The guidelines for management of hypertensive emergencies
Anesthesia and ICU updates
@anesthesiaicuupsates
This is a scientific channel which aims to provide any important new evidence, original research, and practice guidelines in the fields of anesthesia, critical care, and emergency medicine
Anesthesia and ICU updates (English)
Are you a medical professional looking to stay up-to-date with the latest advancements in the fields of anesthesia, critical care, and emergency medicine? Look no further than 'Anesthesia and ICU updates' Telegram channel! This scientific channel is dedicated to providing valuable insights by sharing important new evidence, original research, and practice guidelines. Whether you are an anesthesiologist, intensive care unit nurse, or emergency medicine physician, this channel is designed to keep you informed and educated on the latest developments in your field. Stay ahead of the curve and join 'Anesthesia and ICU updates' today to enhance your knowledge and improve patient care.
Anesthesia and ICU updates
23 Jan, 17:12
An important article was published in JAMA surgery this month about the value of tranexamic acid in general surgery
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https://pubmed.ncbi.nlm.nih.gov/39813061/
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https://pubmed.ncbi.nlm.nih.gov/39813061/
Anesthesia and ICU updates
20 Jan, 19:27
https://link.springer.com/content/pdf/10.1007/s00134-025-07782-8.pdf
Anesthesia and ICU updates
20 Jan, 19:27
Echocardiography in the management of septic shock: the good, the bad, and the ugly profiles
Anesthesia and ICU updates
19 Jan, 07:56
An interesting article about point-of-care ultrasound findings in acute valvular emergencies. January 2025
Anesthesia and ICU updates
18 Jan, 19:31
https://journals.lww.com/ccmjournal/pages/articleviewer.aspx?year=2025&issue=01000&article=00017&type=Fulltext
Anesthesia and ICU updates
03 Jan, 23:27
https://journals.lww.com/ejanaesthesiology/pages/articleviewer.aspx?year=2025&issue=02000&article=00002&type=Fulltext&cid=eTOC%20Issues.2025-ejanaesthesiology-00003643-202502000-00000&rid=V_0000000039150821&TargetID=&EjpToken=W2ugjP0lUjAQjxbnbRmN-TW97Es3-dP1nZhNo7jP9Uxj1Kd9LQFL5dnvSB-i07-76KO22HWVzlgg8MsEQjI&mkt_tok=NjgxLUZIRS00MjkAAAGXxjnrKjokPhcYAmjb0KFC1UwZxtcO_KYYTtATZopXEdZGbPGQ5jPUevAcg13XuoRXNr0PnOvua8LaxrvZ3WEVMNjUQbipNRbQcJGhjsV9imUmeredhQ
Anesthesia and ICU updates
28 Dec, 05:25
Guidelines for the management of sepsis and septic shock in resource limited settings. Just published last week.
Anesthesia and ICU updates
17 Dec, 14:06
https://www.facebook.com/share/p/191bWiA63d/?mibextid=wwXIfr
Anesthesia and ICU updates
12 Dec, 08:09
Ten rules for Acute kidney injury in critically ill patients.
1- If a patient has rising kidney functions without oliguria, it is impossible that this AKI is due to pre-renal cause. PLEASE do not push fluids in such patients.
2- If a patient developed oliguria after staying inside the ICU for several days, and is receiving adequate fluid volume every day without any clear loss (no bleeding - no stomas - no surgical complications), it is very unlikely that this AKI is due to pre-renal cause. Thus, be very careful if you decided to push fluids in this patient.
3- If a patient developed oliguria and his cardiac output is high (distributive shock), this AKI is not pre-renal. Do not push fluids in this patients.
4- When you evaluate the volume status in an oliguric patient, low CVP is not a good indicator for hypovolemia.
5- If a patient is clearly edematous (limbs - lungs - abdominal wall), this patient is not hypovolemic (not pre-renal), even if the CVP is low. No more fluids in this patient.
6- Even if you do not have any advanced monitor for hemodynamic assessment, having a clinical look on the patient using your EYES + patient history would give you information which are more valuable than the CVP.
7- In AKI, Once you settled the diagnosis and excluded pre-renal pathology, you MUST DECREASE fluid intake and not INCREASE it. Pushing fluid in a pathological kidney would not force them to work; it would indeed harm the kidneys, promote congestion,
and hasten dialysis.
