With Dr. Prem Kandiah, neurointensivist, transplant intensivist, and ammonia enthusiast, we explore the physiology of hyperammonemia, the nuances of its measurement and interpretation, and unpack some less-recognized causes, including infection by urease-producing organisms and malnutrition/gastric bypass. Learn more at the Intensive Care Academy! References and resources Acute Liver Failure Overall management of ALF CRRT in … Continue reading "Episode 96: Understanding ammonia, with Prem Kandiah"

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We dive into the common dilemma of when to give stress-dose corticosteroids in septic shock, with Dr. David Janz, pulm/crit intensivist with a Masters of Science in Clinical Investigation, former director of the Clinical Research Unit for the critical care section at LSU, founding member of the Pragmatic Critical Care Research Group, and associate Chief … Continue reading "Lightning rounds 58: Steroids for septic shock with David Janz"

We explore the fascinating intricacies and unique features of the burned critically ill patient, with Clint Leonard, NP in the burn ICU at Vanderbilt and ABLS instructor. Learn more at the Intensive Care Academy! Want to work at the University of Kentucky? UK’s Anesthesia Critical Care department is hosting a hiring webinar on November 20, … Continue reading "Lightning rounds 57: Burn critical care with Clint Leonard"

We discuss the evidence and practicalities of spontaneous breathing trials and ventilator weaning with Martin Tobin, pulmonologist and intensivist, author of seven textbooks including “Principles and Practice of Mechanical Ventilation,” researcher, and pioneer of the entire concept of SBT as well as the RSBI (or “Tobin index”). Learn more at the Intensive Care Academy! References … Continue reading "Episode 95: Spontaneous breathing trials with Martin Tobin"

We explore the vagaries and nitty-gritty of drugs for seizure termination, including benzos and ASMs, with the great Tom Bleck, MD MCCM FNCS, neurointensivist, professor, and founding member of the Neurocritical Care Society. Check out the REVIVE conference here! Learn more at the Intensive Care Academy! More reading Takeaway lessons

We dive into fluid resuscitation in sepsis, with Dr. Jon-Emile Kenny, pulmonary and critical care physician, author of the physiology textbook Heart-lung.org, and inventor of the FloPatch device. Disclosures: Dr. Kenny appears here as both a clinician as well as a representative of his company and product, and should be presumed to retain a degree … Continue reading "Episode 93: Fluid in sepsis and the FloPatch, with Jon-Emile Kenny"

We discuss propofol infusion syndrome (PRIS) and propylene glycol toxicity from lorazepam infusions, with medical toxicologist Dr. Jerry Snow, director of the toxicology fellowship at Banner University Medical Center in Phoenix. Learn more at the Intensive Care Academy! Takeaway lessons

Brandon and Bryan mock up a goals of care discussion for a critically ill patient, and reflect on the right and wrong ways to execute this complex procedure. Learn more at the Intensive Care Academy! Resources Center to Advance Palliative Care The Conversation Project

We chat about neuromuscular blockade, monitoring, and reversal in the ICU, including why sugammadex isn’t more widely used, with Sara J Hyland, PharmD, BCCCP, FCCP, researcher and clinical pharmacist in perioperative and emergency medicine. Learn more at the Intensive Care Academy! Takeaway lessons References