I was lucky enough to be able to chat to Louise Rose again. She and I first had a conversation back on CCP Podcast 013: Mind and Body. In this episode we talk about a study she was involved in, which looked at the use of meters to measure the angle of the bed when nursing the ITU patient. We also go onto discuss whether it matters if we do this at thirty degrees or forty five degrees.
We also go on to chat about some of the issues with mobilising the critical care patient at a much earlier stage than perhaps most of us do currently. This is an issue I discussed with Carol Hodgson in CCP Podcast 039: Early Mobilisation- Get Them Moving! It is becoming a subject close to my heart and one that I think I may investigate further in the future.
Tom, one of my colleagues from the Critical Care Outreach Team and I discuss this paper and its findings reaching our own conclusions. Deferring Arterial Catheterisation in Patients with Septic Shock.
Read More
We return to our 48-year-old patient: jaundiced, hypotensive, drowsy, and bleeding. In decompensated cirrhosis, every treatment targets a disrupted system — splanchnic vasodilation, portal hypertension, toxin accumulation, and renal hypoperfusion.Although these patients look fluid overloaded, they are effectively hypovolaemic. Start with small aliquots of balanced crystalloid, avoiding 0.9% saline. In hepatorenal syndrome or tense ascites, 20% albumin is
Read More
In this episode, I walk through the real-world critical care management of acute decompensated alcohol-related liver disease, using a high-risk ICU case to anchor the discussion. The focus is on understanding the underlying physiology—portal hypertension, rebalanced haemostasis, hepatic encephalopathy, infection, and hepatorenal syndrome—and translating that physiology into clear first-hour priorities at the bedside. Listeners are
Read More