Tuesday December 22, 2009
Q: Define Hemothorax?
Answer: Even a very small quantity of blood can make pleural fluid apppears bloody but a hemothorax is the presence of blood in the pleural cavity such that the ratio of pleural fluid hematocrit to blood hematocrit is more than 0.5.
Tuesday, December 22, 2009
Monday, December 21, 2009
Monday December 21, 2009
2 CD VIP
In response to our yesterday pearl "WEANS NOW" we received following pearl from
MABULMAGD , MD, EDIC
Lecturer of critical care medicine, Cairo university
Consultant intensivist, Dar Alfouad Hospital
I found this mnemonics helpful for intensivist during daily clinical rounds (2 CDF VIP)
2C,2D,2F
2V,2I,2P
2C..consciousness-connections
2D…hemoDynamics-diuresis
2F..fluids-feeding
2V..ventilation-vasopressors
2I..investigations-drug Interactions
2P…dvt prophylaxis-ulcer prophylaxis
2 CD VIP
In response to our yesterday pearl "WEANS NOW" we received following pearl from
MABULMAGD , MD, EDIC
Lecturer of critical care medicine, Cairo university
Consultant intensivist, Dar Alfouad Hospital
I found this mnemonics helpful for intensivist during daily clinical rounds (2 CDF VIP)
2C,2D,2F
2V,2I,2P
2C..consciousness-connections
2D…hemoDynamics-diuresis
2F..fluids-feeding
2V..ventilation-vasopressors
2I..investigations-drug Interactions
2P…dvt prophylaxis-ulcer prophylaxis
Sunday, December 20, 2009
Saturday, December 19, 2009
Saturday December 19, 2009
The Impella - minimally invasive, catheter-based cardiac assist device
The Impella is a minimally invasive, catheter-based cardiac assist device designed to directly unload the left ventricle, reduce myocardial workload and oxygen consumption, and increase cardiac output and coronary and end-organ perfusion.
The Impella can be inserted into the left ventricle in a Cath Lab via a standard guidewire through the femoral artery, into the ascending aorta, across the valve and into the left ventricle.The tip of the catheter contains a “pigtail” that crosses the patient’s heart valve and rests in the left ventricle, generating flows up to 2.5 L/min. The Impella is hemocompatible, does no compromise to valve function. There is low hemolysis, bleeding, and stroke rates.
The Impella - minimally invasive, catheter-based cardiac assist device
The Impella is a minimally invasive, catheter-based cardiac assist device designed to directly unload the left ventricle, reduce myocardial workload and oxygen consumption, and increase cardiac output and coronary and end-organ perfusion.
The Impella can be inserted into the left ventricle in a Cath Lab via a standard guidewire through the femoral artery, into the ascending aorta, across the valve and into the left ventricle.The tip of the catheter contains a “pigtail” that crosses the patient’s heart valve and rests in the left ventricle, generating flows up to 2.5 L/min. The Impella is hemocompatible, does no compromise to valve function. There is low hemolysis, bleeding, and stroke rates.
Friday, December 18, 2009
Thursday, December 17, 2009
Thursday December 17, 2009
Q: Lab call you with result that patient's pleural fluid has cholesterol level more than 45 mg/dL (1.16 mmol/L). What does it mean?
A; Pleural fluid is probably an exudate.
Using a cutoff point of 45 mg/dL for pleural cholesterol and/or LDH over 200 IU/L identified exudates with a sensitivity of 99% and a specificity of 98%.
Measurement of Pleural Fluid Cholesterol and Lactate Dehydrogenase - A Simple and Accurate Set of Indicators for Separating Exudates From Transudates - CHEST November 1995 vol. 108, no. 5 1260-1263
Q: Lab call you with result that patient's pleural fluid has cholesterol level more than 45 mg/dL (1.16 mmol/L). What does it mean?
A; Pleural fluid is probably an exudate.
Using a cutoff point of 45 mg/dL for pleural cholesterol and/or LDH over 200 IU/L identified exudates with a sensitivity of 99% and a specificity of 98%.
Measurement of Pleural Fluid Cholesterol and Lactate Dehydrogenase - A Simple and Accurate Set of Indicators for Separating Exudates From Transudates - CHEST November 1995 vol. 108, no. 5 1260-1263
Wednesday, December 16, 2009
Wednesday December 16, 2009
Q: What is the mechanism of action of Mannitol in control of Intracranial Hypertension (Increase ICP)?
A; Immediately after bolus administration Mannitol expands circulating volume by help of osmotic forces, decreases blood viscosity, resulting in reflex vasoconstriction and lowering of intracranial pressure. Its osmotic properties take effect in 15-30 minutes when it sets up an osmotic gradient and draws water out of neurons.
Q: What is the mechanism of action of Mannitol in control of Intracranial Hypertension (Increase ICP)?
A; Immediately after bolus administration Mannitol expands circulating volume by help of osmotic forces, decreases blood viscosity, resulting in reflex vasoconstriction and lowering of intracranial pressure. Its osmotic properties take effect in 15-30 minutes when it sets up an osmotic gradient and draws water out of neurons.
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