8- In AKI, once you settled the diagnosis and excluded pre-renal pathology, do frusemide stress test (1-1.5 mg per kg). If the patient did not respond within 2 h, he is unlikely to respond to diuretics and would probably proceed to higher stages of AKI
9- The target MAP to maintain renal perfusion is 65-70 mmHg. Higher values are NOT indicated, even in patients with chronic hypertension. Even if you want to do a "vasopressor test" by elevating the MAP transiently, this test is NOT related to chronic hypertension and can be done in any patient.
10- We can wait for dialysis in patient with AKI as long as there is no (congestion - hyperkalemia - acidosis - encephalopathy related to uremia). we can wait for 48 h even if the patient is oliguric. Most of the patients will recover without the need to dialysis. However, if you pushed too much fluids in these patients, you are increasing the likelihood for the need to dialysis.
1- If a patient has rising kidney functions without oliguria, it is impossible that this AKI is due to pre-renal cause. PLEASE do not push fluids in such patients.
2- If a patient developed oliguria after staying inside the ICU for several days, and is receiving adequate fluid volume every day without any clear loss (no bleeding - no stomas - no surgical complications), it is very unlikely that this AKI is due to pre-renal cause. Thus, be very careful if you decided to push fluids in this patient.
3- If a patient developed oliguria and his cardiac output is high (distributive shock), this AKI is not pre-renal. Do not push fluids in this patients.
4- When you evaluate the volume status in an oliguric patient, low CVP is not a good indicator for hypovolemia.
5- If a patient is clearly edematous (limbs - lungs - abdominal wall), this patient is not hypovolemic (not pre-renal), even if the CVP is low. No more fluids in this patient.
6- Even if you do not have any advanced monitor for hemodynamic assessment, having a clinical look on the patient using your EYES + patient history would give you information which are more valuable than the CVP.
7- In AKI, Once you settled the diagnosis and excluded pre-renal pathology, you MUST DECREASE fluid intake and not INCREASE it. Pushing fluid in a pathological kidney would not force them to work; it would indeed harm the kidneys, promote congestion,
and hasten dialysis.
8- In AKI, once you settled the diagnosis and excluded pre-renal pathology, do frusemide stress test (1-1.5 mg per kg). If the patient did not respond within 2 h, he is unlikely to respond to diuretics and would probably proceed to higher stages of AKI
9- The target MAP to maintain renal perfusion is 65-70 mmHg. Higher values are NOT indicated, even in patients with chronic hypertension. Even if you want to do a "vasopressor test" by elevating the MAP transiently, this test is NOT related to chronic hypertension and can be done in any patient.
10- We can wait for dialysis in patient with AKI as long as there is no (congestion - hyperkalemia - acidosis - encephalopathy related to uremia). we can wait for 48 h even if the patient is oliguric. Most of the patients will recover without the need to dialysis. However, if you pushed too much fluids in these patients, you are increasing the likelihood for the need to dialysis.
Anesthesia and ICU updates
11 Dec, 06:49
Recently published in CCM: updated guidelines for steroid use in ARDS, sepsis, and CAP.
Anesthesia and ICU updates
08 Dec, 09:05
An newly published article demonstrating the harmful effect of hyperoxemia on the neurological outcomes in post-arrest patients
https://www.resuscitationjournal.com/article/S0300-9572(24)00835-9/fulltext?dgcid=raven_jbs_aip_email
https://www.resuscitationjournal.com/article/S0300-9572(24)00835-9/fulltext?dgcid=raven_jbs_aip_email
Anesthesia and ICU updates
07 Dec, 10:08
This is a very informative video demonstrating airway ultrasound which was captured from anesthesia and analgesia journal website.
Anesthesia and ICU updates
05 Dec, 02:47
A recent review article entitled “Sepsis and Septic shock “ was just published in the NEJM this week
Anesthesia and ICU updates
17 Nov, 21:37
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01818-X/fulltext?dgcid=facebook_organic_reviews24_lancet&utm_campaign=reviews24&utm_content=316459540&utm_medium=social&utm_source=facebook&hss_channel=fbp-374651963469&fbclid=IwY2xjawGnQTxleHRuA2FlbQIxMAABHWaScPDVjWtHay5KlLxyTAoLA3PEdhf4UWzTlHosGrbdMOnvmLa5Jvm_Gw_aem_qj4kKw39U1kbHNrnia-BHQ
Anesthesia and ICU updates
05 Nov, 07:11
https://journals.lww.com/ejanaesthesiology/fulltext/9900/preoperative_assessment_of_adults_undergoing.227.aspx
Anesthesia and ICU updates
04 Nov, 05:55
https://www.facebook.com/share/p/LXqLX8nBNoWfsC33/?mibextid=WC7FNe
Anesthesia and ICU updates
29 Oct, 19:57
https://link.springer.com/article/10.1007/s00134-024-07688-x
Anesthesia and ICU updates
22 Oct, 20:28
https://www.sciencedirect.com/science/article/pii/S2352556824001048?dgcid=raven_sd_aip_email
Anesthesia and ICU updates
11 Oct, 12:57
The latest high-quality evidence about transfusion strategies in acute brain injury.
