Critical Care

A

• Acute Kidney Injury in the ICU - CRRT vs Intermittent Dialysis

  Use KDIGO criteria for staging, correct reversible causes, and choose CRRT for hemodynamic instability or cerebral edema while intermittent hemodialysis suits stable patients.
• Acute Respiratory Distress Syndrome - Low Tidal Volume and PEEP Strategy

  Use 6 mL per kg predicted body weight tidal volume, limit plateau and driving pressures, and titrate PEEP with oxygenation tables.
• Acute Respiratory Distress Syndrome — Lung‑Protective Ventilation, Proning, and Adjuncts

  Use low tidal volume ventilation (4–8 mL/kg PBW) and limit plateau pressure ≤30 cm H2O; apply appropriate PEEP and early prolonged prone positioning in moderate–severe ARDS. Consider neuromuscular blockade and conservative fluid strategy; ECMO in refractory hypoxemia.

I

• ICU Analgesia and Sedation - Targets and Protocols

  Use analgesia first, target light sedation with validated scales, employ daily sedation interruption or titration, and avoid prolonged benzodiazepines when possible.
• ICU Delirium - Prevention and Management

  Screen regularly, correct modifiable risks, prefer nonpharmacologic bundles, and reserve antipsychotics for severe distress or safety.
• ICU Nutrition - Early Enteral Feeding

  Start early enteral nutrition in hemodynamically stable patients, assess protein-calorie targets, and avoid overfeeding; use post-pyloric access when aspiration risk is high.

M

• Mechanical Ventilation - Initial Settings in Adults

  Set low tidal volume based on predicted body weight, choose appropriate PEEP and FiO2, and adjust respiratory rate to pH and PaCO2 while ensuring patient safety.

P

• Propofol Infusion Syndrome — Recognition, Prevention, and ICU Management

  Critically ill patient on high‑dose or prolonged propofol sedation develops unexplained metabolic acidosis, rhabdomyolysis, acute kidney injury, and cardiac dysfunction—concerning for propofol‑related infusion syndrome (PRIS).

R

• Refractory Hypoxemia - ICU Rescue Strategies

  For severe hypoxemia despite optimized ventilation, use prone positioning, short-course neuromuscular blockade in select cases, recruitment and PEEP strategies, inhaled vasodilators as a bridge, and early ECMO consultation.

S

• Sepsis and Septic Shock - Early Recognition and Bundle

  Screen early, obtain cultures, start broad-spectrum antibiotics, give fluids and vasopressors to maintain MAP, and monitor lactate and perfusion.
• Sepsis and Septic Shock — 1‑Hour Bundle, Source Control, and Vasopressors

  Apply Surviving Sepsis bundles: obtain cultures, start broad antibiotics, and give 30 mL/kg balanced crystalloids for hypotension or lactate ≥4. Use norepinephrine as first‑line vasopressor to target MAP ≥65; add vasopressin or epinephrine as needed. Achieve early source control.
• Sepsis and Septic Shock — Early Management

  Identify sepsis early; obtain cultures and start broad-spectrum antibiotics promptly; give 30 mL/kg crystalloid for shock or hypoperfusion; use norepinephrine as first-line vasopressor; reassess frequently.
• Sepsis and Septic Shock — Hour-1 Bundle and Vasopressor Strategy

  Early recognition and treatment with cultures, broad-spectrum antibiotics, 30 mL/kg crystalloid for hypotension or lactate ≥4, and norepinephrine as first-line vasopressor to MAP ≥65; add vasopressin and corticosteroids for refractory shock.
• Sepsis — Early Recognition & Management

  Recognize suspected infection plus organ dysfunction; start antibiotics within 1 hour; 30 mL/kg balanced crystalloids for hypotension or lactate ≥4; norepinephrine is first-line vasopressor; reassess lactate and perfusion.
• Septic Shock — Early Antibiotics, 30 mL/kg Fluids, and Norepinephrine-First

  Suspected infection with hypotension requiring vasopressors to maintain MAP ≥65 mmHg or lactate ≥2 mmol/L despite fluids. Begin antibiotics within 1 hour, give initial 30 mL/kg crystalloid, use norepinephrine as first-line vasopressor (add vasopressin), target MAP and perfusion, and ensure early source control.

V

• Vasopressors in Septic Shock - Selection and Titration

  Norepinephrine is first line; add vasopressin to reduce norepinephrine dose, consider epinephrine for refractory shock, and titrate to perfusion targets.
• Ventilator Liberation - SAT and SBT Protocols

  Pair daily spontaneous awakening trials with spontaneous breathing trials and use standardized weaning criteria to reduce time on the ventilator.