#84 Acid-Base w/ Dr Sara Crager
Returning guest Dr. Sara Crager joins us again on Critical Care Time, this time to tackle one of the most important, and most commonly overcomplicated, topics in critical care: acid–base physiology. Rather than treating acid–base as a collection of equations and compensation formulas, Sara walks us through her practical State → Process → Story framework for rapidly interpreting blood gases and electrolytes at the bedside. We discuss how to distinguish acidemia from acidosis, interpret CO₂ in the context of bicarbonate, use the anion gap and strong ion difference to uncover mixed metabolic disorders, recognize the importance of chloride and albumin, and understand why a “normal” pH—or a “normal” CO₂—may be anything but normal. Along the way, we work through several real-world ICU cases involving chronic hypercapnia, DKA, vomiting, septic shock, renal failure, saline-induced hyperchloremia, and hypoalbuminemia. The goal isn’t more acid–base math. It’s a better mental model and a faster way to understand what your patient’s numbers are actually telling you.
#73 Diabetic Ketoacidosis
On this week's episode of Critical Care Time, Cyrus & Nick go all-in on DKA and spend a little time talking about alcoholic and starvation ketosis too! In this jam-packed, clinically robust episode, the guys discuss the importance and pathophysiology of DKA before discussing all things treatment. After listening to this - and perusing the show notes - you'll be a DKA master! Check it out and let us know what you think. Special thanks to Integration Health and The Difficult Airway Course: Critical Care for supporting the production of this episode!
#56 Tales from the ICU: BRASH Syndrome
This week, Nick & Cyrus try something a little different with Tales from the ICU. Here, we explore clinical reasoning in the ICU in the context of a mystery case! Don't worry, we'll reveal the diagnosis and go through all the pitfalls, pearls and pathophysiology! This way, you get to play along for a while AND learn some cool medicine. As this is a new episode format, PLEASE leave us feedback and let us know if you like it or if we should send this one to the crypt!
#55 Cirrhosis and Variceal GI Bleeds
On this week's episode of Critical Care Time, Dr. David Dulaney rounds out GI bleeds in the ICU by taking on cirrhosis & variceal bleeds! During this show we discuss the unique challenge associated with managing a patient with cirrhosis - specifically focusing on the coagulopathy of advanced liver disease. We then delve into the nuances associated with managing a variceal bleed, both in terms of the unique critical care elements but also the challenges faced by the endoscopist when trying to saves these patients in extremis. Tune in, leave us a review and most importantly - leave us some feedback!
#54 Non-Variceal GI Bleeds
Join us on this week's episode of Critical Care Time as we embrace blood-and-guts with Dr. David T. Dulaney, gastroenterologist-extraordinaire! Nick & Cyrus host David for a pearl-laden discussion on non-variceal GI bleeds where we talk guidelines, expert opinion and so much more. Who needs a scope? When do you scope them? Why is stabilizing your patient SO important before GI comes in to save the day? How can we work together effectively with our colleagues in GI to ensure the best outcomes for our patient? We tackle a ton of content on this episode so you'll definitely want to tune in... and maybe even take some notes! Make sure to leave us feedback and let us know what you think! Oh... and spoiler alert: cirrhosis and variceal bleeds is on deck for our next installment so keep your eyes peeled for that one too!
#53 Lactate & Lactic Acidosis
On this episode of Critical Care Time, Nick & Cyrus embark on a deep dive into the world of lactic acidosis! As it is the beginning of the academic year, we figured this would be a great topic to demystify and disambiguate for our listeners. We discuss why lactic acidosis matters, and deconstruct all the clinically relevant elements from diagnosis to management, so that you are fully equipped with the tools necessary to conquer your next case of lactic acidosis - or maybe your first!! Ring in this new season of CCT with a banger of an episode and let us know what you think!