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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

Sepsis 95
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REBEL Cast Ep120: Etomidate vs Ketamine for RSI in the ED?

RebelEM

Click here for Direct Download of the Podcast Paper: Knack SKS et al. Got FDA exemption as well as went to the community and made sure their community was ok with the trial). It is possible that the induction agent used could play an important role on hemodynamic effects in critically ill adults. Range 5 to 9) Etomidate: 7.0

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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%.

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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.