Category: Critical Care

Good Doctors...Better People

Fill Me Up – An Arguement Using More Balanced Solutions

July 3, 2014

History of NS vs LR In the great fluid infusion debate internist have favored normal saline, while surgeons have preferred lactated ringers. It looks like our surgeon friends may have gotten it right. Normal saline was never actually “invented” to be a volume replacement therapy. Wikipedia reports that it was discovered in 1831 by William…
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Dialysis vs Bicarbonate Therapy For Lactic Acidosis

April 12, 2014

In the world of critical care medicine sepsis with subsequent Type A Lactic Acidosis (fig 1.) is a common occurrence. And of course the question of should the patient be dialysis for acidosis (the A in AEIOU for emergent dialysis again) arises. This is a difficult answer and one that should be evaluated on a…
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A Hepatorenal Syndrome Review

October 18, 2013

Here is great presentation on HRS by former fellow Damadar Kumbala.  

The Soy Sauce Challenge – Surviving Severe Acute Hypernatremia

August 7, 2013

Volume Management in ALI/ARDS in Dialysis Patients

July 10, 2013

There is often the discussion of proper volume management in patients with ALI (acute lung injury) or ARDS (acute respiratory distress syndrome). We are often called when the patients develop worsening renal function for whatever reason or issues with volume management, so I thought it best to breifly review both ALI/ARDS and volume management in…
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Swamp Fever

July 8, 2013

For the second time in as many years we have seen a patient with Leptospirosis at Tulane Medical Center. This is a fairly rare disease that we are seeing in New Orleans more often that we probably should. Part of the reason is that there are so many gutted house being renovated. People are exposed…
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