In this edition of the series, Dr. Molinar provides an excellent review of the different types of hetastarches available along with associated pharmacokinetic and pharmacodynamic profiles.

CLICK HERE TO VIEW THE RECORDED JOURNAL CLUB WEBINAR

This is followed by Dr. Ahn’s review and discussion of the Schortgen et al. study in Lancet 2001. This was thew first “larger” study to evaluate hetastarch and its possible deleterious effect on the kidneys when compared to Gelatin in a multi-center randomized trial in France.

Finally, not until 2008 did we have a large multi-center German study called the VISEP trial published in NEJM which looked at severe sepsis and septic shock patients and compared Hetastarch to Lactated ringers (along with evaluation of intensive vs conventional glucose control). This too as a secondary endpoint ealuated the effects of therapy on renal failure and need for RRT. Although this trial was stopped prematurely because of severe hypoglycemic episodes in the intensive insulin therapy group, it is still the single largest multicenter trial to date looking at the outcomes of septic patients receiving Hetastarch.

These two trials really are the basis of what I have termed the “anti-hextend” movement in the critical care community however they are marked by a myriad of SIGNIFICANT design and statistical FLAWS which have also led to widespread criticism. This journal club webinar aims to dig deep into the analysis of these two trials and was a very engaging and though provoking session. Please FEEL free to comment below and let the discussion continue!!

In keeping with the spirit of ICU 2.0-3.0, I am proud to announce the introduction of the Critical Care Journal Club Series. The series will feature weekly or bi-weekly online, live, real time broadcasts of journal club conferences in the Surgical Intensive Care. The presenters will be residents and fellows rotating through the Surgical ICU and will be moderated by an attending physician. These discussions, much like the anesthesia ones are lively, educational and usually lead to animated conversations on controversial critical care topics facing us today.

Subscribe to the site via twitter or rss to get regular updates and find out how you can attend the next session LIVE online. In the mean time:

CLICK HERE

to get to the list of recordings of the sessions.  As always, comments, suggestions and lively discussion is heavily encouraged!!

Now featuring live online journal clubs on exciting topics in Anesthesia primarily focused on the ambulatory setting.  Follow the link to the Journal Club Series to explore the site and register for the next event. Theses live journal clubs are moderated, live events that lead to lively discussions and feature some of the experts in the field. After the event, you can find a link to the recording of the event where you can review the conference and continue the conversation online …. click on the link and enjoy …

iPad hands on review: Fits in your white coat and is fast enough for Medical point of care use [Healthcare Perspective]

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I apologize for the long delay between posts but I have been working on getting some updates into the website. As you can see, our theme is entirely different and starting today – We are iPhone friendly! now you can visit anytime and have the same ease of use that you do from the computer at home or work. Enjoy!

Her is a presentation that goes over what my vision is for the “FUTURE ICU.” I originally presented this about a year ago during my fellowship. Enjoy!

Here is another fantastic ICU 2.0 resource. You can subscribe to these podcasts in iTunes or listen to them directly on the website. Dr. Jeffrey S. Guy has taken topics he discussed on teaching rounds in the Burn ICU at Vanderbilt and brought them to you as onDemand solutions! It is these sort of resources that are inspirational for me and truly on the forefront of teaching in the 21st century. Well Done Dr. Guy! I hope you enjoy and become a subscriber (as I did).

BTW. Look out for the Critical Care Minutes podcast and vodcast series which will be starting up very soon. Stay Tuned!

You can now follow along with us by signing up for our twitter updates. Just click on the link below. Also you can always subscribe to the site with your favorite RSS reader. Stay tuned, exciting new ICU 2.0 features will be coming to the site very soon including the ability to join in our LIVE! web conferences. Click the logo to follow along!

Here is another excellent and thorough resource I found online in the blogger community that reviews several procedures including Central Line Placement, Thoracentesis, Paracentesis, Arterial Line, Lumbar Puncture, etc. The review is not video based but does have very detailed images used to illustrate the techniques as well as nice decriptive explanations. ClinicalCases.org is a free online case-based curriculum of clinical medicine and is one of the most popular medical blogs on internet. A lot of the information may not be relevant to the ICU but it is still a good resource for topic reviews. I would encourage you to browse the site and get your learn on Incidentally, this website has significant input from the Cleveland Clinic and the Case Western Lerner College of Medicine – The blog was developed by Dr. Vesselin Dimov (Internal Medicine, CCF).

ClinicalCases.org was featured in the British Medical Journal and Medscape.com, and was referenced several times in the medical education literature. The project is hyperlinked in the web sites of 11 medical schools in the U.S., Canada and Europe. This case-based curriculum was started by physicians at Cleveland Clinic and Case Western Reserve University (St. Vincent/St. Luke) Internal Medicine Residency Program for the purpose of medical education.

Check it out Clinicalcases.org.

Here is a link to the Procedural guides.

Here is a five part series nicely done by an ER resident from University of Chicago that goes over step by step what is requires to place a central line. This is directed towards an ER resident but certainly the techniques can be applied to the SICU as well. This is a good review for the new residents who have may have never seen the inside of the kits and who have never seen a line performed. Soon we will have our own videos and then you might be able to see another way this is done.

Part 1 of 5 of the series is included here: (view the rest on YouTube.com by clicking here)

Click here to view the embedded video.