An excellent summary:
Should we still be trying to modify the dysregulated immune response in sepsis? An interesting evolutionary perspective:
Although not improving (or worsening) mortality, if steroids reduce duration of shock and length of ICU stay then they are probably worth a go, given that the absolute possible increase in risk of noteworthy adverse outcomes is very low, although this must be borne in mind. Could still argue it either way though. When we can genotype patients we may be able to identify those specific individuals in whom steroid may do significant benefit or harm. Or maybe not!
Useful online educational resource for ICU covering, amongst other things, ECMO and echo.
Summating B-lines to determine extra-vascular lung water
The transition from a-lines to b-lines = stop fluid bolus
From Sitzwhol & Lichtenstein, 14th Annual Critical Care Symposium
If underlying lung is recruitable (ref?)
Specific indications e.g. Surgical, BTS guidelines
Stalled wean + large effusion. If max distance between diaphragm measures >5cm then almost certainly >800ml and drainge will improve situation (ref?)
High RSB index
Overall nil definitive evidence, so take a pragmatic approach.
From CUSIC day @ICSSeminars