Published in the Journal of American Medical Association ((JAMA)).
https://pubmed.ncbi.nlm.nih.gov/39382241/
Published in the Journal of American Medical Association ((JAMA)).
https://pubmed.ncbi.nlm.nih.gov/39382241/
Anesthesia and ICU updates
28 Sep, 09:26
The latest recommendations for perioperative fluid therapy published today in the BJA
Anesthesia and ICU updates
28 Sep, 08:30
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.16434?campaign=wolearlyview
Anesthesia and ICU updates
25 Sep, 11:28
The new American guidelines for anesthesia for cardiac patients
Anesthesia and ICU updates
17 Sep, 18:19
A simplified approach to diagnosis of bundle branch block
Anesthesia and ICU updates
16 Sep, 17:14
Ten rules for Acute kidney injury in critically ill patients.
1- If a patient has rising kidney functions without oliguria, it is impossible that this AKI is due to pre-renal cause. PLEASE do not push fluids in such patients.
2- If a patient developed oliguria after staying inside the ICU for several days, and is receiving adequate fluid volume every day without any clear loss (no bleeding - no stomas - no surgical complications), it is very unlikely that this AKI is due to pre-renal cause. Thus, be very careful if you decided to push fluids in this patient.
3- If a patient developed oliguria and his cardiac output is high (distributive shock), this AKI is not pre-renal. Do not push fluids in this patients.
4- When you evaluate the volume status in an oliguric patient, low CVP is not a good indicator for hypovolemia.
5- If a patient is clearly edematous (limbs - lungs - abdominal wall), this patient is not hypovolemic even if the CVP is low.
6- Even if you do not have any advanced monitor for hemodynamic assessment, having a clinical look on the patient using your EYES + patient history would give you information which are more valuable the the CVP.
7- In AKI, Once you settled the diagnosis and excluded pre-renal pathology, you MUST DECREASE fluid intake and not INCREASE it. Pushing fluid in a pathological kidney would not force them to work; it would indeed harm the kidneys, promote congestion,
and hasten dialysis.
8- In AKI, once you settled the diagnosis and excluded pre-renal pathology, do frusemide stress test (1-1.5 mg per kg). If the patient did not respond within 2 h, he is unlikely to respond to diuretics and would probably proceed to higher stages of AKI
9- The target MAP to maintain renal perfusion is 65-70 mmHg. Higher values are NOT indicated, even in patients with chronic hypertension. Even if you want to do a "vasopressor test" by elevating the MAP transiently, this test is NOT related to chronic hypertension and can be done in any patient.
10- We can wait for dialysis in patient with AKI as long as there is no (congestion - hyperkalemia - acidosis - encephalopathy related to uremia). we can wait for 48 h even if the patient is oliguric. Most of the patients will recover without the need to dialysis. However, if you pushed too much fluids in these patients, you are increasing the likelihood for the need to dialysis.
1- If a patient has rising kidney functions without oliguria, it is impossible that this AKI is due to pre-renal cause. PLEASE do not push fluids in such patients.
2- If a patient developed oliguria after staying inside the ICU for several days, and is receiving adequate fluid volume every day without any clear loss (no bleeding - no stomas - no surgical complications), it is very unlikely that this AKI is due to pre-renal cause. Thus, be very careful if you decided to push fluids in this patient.
3- If a patient developed oliguria and his cardiac output is high (distributive shock), this AKI is not pre-renal. Do not push fluids in this patients.
4- When you evaluate the volume status in an oliguric patient, low CVP is not a good indicator for hypovolemia.
5- If a patient is clearly edematous (limbs - lungs - abdominal wall), this patient is not hypovolemic even if the CVP is low.
6- Even if you do not have any advanced monitor for hemodynamic assessment, having a clinical look on the patient using your EYES + patient history would give you information which are more valuable the the CVP.
7- In AKI, Once you settled the diagnosis and excluded pre-renal pathology, you MUST DECREASE fluid intake and not INCREASE it. Pushing fluid in a pathological kidney would not force them to work; it would indeed harm the kidneys, promote congestion,
and hasten dialysis.
