs in as many. Most infectious processes will require admission and close observation for improvement or decompensation. Read more

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Back to the BaSICS: does the infusion rate of a fluid bolus affect mortality?

PulmCCM

And so, Zampieri and colleagues recently released the Balanced Solutions in Intensive Care Study [BaSICS], comparing two types of crystalloid resuscitation fluid, discussed previously , as well as two infusions rates of these fluids , considered below. sepsis – defined as suspected or confirmed infection plus acute organ dysfunction; d.]

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ICU Physiology in 1000 Words: Phenylephrine Pushes & Stroke Volume

PulmCCM

Notably, they observed that while phenylephrine rectified hypotension, it significantly reduced heart rate [HR], SV – and, therefore, total cardiac output [CO] – as well as cerebral oxygenation [SctO2]. evaluated phenylephrine in 7 critically-ill patients with ‘hyperdynamic’ sepsis [defined as sepsis with CO above 6.0

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Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS

PulmCCM

45% of patients were admitted to the ICU directly from operating or recovery rooms, 79% were mechanically-ventilated and 42% had sepsis. As well, after randomization, 63% of patients randomized to balanced fluids received 500 mL or more of open-label saline, while only 3.5% Download his free textbook here.

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REBEL Core Cast 94.0 – SBO

RebelEM

Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43 Absent bowel sounds Peritoneal signs (i.e. rebound and guarding) Diagnostics Laboratory Tests Commonly ordered lab tests (i.e. Late findings Fever Abdominal distension (+) LR: 5.64 – 16.8 (-) LR: 0.34 – 0.43

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What Minimal Volume of Intravenous Fluid Challenges the Heart?

PulmCCM

As well, the volume of administration might be much lower than 500 mL, with previous research indicating that 4 mL/kg of crystalloid was an optimal volume needed to increase mean systemic filling pressure. Download his free textbook here. Following the 500 mL protocol, 80% of the patients increased SV by at least 15%.