DIC and TTP

Disseminated Intravascular Coagulation  DIC, also called consumption coagulopathy, is a systemic process producing both thrombosis and hemorrhage. It consists of the following components:    Exposure of blood to procoagulants such as tissue factor and cancer procoagulant   Formation of fibrin within the circulation   Fibrinolysis   Depletion of clotting factors   End-organ damage  Purpura fulminans is a severe form of DIC resulting from thrombosis … Read moreDIC and TTP

Cardiac Tamponade

Cardiac Tamponade:  Cardiac tamponade – Characterized by the accumulation of pericardial fluid under pressure.   Constrictive pericarditis – Scarring of pericardium with resultant loss of elasticity of the pericardial sac.   An important pathophysiologic feature of both cardiac tamponade and constrictive pericarditis is greatly enhanced ventricular interaction or interdependence, in which the hemodynamics of the left and right … Read moreCardiac Tamponade

Pulmonary Hypertension

PULMONARY HYPERTENSION  Pulmonary hypertension (PH) is defined simply as a mean pulmonary artery pressure of 25 mmHg or greater. The normal mean pulmonary arterial pressure is 14+-3, with upper limit being 20. Normal pulmonary arterial systolic pressure is around 10 and diastolic pressure around 5 mmHg.    Although pulmonary hypertension is primarly due to elevation of pressure … Read morePulmonary Hypertension

Proportional Assist Ventilation

 Proportional Assist Ventilation    PAV is a spontaneous breathing mode that offers assistance to the patient in proportion to the patient’s effort. It can be considered as adaptive pressure support. In pressure support, the support is a fixed driving pressure. In PAV, the support is adaptive to keep work of breathing constant.  In this mode, the magnitude of ventilator … Read moreProportional Assist Ventilation

APRV

Airway Pressure Release Ventilation    Airway pressure release ventilation (APRV) mode of mechanical ventilation is an elevated CPAP level with timed pressure releases. This short release for brief periods along with spontaneous breathing promotes CO2 elimination. Release time is short enough to prevent peak expiratory flow from returning to a zero baseline.  The other advantage of … Read moreAPRV

Nutrition

Nutrition in ICU:    During critical illness, catabolism (breakdown of muscle protein, fat and other complex molecules) occurs faster than anabolism. The major goal of nutritional support during this period of acute illness was to ensure the body has adequate energy and nutrients available to slow down this process of fat and muscle loss. Loss of … Read moreNutrition

Drug Overdose

Toxicology:    Approach to Acute Poisoning  Resuscitation  Airway  Breathing  Circulation  Seizure control  Correct hypoglycemia  Correct hyperthermia  Resuscitation antidotes  Risk assessment  Investigations  Supportive care and monitoring  Decontamination with activated charcoal. It should be given within 1 hour.  Enhanced elimination:  Multiple dose charcoal in quinine, carbamazepine, theophylline and barbiturate poisoning  Whole bowel irrigation with golytely  Urinary alkalinization: Alkaline … Read moreDrug Overdose