POPULARITY
In this episode of the podcast, we will discuss Fluid Management for Sepsis through the lens of the recently published CLOVERS clinical trial. Our guest is Dr. Nathan Shapiro, Professor of Emergency Medicine at Harvard Medical School, and an attending physician in the Department of Emergency Medicine at Beth Israel Deaconess Medical Center. Dr. Shapiro is the Vice Chairman of Research for the Emergency Department. Dr. Shapiro is a lead author and investigator for the recently published CLOVERS clinical trial. Additional Resources Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. CLOVERS clinical trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2212663 Restriction of Intravenous Fluids in ICU Patients with Septic Shock. CLASSIC clinical trial: https://www.nejm.org/doi/full/10.1056/NEJMoa2202707 Surviving Sepsis Campaign: Guidelines 2021: https://www.sccm.org/Surviving-Sepsis-Guidelines-2021 Early Goal-Directed Therapy in the Treatment of Severe Sepsis and Septic Shock: https://www.nejm.org/doi/full/10.1056/nejmoa010307 Early, Goal-Directed Therapy for Septic Shock: Metanalysis of the ARISE, ProCESS, and PriMISe clinical trials: https://www.nejm.org/doi/10.1056/nejmoa1701380 Books Mentioned in this Episode: Extreme Ownership: How Navy SEALs Lead and Win. By Jocko Willink and Leif Babin: https://bit.ly/3Ktadmk
Theme: Critical Care.Participants: Dr Alex Yartsev (intensivist at Westmead Hospital), Dr Mark Salter (emergency physician at Westmead Hospital), Maddy Jegatheeswaran (intensive care Fellow at Westmead Hospital), Gladis Kabil (registered nurse at Westmead Hospital), Kristian Adams, Pramod Chandru, Caroline Tyers, Amanda De Silva, Shreyas Iyer, and Samoda Wilegoda. Discussion:Kabil, G., Liang, S., Delaney, A., Macdonald, S., Thompson, K., Saavedra, A., Suster, C., Moscova, M., McNally, S., Frost, S., Hatcher, D., & Shetty, A. (2021). Association between intravenous fluid resuscitation and outcome among patients with suspected infection and sepsis: A retrospective cohort study. Emergency Medicine Australasia, 34(3), 361–369. https://doi.org/10.1111/1742-6723.13893. Presenter: Gladis Kabil - registered nurse at Westmead Hospital and PhD candidate. Music/Sound Effects: Lagoon by LiQWYD & Luke Bergs | https://www.liqwydmusic.com, https://soundcloud.com/bergscloud, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. My Old East Coast by Vendredi feat. Melanie | https://soundcloud.com/vendrediduo, Music promoted by https://www.free-stock-music.com, Creative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. Slipz (audio logo) by tubebackr | https://soundcloud.com/tubebackr, Music promoted by https://www.free-stock-music.com. Trick Or Treat by LiQWYD | https://www.liqwydmusic.com, Music promoted by https://www.free-stock-music.comCreative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. When The Lights Go On by Vlad Gluschenko | https://soundcloud.com/vgl9, Music promoted by https://www.free-stock-music.comCreative Commons Attribution 3.0 Unported License, https://creativecommons.org/licenses/by/3.0/deed.en_US. Disclaimer:Please be advised that the individual views and opinions expressed in this recording strive to improve clinical practice, are our own, and do not represent the views of any organization or affiliated body. Therapies discussed are general and should not be a substitute for an individualized assessment from a medical professional.Thank you for listening!Please send us an email to let us know what you thought.You can contact us at westmeadedjournalclub@gmail.com.You can also follow us on Facebook, Instagram, and Twitter!See you next time!~
In deze aflevering van Intensief de Podcast bespreek ik samen met Thomas Smits alles omtrent vocht toediening en fluid responsiveness. Thomas is IC-verpleegkundige en verplegingswetenschapper en heeft tijdens zijn studie veel expertise opgedaan over het bepalen van fluid responsiveness en zal deze expertise met ons delen. We bespreken de o.a. volgende onderwerpen:Wat is fluid responsiveness en het Frank-Starling principe?Waarom geven we vocht aan onze IC-patiënten?Waarom moeten we vocht als medicijn gaan zien?Waarom zijn tachycardie, hypotensie, een lage CVD en een hoog lactaat slechte tekenen voor fluid responsiveness? En wat zijn dynamische en statische parameters?Wat is een fluid challenge en een passive leg raise?Hoe kan je de beademingsmachine gebruiken om fluid responsiveness te bepalen?Waarom moeten we vocht met een drukzak toedienen en niet met een infuuspomp?Wat zijn de nieuwste technieken en hoe ziet de toekomst eruit?Bronnen:CV Physiology | Frank-Starling MechanismFluid responsiveness in acute circulatory failure | Journal of Intensive CareFluid challenges in intensive care: the FENICE studyIV Fluid Overload: Don't Drown your Patients!Ventricular Pressure-Volume Relationship: Preload, Afterload, Stroke Volume, Wall Stress & Frank-Starling's law – ECG & ECHOHypotension: Differential Diagnosis – emupdatesTachycardia DDx • LITFL • CCC Differential DiagnosisWill This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids? | Acid Base, Electrolytes, Fluids | JAMA | JAMA NetworkNoninterventional follow‐up vs fluid bolus in RESPONSE to oliguria—The RESPONSE trial protocol and statistical analysis plan Fluid Bolus in Resuscitation: Pressure Bag vs. 999ml/hr on the IV PumpPrediction of fluid responsiveness. What's new?Hoeveel zout mag ik eten? | VoedingscentrumBalanced Crystalloids Versus Saline in Critically Ill Adults: A Systematic Review and Meta-analysisEffect of a fluid bolus on cardiovascular collapse among critically ill adults undergoing tracheal intubation (PrePARE): a randomised controlled trial Effect of Fluid Bolus Administration on Cardiovascular Collapse Among Critically Ill Patients Undergoing Tracheal Intubation (PREPAREBedankt voor het luisteren!Volg @intensiefdepodcast op InstagramVragen? intensiefdepodcast@gmail.com
We're back after a nice relaxing summer taking care of a surge of COVID-19 patients. To start off season 3 we decided to do a rapid review of some of the best articles over the last three months. Dr. Brian Locke returns to help us break down some critical care papers, we talk about the miracle of SGLT-2 inhibitors, the treatment of UTIs in men, and the latest in COVID-19 literature. Hypothermia vs Normothermia after Cardiac ArrestEmpagliflozin for Heart Failure with Preserved EFAntibiotic Duration for Afebrile UTIs in MenNormal Saline vs Balanced Solution in ICU patients Baricitinib for COVID-19Therapeutic Anticoagulation for COVID-19Music from Uppbeat (free for Creators!):https://uppbeat.io/t/soundroll/dopeLicense code: NP8HLP5WKGKXFW2R
This episode covers intravenous fluids.Written notes can be found at https://zerotofinals.com/surgery/general/ivfluids/ or in the general surgery section of the Zero to Finals surgery book.The audio in the episode was expertly edited by Harry Watchman.
CHEST April 2021, Volume 159, Issue 4 Nikhil Jagan, MD, joins CHEST Podcast Moderator, Gretchen Winter, MD, to discuss a retrospective analysis of the SAIFR Study. DOI: https://doi.org/10.1016/j.chest.2020.10.078
JAMAevidence The Rational Clinical Examination: Using Evidence to Improve Care
Dr David Simel discusses Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?
In this Audio Summary Erik gives an overview of the evidence around when to change fluid bags and IV sets. Read the full Knowledge Summary here. Audio Summaries are a free resource that enables vets and vet nurses to access and digest relevant and up-to-date evidence quicker and easier! A time-saving way to make better and faster evidence-based decisions.
Part 2 of a two-part episode on intravenous fluid therapy. Having covered basic physiology we now address a systematic approach to prescribing fluids, what fluids are available and the most important complications to pay attention to.
Intravenous Fluid Therapy - an intimidating topic when learning it for the first time, and often underestimated in its significance when prescribing on the wards. This two part episode will provide medical students and junior doctors with a sound foundation of knowledge and a systematic approach to fluid therapy. Part 1 will address the basics of fluid physiology.
When managing septic shock, passive leg raising is the best test to determine if a patient is likely to respond to a fluid bolus, better than CVP lines or even bedside ultrasound. Dr Najib Ayas, Associate professor of Critical Care Medicine at the University of British Columbia, discusses shock management from the context of his Rational Clinical examination article in the September 27, 2016 issue of JAMA, entitled “Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?”
When managing septic shock, passive leg raising is the best test to determine if a patient is likely to respond to a fluid bolus, better than CVP lines or even bedside ultrasound. Dr Najib Ayas, Associate professor of Critical Care Medicine at the University of British Columbia, discusses shock management from the context of his Rational Clinical examination article in the September 27, 2016 issue of JAMA, entitled “Will This Hemodynamically Unstable Patient Respond to a Bolus of Intravenous Fluids?”