This week we have another lecture from Dr. Rodrigo Cavallazzi. Here he discusses the bundles of care that have come out of the Surviving Sepsis guidelines as well as the recent evidence concerning "Early Goal Directed Therapy" pioneered by Dr. Rivers. He also discusses recent updates to the Surviving Sepsis guidelines and some nuances for patients not responding to initial therapies.
Dr. Cavallazzi is an assistant professor of medicine at University of Louisville in the Pulmonary and Critical Care Department. He is a favorite of the residents and is heavily involved in the Community Acquired Pneumonia Organization (CAPO) research.
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Dr. Karem El Kersh describes basics of anatomy, components and indications for tracheostomy. Then he spends time covering when and how to change a trach as well as suggestions for troubleshooting common problems involving tracheostomies.
Dr. Rodrigo Cavallazzi discusses steps toward ventilator liberation including spontaneous breathing trial and other parameters to indicate readiness to wean. He then discusses strategies for weaning: optimizing fluid status, weaning protocols, sedation weaning, rehabilitation therapy.
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Dr. Brian Beauerle covers the basics of cirrhosis including pathophysiology, symptoms and survival of patients with survival. He covers when and how to perform a paracentesis including interpretation of results. He discusses pharmacologic and dietary treatment of ascites and refractory ascites. He closes with complications of ascites including spontaneous bacterial peritonitis and hepatic hydrothorax.
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Dr. Rodrigo Cavallazzi covers the assessment of volume responsiveness including the static exam as well as dynamic markers to aid with treatment of shock without administration of excessive fluids. He spends some time on shock definition and physiologic compensation before discussing physical exam and laboratory findings consistent with tissue ischemia. Then, he delves into methods of determining pre-load responsiveness.
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Dr. Lorrel Brown returns to discuss tamponade cardiac physiology (including demystifying pulsus pardoxus). She continues to cover the differentiation of constrictive and restrictive cardiomyopathies. This action-packed lecture concludes with stress cardiomyopathy and HFpEF (heart failure with preserved ejection fraction).
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Grand Rounds given by Internal Medicine Chairman, Dr. Jesse Roman. He covers the definition of interstitial lung disease as well as it's evaluation and management. He also spends time on idiopathic interstitial pneumonia and idiopathic pulmonary fibrosis.
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Dr. Lorrel Brown covers the common (and less common) results of MI using cases. She includes papillary muscle rupture and mitral regurgitation, free wall rupture, ventricular septal defects, right ventricular infarct, pseudoaneurysm, aneurysm, pericarditis and bradyarrhythmias. Free Open Access Medical Education for Internal Medicine.
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Dr, Rodrigo Cavallazzi gives a comprehensive review of ARDS; he includes the definition, pathophysiology, risk factors, prognosis and differential. He spends time discussion the ARDS Network trial including fluid and ventilation strategies as well as advanced treatments (prone positioning, ECMO, neurally adjusted ventilation.
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Dr, Lorrel Brown covers the basics of shock including how to recognize cardiac shock from history, physical exam and invasive monitoring. She discusses physiology and interpretation of pulmonary artery catheterization and then covers choice of vasopressors for therapy.
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