I was fortunate to be able to have a good chat at the ICS State of the Art 2016 conference with Roger Harris (@RogerrdHarris), Danni Bear (@Danni_Dietician), Ella Segaran @ESegaran) and Todd Rice about their interpretation of the Nutrition Guidelines released last year. Todd is one of the original authors and both Ella and Danni are senior dieticians with an obvious interest in the interpretation of the guidelines.
I think we cover a number of important points during the discussion. If you have any comments then please don’t hesitate to let me know. (https://carolinafoothillschamber.com)
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.
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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
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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
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