Critical Care

Heart Failure with Preserved Ejection Fraction

Cardiac Critical care /

Heart Failure with Preserved Ejection Fraction (HFpEF) 1. Definition  Symptoms ± signs of heart failure LVEF ≥50% Evidence of cardiac structural and/or functional abnormality Elevated natriuretic peptides Feature HFpEF HFrEF EF ≥50% ≤50% Dysfunction Diastolic Systolic LV Geometry Concentric Eccentric Main cause HTN CAD 2.  Pathophysiology  A. Central Concept It is  systemic disease with multi-organ […]

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Pulmonary Embolism

Pulmonology Critical care /

Pulmonary Embolism Pulmonary embolism is obstruction of the pulmonary arterial circulation, usually by thrombus originating from the deep veins of the lower extremities or pelvis. Risk Factors—Virchow’s Triad  Mechanism Examples Venous stasis Immobilization, ICU stay Hypercoagulability Cancer, pregnancy Endothelial injury Surgery, trauma,Central venous Catheter Major Major surgery Trauma Malignancy Prior VTE Pregnancy/postpartum Moderate OCP use

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DVT prophylaxis in hospitalized and critically ill patients

General ICU Care /

DVT prophylaxis in hospitalized and critically ill patients  Every hospitalized/critically ill patient should undergo a daily assessment of VTE risk AND bleeding risk. If VTE risk is significant and bleeding risk is acceptable → pharmacological prophylaxis, usually LMWH, is preferred. If pharmacological prophylaxis is contraindicated → intermittent pneumatic compression (IPC) should be used.   Why

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ASTHMA EXACERBATION

Pulmonology Critical care /

ASTHMA EXACERBATION  Recommendations below are aligned primarily with the 2026 GINA Strategy Report, the current GINA reference available in 2026.  ADULT ASTHMA EXACERBATION — QUICK DOSE TABLE 1. WHAT IS AN ASTHMA EXACERBATION? An asthma exacerbation is an acute or subacute worsening of asthma symptoms and lung function compared with the patient’s usual state.Typical manifestations:

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Immune Thrombocytopenic Purpura

Hemat Critical Care /

Immune Thrombocytopenic Purpura (ITP) Definition Immune Thrombocytopenic Purpura (ITP) — also known as Immune Thrombocytopenia — is an acquired autoimmune disorder characterized by isolated thrombocytopenia (platelet count <100,000/µL)  It is a diagnosis of exclusion — no other cause of thrombocytopenia should be present. Hematologist Referral is must Classification Type Description Primary ITP Isolated thrombocytopenia without

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Neurogenic Pulmonary Edema

Neuro Critical Care, Pulmonology Critical care /

Neurogenic Pulmonary Edema(NPE) Introduction Neurogenic pulmonary edema (NPE) is an acute pulmonary edema syndrome occurring after a severe acute CNS insult, particularly when the neurological event causes an abrupt rise in intracranial pressure and/or massive sympathetic activation. It can be confused with: aspiration pneumonitis cardiogenic pulmonary edema ARDS pneumonia fluid overload pulmonary embolism NPE may

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Acute Decompensated Heart Failure

Cardiac Critical care /

 Acute Decompensated Heart Failure (ADHF) What is ADHF? Acute Decompensated Heart Failure (ADHF) is the rapid onset or worsening of signs and symptoms of heart failure requiring urgent therapy and often hospitalization. It may occur as: De novo HF (newly diagnosed) Acute decompensation of chronic HF Progression to cardiogenic shock Major guidelines: American Heart Association

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CONSTIPATION IN ICU

Gastro and HepatoBilliary Critical Care​ /

CONSTIPATION IN ICU  1.  DEFINITION (No universal consensus) Most ICU studies define constipation as: No bowel movement for ≥3 days OR need for rescue laxatives/enema OR hard stools / difficult evacuation 2.  EPIDEMIOLOGY Incidence: 15–83% (very common in ICU) Higher in: Mechanically ventilated patients Sedated/paralyzed patients Opioid use Enteral feeding patients 3.  WHY IT MATTERS

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HYPERPHOSPHATEMIA

Fluid and Electrolytes /

HYPERPHOSPHATEMIA  Hyperphosphatemia = Serum phosphate > 4.5 mg/dL (1.45 mmol/L) in adults Severity Serum Phosphate Mild 4.6–6 mg/dL Moderate 6–9 mg/dL Severe >9–10 mg/dL  Life-threatening when associated with: Hypocalcemia Arrhythmias Acute kidney injury Tumor lysis syndrome Normal Phosphate Physiology  Distribution 85% – bone (hydroxyapatite) 14% – intracellular <1% – extracellular (measured serum phosphate) Normal Serum

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Arterial Blood Gas Analysis

General ICU Care /

Arterial Blood Gas (ABG) Analysis  What Does an ABG Measure? Parameter Normal arterial value significance pH 7.35–7.45 Overall acid–base status PaCO₂ 35–45 mmHg Respiratory component / alveolar ventilation PaO₂ 80–100 mmHg in young adult on room air Oxygenation SaO₂ ~95–100% Arterial Hb oxygen saturation HCO₃⁻ 22–26 mEq/L HCO₃⁻(actual) → bicarbonate at the patient’s actual PaCO₂

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