11.30.2020 - By Scott D. Weingart, MD FCCM
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We've spoken about the concepts of venous congestion being problematic beyond just pulmonary edema. I've had Phil Rola on in the past to discuss Venous-side issues such as Renal Compartment Syndrome, the Vexus score, and other issues of the under-respected side of the circulation.
Prior Episodes
* EMCrit Podcast 240 - Renal Compartment Syndrome - It's all about the Venous Side and We've Been Fracking it up for Years
* EMCrit Podcast 263 - The Venous Side Part 1 - VEXUS Score with Phillipe Rola
Today we go further into these concepts, with some concentration on the micro-circulation. There may be quite deleterious effects from iatrogenic volume overload--especially when we are compelled by government regulation to go against our clinical gestalt.
Journal Articles
* Blood pressure deficits in acute kidney injury: not all about the mean arterial pressure?
* Renal Perfusion Pressure < 60 predisposes to kidney injury
* There is individual variation on micro-circ from NorEpi
* CVP affects Microcirc Flow (Editorial)
* Physiology of the Microcirculation
* Perioperative Blood Pressure
* Sublingual Microcirculatory Microscopy
* Hot off the Press: Relative Hypotension and Adverse Kidney-related Outcomes among Critically Ill Patients with Shock. A Multicenter, Prospective Cohort Study. Am J Respir Crit Care Med. 2020 Nov 15;202(10):1407-1418. doi: 10.1164/rccm.201912-2316OC.
Special Mention to Ince on Microcirculatory Hemodynamic Coherence
* Ince hemodynamic coherence
Now on to the Podcast...