Hypernatremia And Free Water Deficit

Sodium (Na) fluctuations portend increased in-hospital death for ICU patients, and when working them up, it's essential to determine if these disorders are acute or chronic (> 48 hours or unknown duration). For hypernatremia...

Retrograde Cerebral Perfusion (RCP)

Retrograde cerebral perfusion (RCP) is a neuroprotective technique originally described in the early 1990s to deliver cold, oxygenated blood via the cardiopulmonary bypass (CPB) circuit to the cerebral vasculature by way of the superior...

Subclavian Central Line Pneumothorax

Compared to internal jugular and femoral central venous catheters (CVCs), I prefer placing subclavian CVCs because they don't tether patients' necks, they're easy to access, they're easy to dress, and they're in a part...

Anticoagulation In Cirrhosis

Patients with liver cirrhosis often have low platelets (splenic sequestration), and elevated INRs due to decreased synthesis of factor VII (among other clotting factors); however, remember that they also have decreased synthesis of anticoagulant...

West’s Lung Zones

Alveoli that are well ventilated (V) should be associated with good pulmonary capillary blood perfusion (Q) to maximize gas exchange. This is the idea behind V/Q matching. Gravitational forces create heterogeneity perfusing dependent portions...

Cardiac Action Potential

In order for the heart muscle to actually contract, the physiological process of excitation-contraction coupling must occur via an action potential propagated through the myocardium. Normally, these muscle cells have a resting transmembrane potential...

Posey Cufflator Manometer

Endotracheal tubes (ETTs) and tracheostomy tubes have pilot balloons which are inflated to expand a pilot cuff situated within the trachea below the vocal cords. This is termed a "secure airway." If this cuff is...

Subcutaneous Emphysema

Subcutaneous emphysema occurs when air gets trapped within the subcutaneous regions of the face, neck, chest wall, abdomen, and even down to the thighs/legs. The characteristic physical exam finding of crepitus ("snap-crackle-pop") is caused...

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