INVOS™: In Vivo Optical Spectroscopy

INVOS™: In Vivo Optical SpectroscopyOverview: ➧ INVOS™ system technology gives a noninvasive “window” to the body’s microvasculature; a direct and dynamic site of gas exchange that transports about half the body’s blood volume.  ➧ Measuring blood oxygenation in the microvasculature results in sensitive and site-specific insights on perfusion adequacy and multi-sensor...

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Acute Kidney Injury Biomarkers

Acute Kidney Injury Biomarkers I) Functional markers 1-Serum Creatinine (SCr): ➧ It is a degradation product of muscle cells and represents a surrogate for the efficiency of glomerular filtration. ➧ It has poor predictive accuracy for renal injury, particularly, in the early stages of AKI. ➧ In the case of critical illness, SCr concentrations are subject to large...

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Bronchoscopy in ICU

Bronchoscopy in ICUIndications: A) Diagnostic:1-Investigation of an infectious process: ➧ Bronchoscopy and broncho-alveolar lavage (BAL) are commonly used for the identification of pathogens in the lower airways in the following circumstances:  a) When it is not clear whether the presence of organisms represents infection or colonization.  b) When...

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Diabetic Ketoacidosis (DKA)

Diabetic Ketoacidosis (DKA) Physiology: Hyperglycemia: ➧ Increased hepatic production of glucose. ➧ Diminished glucose uptake by peripheral tissues. ➧ Insulinopenia / Hyperglucagonemia. Ketoacidemia: ➧ The ketoacid is acetoacetic acid. The byproduct is acetone. The non-keto-acid is beta-hydroxybutyric acid. ➧ Increased lipolysis and hepatic ketogenesis ➧...

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Hypoglycemic Coma

Hypoglycemic ComaHypoglycemia in Type I DM: ➧ Common in patients intensively controlled with insulin. ➧ Asymptomatic blood glucose levels of < 50 mg/dL occur daily in up to 56% of patients. ➧ Symptomatic hypoglycemia occurs 2X/week on average. Severe Hypoglycemia: ➧ An episode requires intervention by another person for the patient to recover function. Causes of...

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Acute Hypocalcemia

Acute Hypocalcemia Causes: 1-Hypoparathyroidism ➧ Destruction of parathyroids (most commonly surgical – parathyroid resection or accidental). ➧ Acute hypomagnesemia 2-Reduced 1,25 (OH) vit D 3-Chronic renal insufficiency ➧ Acute systemic illness ➧ Drugs: ketoconazole, doxorubicin, cytarabine ➧ Increased uptake of Ca in bone ➧ Osteoblastic metastases ➧ Hungry...

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