I am grateful to tapesh for starting this excellent forum..Firsty critical care in this part is never given much priority .. Most of time whenever we ask for upliftment of critical care services hospital owners simply ask bizzare questions like what profit will i get...So when new doctors willing to pursue icu course comes to such hospital they get dissapointed over period of time and gradually quit..Lack of adequate manpower, mediocre i infrastructure, inability to invest in new icu technologies leads to a vicious cycle of job dissatisfaction..I also had the same feeling till i came across tapesh sir beautiful presentation of challlenging case of icu..Now i am really happy for critical care is something which requires extensive knowledge, team work and mordern technology which many hospital owners never understand..For them what matters in icu is money..
U r right diuretics decrease BP by duiresis as intravascular vol decreases. However in lvf because fluid is removed heart gets dexongested and cardiac fn improves thus BP is also better. BP may fall then add NA. One has to monitor and treat accordingly
yes, but not in pts with hx of af, as ivabrad use can cause af at times. also monitor for brady. it is being used. levosimendan is an option ,does not increase hr// sorry late reply..i had posted it earlier somehow missed
So I suggest u have access to uptodate which has section for new developments apart from its content being newest Then the best journal is NEJM and also its offshoots like hospital watch etc which give you updates from difft journals. It's not possible to prescribe to all journals. It's not affordable neither can one read Also there is JAMA,LANCET ,BMJ -u can subscribe to their table of contents which wl help u keep updated
I am grateful to tapesh for starting this excellent forum..Firsty critical care in this part is never given much priority .. Most of time whenever we ask for upliftment of critical care services hospital owners simply ask bizzare questions like what profit will i get...So when new doctors willing to pursue icu course comes to such hospital they get dissapointed over period of time and gradually quit..Lack of adequate manpower, mediocre i infrastructure, inability to invest in new icu technologies leads to a vicious cycle of job dissatisfaction..I also had the same feeling till i came across tapesh sir beautiful presentation of challlenging case of icu..Now i am really happy for critical care is something which requires extensive knowledge, team work and mordern technology which many hospital owners never understand..For them what matters in icu is money..
Thank you for your kind words😊
Mindblown😊😊….. thank you sir learning to approach medicine in a different way because of you
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Thanks for these amazing classes.Sir please arrange more classes on cardiac cases.
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Amazing discussion...👍🙌👏👏👏
😊glad u found it useful
Amazing case management and case discussion..Congratulations to whole team
Glad u like it
👍👍👍👍👍👍👍👍👍
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HI, AWESOME DISCUSSION WITH WELL TIMED QUESTIONS
Glad you enjoyed it!
Thank you sir for this amazing discussion
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Very nice , thank u
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How to think of diuretics with bp of 92/58 as mentioned with LVF... Doesn't it worsen the bp ???
U r right diuretics decrease BP by duiresis as intravascular vol decreases. However in lvf because fluid is removed heart gets dexongested and cardiac fn improves thus BP is also better. BP may fall then add NA. One has to monitor and treat accordingly
Can we use Ivabrad to control HR , along with Dobutamine
yes, but not in pts with hx of af, as ivabrad use can cause af at times. also monitor for brady. it is being used. levosimendan is an option ,does not increase hr// sorry late reply..i had posted it earlier somehow missed
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Thank yoy
Sir as a med resident how do we keep up with updates and new trails and how many journals and what journals should we subcribe to???
@applebee ,,R u talking about int med or critical care
@@youngindiaintensivist7709 internal med
@@youngindiaintensivist7709 internal medicine sir
@@youngindiaintensivist7709 internal medicine sir
So I suggest u have access to uptodate which has section for new developments apart from its content being newest
Then the best journal is NEJM and also its offshoots like hospital watch etc which give you updates from difft journals. It's not possible to prescribe to all journals. It's not affordable neither can one read
Also there is JAMA,LANCET ,BMJ -u can subscribe to their table of contents which wl help u keep updated
How to measure sv in icu
SV can be measured by ECHO by calculating VTI.
Other than that there are monitors which give CO. So CO/ HR gives SV
iv gtn dose sir??
Starting is 5ugm/min increased as per effect every 5 mi. To max 100 ugm/min