This is a very interesting chat I had with Dr Bronwen Connolly who is a Consultant Clinical research Physiotherapist and an NIHR post-doctoral research fellow about early mobilisation in the critical care.
She was asked to present at the ICS SOA 2016 to summarise key evidence published in 2016 examining physical rehabilitation in critical illness and also consider methodological trial design features in interpretation of results.
It would seem from the discussion that one of the main problems with the research is that there is no agreement on the end points which should be measured.
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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