RK.md -

Remifentanil (Ultiva) is a potent (~200-300 times more than morphine), short acting, titratable narcotic infusion I use for moderate/deep sedation and maintaining general anesthetics. Unlike many drugs which rely on hepatic and/or renal…
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Rocuronium is an aminosteroid nondepolarizing neuromuscular junction blocker (NMJB) I routinely use to facilitate tracheal intubation. The name rocuronium comes from the fact that it's a rapid onset -curonium (referring to its steroid…
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Milrinone (Primacor) is a phosphodiesterase 3 (PDE3) enzyme inhibitor I routinely use as an inodilator. That is, a drug which enhances cardiac contractility (inotropy) while decreasing vascular resistance (vasodilation).
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The continuity equation illustrates the conservation of energy. In the case of blood flow within the (normal) heart, volumetric flow (cardiac output) at serial sites should be equal. The image shows flow velocities across the left…
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I started my adult cardiothoracic anesthesiology fellowship officially on July 10, 2018. Unlike my critical care fellowship where rotations were broken down into two week blocks, this fellowship varies tremendously as shown below. We do two…
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I upgraded my 2017 MacBook Pro (Fenix) to a 2018 MacBook Pro last month. The 13 inch, Coffee Lake based computer was a tremendous jump in performance compared to the 2017 model which I sold online for ~$1,000. I give you Rigel, my mobile…
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The Doppler effect refers to a shift in frequency perceived by an object in motion relative to the source of a wave. When applying this to ultrasonography, the transducer is a stationary source of ultrasound waves of a known frequency…
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When I was younger, I loved spending time at my dad's office during summer break. He worked for a software company on a floor filled with cubicles, but in one corner was a large data room with the processing mainframes, storage servers,…
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As part of traditional cardiac surgeries, the aorta can be extensively manipulated - especially when performing arterial cannulation and applying the aortic cross-clamp. This can dislodge plaques systemically leading to strokes and other…
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