) who is a consultant respiratory physiotherapist. I noticed from a twitter post that she had been at a meeting and presented on the above topic. She was kind enough to chat with me for the podcast. We talked about a number of issues but mainly discussed the various ways in which we can help the ventilated patient to clear their secretions.
I certainly found out a few things I didn't know about and some equipment I had not heard of before. We discussed the
and Mechanical In-Exsufflation.
Lots of new and old techniques as well as the more traditional hands-on ways of getting the secretions up and out.
Some of the research papers we discussed are below.
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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This episode offers a structured, bedside-focused exploration of Non-Invasive Ventilation (NIV) for acute hypercapnic respiratory failure in COPD, aligned with NICE NG115 and BTS/ICS 2016 guidance. Aimed at early-career critical care nurses, it breaks the topic down into physiology, practical setup, monitoring, and escalation.Key Topics CoveredMechanisms behind acute-on-chronic hypercapnic respiratory failure in COPD.How NIV improves
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