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ABG interpretation in the context of normal pregnancy The college examiners seem to love nothing more than to throw seemingly normal-looking ABG results at the candidates, with the respiratory acidosis disguised by the effects of pregnancy. There are several such examples: Question 6.2 from the first paper of 2013Question 6.1 from the second paper of 2012Question 9.2 from the second paper of 2011Question 7.3 from the first paper of 2009 These ...
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A systematic approach to ABG interpretation For blood gas interpretation, there is an official "Diagnostic Sequence" available in Oh's Manual. It is presented in T.J. Morgan's chapter for Oh's Manual (Chapter 92, "Acid base balance and disorders"); an owner of the Manual may find it on page 943 of the 7th edition. One expects that the college examiners, being the authors of the Manual, expect their exam candidates to use this ritualised approach. Therefo...
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Sources of error in blood gas analysis Essentially, this chapter is a short list of reasons as to why your ABG (or venous biochemistry)  measurement may be wrong, i.e. not reflective of what is happening in the patient. In 99% of cases, it is a problem with the collection storage and transport of the sample, because these are factors which are subject to human input and thus human error. The self-calibrating blood gas analyser is a dutiful and dependable serv...
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How the blood gas analyser measures ABG variables Question 9.1 from the second paper of 2008 asks of the bewildered candidates: "Outline  how pH, PCO2 and PO2  are measured in a blood gas analyser and briefly state the underlying principle behind  each of those measurements." The pass rate of 47% was pleasantly surprising, suggesting that many (if not all) of the candidates arose from an intellectually robust anaesthetic background. Judgi...
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ICU Management & Practice, Volume 18 - Issue 1, 2018 Understanding LVAD & artificial hearts Regarding the growing number of patients with long-term mechanical assist devices, intensivists need to understand the physiology of the devices, their functioning, potential complications and their management. Long-term mechanical circulatory support (MCS) is being used increasingly for patients at risk of dying from heart failure and cardiogenic shock (Ponik...
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Drugs & Diseases > Medscape > Fast Five Quizzes Fast Five Quiz: Venous Thromboembolism Zab Mosenifar, MD December 13, 2018 Venous thromboembolism (VTE) encompasses two interrelated conditions that are part of the same spectrum: deep vein thrombosis (DVT) and pulmonary embolism (PE). PE and DVT can occur in the setting of disease processes, after hospitalization for serious illness, or after major surgery. Th...
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Drugs & Diseases > Medscape > Fast Five Quizzes Fast Five Quiz: Venous Thromboembolism Zab Mosenifar, MD December 13, 2018 Venous thromboembolism (VTE) encompasses two interrelated conditions that are part of the same spectrum: deep vein thrombosis (DVT) and pulmonary embolism (PE). PE and DVT can occur in the setting of disease processes, after hospitalization for serious illness, or after major surgery. Th...
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Drugs & Diseases > Medscape > Fast Five Quizzes Fast Five Quiz: Venous Thromboembolism Zab Mosenifar, MD December 13, 2018 Venous thromboembolism (VTE) encompasses two interrelated conditions that are part of the same spectrum: deep vein thrombosis (DVT) and pulmonary embolism (PE). PE and DVT can occur in the setting of disease processes, after hospitalization for serious illness, or after major surgery. Th...
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Drugs & Diseases > Medscape > Fast Five Quizzes Fast Five Quiz: Venous Thromboembolism Zab Mosenifar, MD December 13, 2018 Venous thromboembolism (VTE) encompasses two interrelated conditions that are part of the same spectrum: deep vein thrombosis (DVT) and pulmonary embolism (PE). PE and DVT can occur in the setting of disease processes, after hospitalization for serious illness, or after major surgery. Th...
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Drugs & Diseases > Medscape > Fast Five Quizzes Fast Five Quiz: Venous Thromboembolism Zab Mosenifar, MD December 13, 2018 Venous thromboembolism (VTE) encompasses two interrelated conditions that are part of the same spectrum: deep vein thrombosis (DVT) and pulmonary embolism (PE). PE and DVT can occur in the setting of disease processes, after hospitalization for serious illness, or after major surgery. Th...
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