8- In AKI, once you settled the diagnosis and excluded pre-renal pathology, do frusemide stress test (1-1.5 mg per kg). If the patient did not respond within 2 h, he is unlikely to respond to diuretics and would probably proceed to higher stages of AKI
9- The target MAP to maintain renal perfusion is 65-70 mmHg. Higher values are NOT indicated, even in patients with chronic hypertension. Even if you want to do a "vasopressor test" by elevating the MAP transiently, this test is NOT related to chronic hypertension and can be done in any patient.
10- We can wait for dialysis in patient with AKI as long as there is no (congestion - hyperkalemia - acidosis - encephalopathy related to uremia). we can wait for 48 h even if the patient is oliguric. Most of the patients will recover without the need to dialysis. However, if you pushed too much fluids in these patients, you are increasing the likelihood for the need to dialysis.
Anesthesia and ICU updates
09 Sep, 12:33
https://onlinelibrary.wiley.com/doi/10.1111/aas.14470
Anesthesia and ICU updates
08 Sep, 03:59
https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01367-2#Tab2
Anesthesia and ICU updates
22 Aug, 08:36
This us an important article just published in NEJM showing that there is no benefit from having high HB targets (> 10 g/dL) compared to restrictive target (7 g/dL) in patients with traumatic brain injury
https://www.nejm.org/doi/full/10.1056/NEJMoa2404360?query=TOC&cid=DM2356766_Non_Subscriber&bid=-1807569210
https://www.nejm.org/doi/full/10.1056/NEJMoa2404360?query=TOC&cid=DM2356766_Non_Subscriber&bid=-1807569210
Anesthesia and ICU updates
01 Aug, 04:49
https://intjem.biomedcentral.com/articles/10.1186/s12245-024-00660-y
Anesthesia and ICU updates
28 Jun, 05:14
https://journals.lww.com/anesthesia-analgesia/abstract/2024/06000/adverse_events_of_peripherally_administered.13.aspx?
Anesthesia and ICU updates
16 Jun, 20:57
https://www.nejm.org/doi/full/10.1056/NEJMoa2404360?query=RP&ssotoken=U2FsdGVkX1%2FGY3WW152OeCSgclFm%2BN1483t%2BDpkXtK2Q5Sk%2FpPTDp1KUntlgyKCL2h5096PqWZQ3u0Xu4Ef9Q6lzCno6i0cPwHjezhKoI1ulf%2FEEoQl%2FS3ExC0auW%2BgAe%2FJ9%2BsT0ZSi51Mg3wM%2FYpf0HWwhW%2FSNF%2BBC1yeIv6e6%2FJ7%2BRSlY6LTpSzhCoueK5KjoSEHXs5Pjks8L8Pl997FXCJA%2FlYNq0hKusXy31YNQ%3D&cid=NEJM%20Recently%20Published,%20June%2013,%202024%20DM2345599_NEJM_Non_Subscriber&bid=-1938829116
Anesthesia and ICU updates
11 Jun, 20:28
https://www.facebook.com/share/p/tebgQ66F8daKAkeF/?mibextid=WC7FNe
Anesthesia and ICU updates
24 May, 19:45
When should we start enteral nutrition in patients with shock?
.
https://clinicalnutritionespen.com/article/S2405-4577(24)00061-5/fulltext?fbclid=IwZXh0bgNhZW0CMTEAAR1zR66xJG1Ov_Do72r92TvBlQi0nRnlJ1E5LrHm2PFX9Kv38DIIuNOl2cQ_aem_AYQ_L3YckUSCz6Mc0Xj8ip6PhRS9bGpUoQh_T_VBPK95ep21oDihfY8o0Re22raVcTdI5rGVaIdTToWiAPKAs4Sk
.
https://clinicalnutritionespen.com/article/S2405-4577(24)00061-5/fulltext?fbclid=IwZXh0bgNhZW0CMTEAAR1zR66xJG1Ov_Do72r92TvBlQi0nRnlJ1E5LrHm2PFX9Kv38DIIuNOl2cQ_aem_AYQ_L3YckUSCz6Mc0Xj8ip6PhRS9bGpUoQh_T_VBPK95ep21oDihfY8o0Re22raVcTdI5rGVaIdTToWiAPKAs4Sk
Anesthesia and ICU updates
21 May, 20:26
Latest guidelines for fluid selection in different types of patients
Anesthesia and ICU updates
21 May, 20:25
https://ccforum.biomedcentral.com/articles/10.1186/s13054-024-04951-x
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