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Sepsis & Septic Shock
Congestion Cascade: Harnessing the Power of Doppler!
Dr. Senussi will explore the physiology of venous return and fluid responsiveness, and provide a detailed overview of traditional methods used to assess volume status. He then will delve into the various congestion parameters detected by using doppler ultrasound, including lung ultrasonography, inferior vena cava ultrasound, portal vein doppler, hepatic vein doppler, and intrarenal venous doppler. The presentation will be further enriched by multiple illustrative case examples, which will help to contextualize the concepts of congestion cascade and provide a practical understanding of the application of doppler ultrasound in assessing fluid status. Dr. Murad Senussi is an Assistant Professor of Medicine specialized in Cardiology and Critical Care Medicine at Baylor College of Medicine in Houston, Texas. In addition to his academic role, Dr. Senussi also serves as the Medical Director of the Cardiac Care Unit at Baylor St. Luke's Medical Center
De-resuscitation & De-treatment in Sepsis and Septic Shock
Sepsis is associated with generalized endothelial injury and capillary leak and has traditionally been treated with large volume fluid resuscitation. Some patients with sepsis will accumulate bodily fluids. What is the association between a positive fluid balance/fluid overload and outcomes in critically ill adults, and do interventions aimed at reducing fluid balance lead to improved outcomes? What does the literature say? Dr. Mazen Kherallah will explore in details the fluid accumulation syndrome and fluid stewardship in the ICU and will review the available evidence supporting de-resuscitation in septic patients.
Normal Saline vs Balanced Fluids — What Does Recent Literature Say?
Intravenous fluid therapy, a crucial life-saving intervention for critically ill patients, raises questions about the optimal type, dose, and timing. Patient outcomes can be affected by the choice of resuscitation fluids, but only in the past 5-7 years has more attention been given to crystalloid therapy, specifically the differences between 0.9% saline and 'balanced' solutions. Originating from the 1831 cholera pandemic, normal saline has been widely used, but recent concerns highlight its potential complications due to its high chloride concentration. Balanced crystalloids, such as lactated Ringer's and Plasma-Lyte, offer an alternative with electrolyte content closer to extracellular fluid. While intravenous fluids are commonly used, an ideal fluid is yet to be found. Guidelines recommend crystalloids over colloids, but lack specificity on the type of crystalloid. Recent evidence prompts reevaluation of crystalloid choices in critical care. In my presentation, In this presentation, Dr. Islam will examine current research to determine the strength and conclusiveness of the evidence. Dr. Tasbirul Islam is American Board Certified in Internal Medicine, Pulmonary, Critical Care, and Neuro-critical Care Medicine. He serves as a Clinical Associate Professor of Medicine at Indiana University School of Medicine, Medical Director for the Division of Pulmonary and Critical Care Medicine, Pulmonary & Critical Care Medicine Course Director for medical students, and Chairman of Planetary Health Academia (PHA). He graduated from Dhaka Medical College in 1992 and completed an internal medicine residency in 2005 and a pulmonary & critical care medicine fellowship in 2008. He earned membership in the Royal College of Physicians of the UK after passing the MRCP examination in 1997. He was elected the best resident for three consecutive years and received the Golden Apple/Stethoscope Award for teaching excellence at Drexel University College of Medicine. In 2010 and 2022, he was voted the best teaching attending by residents and medical students. Dr. Islam has established an observership program for foreign medical graduates at his hospital since 2013. He has published over 20 papers in peer-reviewed journals.
Phenylephrine in Septic Shock
While some studies suggest that phenylephrine may be associated with a lower heart rate compared to the commonly used medication norepinephrine, it remains unclear whether phenylephrine improves clinical outcomes such as mortality and length of hospital stay in patients with septic shock. These studies are limited by their retrospective design and small sample sizes. To better understand the potential benefits and risks of using phenylephrine in septic shock, larger randomized controlled trials are needed. This video provides insights into the current state of knowledge regarding phenylephrine use in septic shock and highlights the importance of ongoing research in this area.
Nebulized Antibiotics for Ventilator-Associated Pneumonia: What is the best song?
Nebulization of antibiotics offers a promising approach to treat multidrug-resistant gram-negative bacteria in healthcare-associated pneumonia, with aminoglycosides and colistin methanesulfonate being the most common nebulized antibiotics. Join Dr. Hussain Alawadhi in an informative webinar discussing the use of nebulized antibiotics in the treatment of ventilator-associated pneumonia (VAP). In this webinar, Dr. Alawadhi will review the latest research on nebulized antibiotics and their effectiveness in treating VAP.
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