Critical Care

MYOCARDITIS

Cardiac Critical care /

MYOCARDITIS  DEFINITION Myocarditis = inflammatory disease of the myocardium, diagnosed clinically and/or histologically, with myocardial injury that may produce: myocardial necrosis ventricular dysfunction heart failure arrhythmias conduction abnormalities cardiogenic shock sudden cardiac death. MYOCARDITIS vs MYOPERICARDITIS vs PERIMYOCARDITIS Term Predominant disease LV function Pericarditis Pericardium Usually preserved Myocarditis Myocardium May be impaired Myopericarditis Predominantly pericarditis […]

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Hepatic Encephalopathy

Gastro and HepatoBilliary Critical Care​ /

Hepatic Encephalopathy  Hepatic encephalopathy (HE) is a brain dysfunction caused by liver insufficiency and/or portosystemic shunting, producing a spectrum ranging from subtle cognitive impairment to coma. HE is a clinical syndrome, not a diagnosis made by ammonia alone.HE is a diagnosis of exclusion. DEFINITION HE is a syndrome of neurological and psychiatric abnormalities occurring in

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HYPOPHOSPHATEMIA

Fluid and Electrolytes /

HYPOPHOSPHATEMIA  1. Definition Hypophosphatemia = serum phosphate < 2.5 mg/dL (0.81 mmol/L) Severity Serum Phosphate Mild 2.0–2.5 mg/dL (<0.65-0.81 mmol/L) Moderate 1.0–1.9 mg/dL (<0.32-0.65 mmol/L) Severe (life-threatening) < 1.0 mg/dL (<0.32 mmol/L) Symptoms usually appear when <1 mg/dL 2. Functions of phosphate  ATP synthesis → cellular energy 2,3-DPG in RBCs → oxygen delivery Cell membrane

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TUMOR LYSIS SYNDROME

Onco Critical Care /

TUMOR LYSIS SYNDROME (TLS)  What is Tumor Lysis Syndrome? Tumor lysis syndrome (TLS) is a potentially life-threatening oncologic emergency caused by rapid destruction of malignant cells, either: Spontaneously, or After anticancer therapy(TLS generally occurs 12-72 hours after chemotherapy initiation) The massive release of intracellular contents produces the characteristic biochemical abnormalities: ↑ K⁺ + ↑ phosphate

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Hypercalcemia

Fluid and Electrolytes /

Hypercalcemia Normal total serum calcium: Approximately 8.5–10.5 mg/dL (2.1–2.6 mmol/L) Ionized calcium >1.32 mmol/L This severity Classification values are different in Different sources(ionized calcium does not have a universally accepted equivalent 3-tier classification.) Severity Total serum calcium Ionized calcium Normal 8.5–10.5 mg/dL 1.12–1.32 mmol/L Mild 10.5–11.9 mg/dL ~1.33–1.50 mmol/L Moderate 12.0–13.9 mg/dL ~1.51–1.75 mmol/L Severe

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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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LVOT-VTI

POCUS /

LVOT-VTI — Left Ventricular Outflow Tract Velocity–Time Integral   LVOT-VTI is the distance that blood travels through the LV outflow tract during one systolic ejection. It is one of the most useful echocardiographic measurements for estimating stroke volume (SV) and cardiac output (CO). How to measure LVOT-VTI Step 1 —Apical 5-chamber view or Apical 3-chamber

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