Welcoem to posts!!
in the future - u will be able to do some more stuff here,,,!! like pat catgirl- i mean um yeah... for now u can only see others's posts :c
SHORTS -- LESSONS FROM THE ICU (coming soon) personally curated by me๐ฅผ๐๐ฅ
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pl share with the nurses
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FOOD FOR THOGHT๐ค ๐โโ๏ธ๐โโ๏ธ
Why should you treat acute asymptomatic hyponatremia urgently with bolus 3%NS
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FOOD FOR THOGHT๐ค ๐โโ๏ธ๐โโ๏ธ
neb webinar
OUT OF MDI, US, MESH NEBULIZER WHICH SHOULD BE USED FOR GIVING ANTIBIOTICS AND WHY?
ANSWER๐โโ๏ธ๐โโ๏ธ
Simply- nebulized drug delivery to lungs and airways is best with mesh neb -vmn , us are good but they heat up the temp thus ab can get denatured --see comparative chart -- REF ESCMID
GIVE NEBULIZED AB ONLY THROUGH MESH NEB ALSO CALLED VIBRATING MESH NEBULIZER OTHERWISE DONT GIVE --IT WL FAIL
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have a rocking & rollicking 2025 folks , cheers ๐ฅ
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CARDIOGENIC EDEMA WEBINAR
FOOD FOR THOGHT๐ค ๐โโ๏ธ๐โโ๏ธ
A 65-year-old male DM, no HTN ,presents with acute dyspnea, orthopnea, and frothy sputum. No chest pain , Examination reveals elevated JVP, an S3 gallop, bilateral basal crackles, and cold extremities. BP 140/100, 120 NSR .Labs show BNP 1200 pg/mL, ABG with pH 7.30, PaCO2 55 mmHg, and PaO2 60 mmHg on RA . Chest X-ray shows Fluffy shadows. ECHO EF 60% ,no RWMA
What is the most likely cause of his condition?
if you need any more details i can provide
ANSWER๐โโ๏ธ๐โโ๏ธ
Acute heart failure with preserved ejection fraction (HFpEF) is typically triggered by conditions that increase cardiac workload, impair diastolic function, or exacerbate systemic or pulmonary vascular congestion. Common **precipitating factors** include:
1. **Volume Overload**
- **Excessive salt or fluid intake**
- **Renal dysfunction**, leading to fluid retention
- Administration of intravenous fluids or blood transfusions
2. **Hypertension**
- **Acute hypertensive crisis**: Abruptly elevated blood pressure can increase left ventricular filling pressures and worsen diastolic dysfunction. however ef wl decrease in these pts due to increased afterload
3. **Atrial Fibrillation (AF)** Tachyarrhythmias** or **Bradyarrhythmias**
- Loss of atrial contraction reduces left ventricular filling, which is especially significant in HFpEF, where ventricular filling relies on atrial contribution.
- Rapid ventricular rates exacerbate symptoms by shortening diastolic filling time.
4. **Ischemia or Coronary Artery Disease**
- **Acute myocardial ischemia** impairs relaxation and compliance of the left ventricle, worsening diastolic dysfunction.
5. **Exacerbation of Comorbidities**
- Conditions like Cold westher induced vasoconstriction , obesity, diabetes, or metabolic syndrome can destabilize HFpEF.
6. **Infections**
- Systemic or pulmonary infections, such as pneumonia or sepsis, increase metabolic demand and inflammatory stress, precipitating decompensation.
7. **Anemia**
- Reduces oxygen delivery and increases cardiac output demand, exacerbating symptoms.
8. **Thyroid Dysfunction**
- Hyperthyroidism** or **thyrotoxicosis** increases metabolic demand.
-Hypothyroidism** can exacerbate fluid retention.
9. **Renal Dysfunction**
- Worsens fluid and sodium retention, increasing preload and afterload.
10. **Pulmonary Causes**
- Acute exacerbations of chronic obstructive pulmonary disease (COPD) or **pulmonary embolism** increase pulmonary vascular resistance and right heart strain, leading to left heart congestion.
11. **Drugs and Medications**
- **Non-adherence to diuretics** or **antihypertensive therapy**
- Use of medications that retain fluid (e.g., NSAIDs, corticosteroids)
- Initiation of negative inotropes or sodium-retaining drugs
12. **Obstructive Sleep Apnea (OSA)**
- Frequent nocturnal hypoxia and sympathetic surges can precipitate acute HFpEF episodes.
13. **Surgical or Procedural Stress**
- Hemodynamic fluctuations during or after surgery increase cardiac strain.
14. **Alcohol or Illicit Drug Use**
- Alcohol binges or stimulants (e.g., cocaine) can worsen vascular resistance and arrhythmias.
15. **Exacerbation of Comorbidities**
- Conditions like obesity, diabetes, or metabolic syndrome can destabilize HFpEF.
Understanding and managing these triggers is crucial in the acute and long-term management of HFpEF. Prompt intervention tailored to the specific precipitant often leads to improved outcomes.
PL REMEMBER IN AHF THERE IS ALWAYS A PPTING CAUSE -- BRAUNWALDS CARDIOLOGY ๐งก
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FOOD FOR THOGHT๐ค ๐โโ๏ธ๐โโ๏ธ
neb webinar
OUT OF MDI, US, MESH NEBULIZER WHICH SHOULD BE USED FOR GIVING ANTIBIOTICS AND WHY?
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SEPSIS AND SEPTIC SHOCK
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