EMCrit FOAM Feed

EMCrit 286 – The Venous Side Matters Too with Phil Rola

11.30.2020 - By Scott D. Weingart, MD FCCMPlay

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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...

 

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