Question Critically evaluate the role of monitoring blood lactate levels in the critically ill. Answer [DDET Show answer] Introduction: Lactate measurement is easy, widely available and accurate. High blood lactate levels may represent increased production from tissues and/or decreased metabolic clearance. Uses End-point of resuscitation – lactate … [Read more...] about CICM SAQ 2016.1 Q8
Our curious and short human history is littered with betrayals. We betray each other with alarming regularity – Judas Iscariot, Marcus Brutus, Benedict Arnold and Tokyo Rose are all part of our collective history, and, if not salient, at least provide insightful looks at our relationships. But, like the portly naked Emperor, we also betray ourselves, based on falsehoods … [Read more...] about Shock… Do We Know It When We See It?
Question List the possible reasons why a patient with septic shock from infected pancreatitis may have ongoing hypotension despite intravenous fluid therapy, antibiotics and escalating inotrope requirement. Answer [DDET Answer and interpretation] Primary problem not fixed: Untreated focus of infection/ inadequate primary source control e.g. pancreatic … [Read more...] about CICM SAQ 2013.2 Q17
Questions A 45 year old previously healthy man was admitted to your ICU five (5) days ago after a motor vehicle accident with chest and abdominal injuries. He is currently intubated and ventilated, is on 100% oxygen and PEEP of 10cm water. He is deeply sedated and on noradrenaline and adrenaline infusions at 10mcg/min each. He has become oliguric. His blood biochemistry, … [Read more...] about CICM SAQ 2009.2 Q13
Questions A 72 year old male with known triple vessel coronary disease has returned to the ICU following an uncomplicated coronary artery bypass grafting (CABG). An intraoperative transoesophageal echo showed good left ventricular systolic function and no significant valvular dysfunction. Mediastinal drains have been inserted and there is minimal blood loss. Thirty … [Read more...] about CICM SAQ 2011.1 Q16