VUIR ::Browsing From Vanderbilt University Medical Center by Issue Date

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Do not give steroids for post extubation stridor

(Vanderbilt University. Medical Center, 2007-05-13) Guy, Jeffrey S.

What is the role of giving an adult steroids to prevent stridor or reintubation following extubation. This epidose looks at the data.

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Oxygenation & PEEP

(Vanderbilt University. Medical Center, 2007-05-13) Guy, Jeffrey S.

A discussion of ventilation, oxygenation, and the role of PEEP.

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Modes of Mechanical Ventilation

(Vanderbilt University. Medical Center, 2007-05-13) Guy, Jeffrey S.

A discussion of the various types of ventilators with a focus on the various ventilator modes and types of ventilator cycles. Also presented is the topic of pressure support ventilation (PSV)

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Lightning Injuries

(Vanderbilt University. Medical Center, 2007-05-14) Guy, Jeffrey S.

Lightning injuries are rare, but when you do treat a patient they can have facinating presentations. This lecture follows a patient we treated at Vanderbilt. The patient present to a local ED with stroke like symptoms following the lightning strike. Initially, physicians were confused by the presentation, but in this lecture you will learn that his presentation was near textbook.

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Glutamine In Critical Illness: what's all the fuss about?

(Vanderbilt University. Medical Center, 2007-05-17) Guy, Jeffrey S.

All surgical residents know that glutamine is the amino acid known as the fuel for the gut. But what is all the fuss about? The episode will look at the data on glutamine. Does glutamine improve outcomes, and if so and in who? How much should we use and what are the hazards? Enteral versus parenteral.

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Complications of PEEP and Auto-PEEP

(Vanderbilt University. Medical Center, 2007-05-18) Guy, Jeffrey S.

Virtually all patients on ventilators are on PEEP. PEEP has several interactions with various organ systems and some can result in profound complications. An understanding of PEEP and auto-PEEP are required before we can understand modes of ventilation like APRV (Bi-Vent)

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Airway Pressure Release Ventilation (APRV) or BiVent: What the heck is this?

(Vanderbilt University. Medical Center, 2007-05-20) Guy, Jeffrey S.

Airway pressure release ventilation (APRV) is not a new mode of mechanical ventilation, but it seems to be gaining a great deal of popularity lately. Many people find this mode very complicated and think that it is reserved only for the very ill. Neither one of these assumptions are corrrect. This mode is very easy to learn and use. Furthermore, this mode is very physiological and tolerated by all types of patients.

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Acute Renal Failure

(Vanderbilt University. Medical Center, 2007-05-22) Guy, Jeffrey S.

Acute renal failure is a dreaded complication in the ICU. This podcast will review the various types of acute renal failure, the etiology, as well as acute management.

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Weaning (Liberating) from the mechanical ventilator

(Vanderbilt University. Medical Center, 2007-05-25) Guy, Jeffrey S.

Don't wean people from their ventilators-- liberate them!! When are people ready to come off the ventilator? What are weaning parameters? How does one do a spontaneous weaning trial? What is the role of noninvasive ventilation (NIV)?

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Intraosseous Vascular Access: not just for the kids anymore

(Vanderbilt University. Medical Center, 2007-05-28) Guy, Jeffrey S.

Intraosseous vascular access was was developed for use in adult trauma patients over 80 years ago. Only recently has this technique regained popularity for rapid and safe access to the vascular space in patients in extremis.

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Renal Replacement Therapy: SCUF, SLED, CVVH, CVVHD, IHD--what does it all mean

(Vanderbilt University. Medical Center, 2007-06-01) Guy, Jeffrey S.

Renal replacement therapy (RRT) is rather a confusing topic. What do all those initials mean and why use one therapy over another? This podcast will explain the difference between intermittent and continous. What are the various forms of continuous and how do they differ? What are the concepts of ultrafiltration, diffusion, and convection? These questions will be answered in this introduction to renal replacement.

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Burns: Fluid Creep in Burn Resuscitation

(Vanderbilt University. Medical Center, 2007-06-07) Guy, Jeffrey S.

Excessive fluid resuscitations lead to horrible complications such as abdominal compartment syndrome. This article takes a critical look and challanges many of our practices in fluid resuscitation of burn patients.

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Blood Conservation in the ICU

(Vanderbilt University. Medical Center, 2007-06-14) Guy, Jeffrey S.

When should a patient receive a transfuse of blood? What is an acceptable hemoglobin concentration in an ICU patient and should we use EPO? Summer is a time when the blood banks often have a single day's worth of blood. Perhaps with more conservative transfusion practices we can avoid or certainly help with some of the blood shortages. Everyone wants to put patients on Epo, but does it increase the hemoglobin concentration enough to off set its high cost?

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Metabolism: Starvation versus Stress

(Vanderbilt University. Medical Center, 2007-06-19) Guy, Jeffrey S.

Not feeding an injured or ill patient is not that same as a normal individual who is fasting. A pound of weight loss in the stress patient is significantly different than a pound of weight loss in someone on a diet. A basic understanding of stress metabolism is needed prior to a discussion of nutrition.

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Early Surgery Improves Outcomes Following Critical Burns

(Vanderbilt University. Medical Center, 2007-06-28) Guy, Jeffrey S.

Early surgical excision is likely to be the most significant individual variable to improve the outcome of a patient (adult or child) with a critical burn. Nevertheless, many nonburn physicians still want to apply to 1970 treatment paradigms to this population of injured patients. This episode will hopefully replace these falsehoods with fact supported in the literature.

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Bomb and Blast Injuries

(Vanderbilt University. Medical Center, 2007-07-04) Guy, Jeffrey S.

Bomb and blast injuries: In the past blast injuries were limited to the battlefield of a rare industrial accident. The events of the past week are a reminder that civilian population centers are targets for bombing attacks. Most civilian providers have no to limited knowledge or experience treating patients with such injuries. This episode is dedicated to a discussion of some of the unique properties and injuries associated with blast injuries. In the event of a terrorist attack, like those attempted in London this past week, the injuries will be in the hundreds