Clinical Resources

May 232018
 
A Free On-Line Hemodynamic Curriculum Grows

Jon-Emile S Kenny MD [@heart_lung] “What is memory but a story about how we have lived?” -Mark Doty During the recent ‘Hospitalist and the Resuscitationist’ conference in Montreal, there were discussions around the hemodynamics of prone positioning as well as using venous Doppler as a hemodynamic metric.  Much of this discussion was generated and driven [… read more]

Apr 232018
 
Lectures from the Inaugural 'Hospitalist and the Resuscitationist' Conference in Montreal, Canada

Jon-Emile S. Kenny MD [@heart_lung] “The real process of education should be the process of learning to think through the application of real problems.” -John Dewey On April 18 & 19, 2018, I had the pleasure of participating in the inaugural conference “The Hospitalist and the Resuscitationist” in Montreal.  The entirety of this meeting was [… read more]

Feb 222018
 
The Great Lactate Debate Part 2: can we ‘myth-bust’ the strong ion approach?

Jon-Emile S. Kenny MD [@heart_lung] “The truth is rarely pure and never simple.” -Oscar Wilde In part 1, the crux of this ‘Great Lactate Debate’ was distilled into the unclear origin of the proton in the setting of ‘lactic acidosis.’  Is the [H+] secondary to biochemical work and ATP hydrolysis or is the proton from [… read more]

Jan 292018
 
ICU Physiology in 1000 Words: Venous Doppler & Volume Tolerance

Jon-Emile S. Kenny MD [@heart_lung] With the birth of ‘fluid responsiveness’ physiology [1], there has been a slow and solemn drumbeat ushering the central venous pressure [CVP] up the squeaking planks of the hemodynamic gallows [2, 3].  Despite this, a few years ago I made a humble defense of the central venous pressure.  Importantly, I was [… read more]

Nov 112017
 
ICU Physiology in 1000 Words: Venous Excess & the Myth of Venous Return

Jon-Emile S. Kenny MD [@heart_lung] In the last few weeks I have been contacted by curious clinical physiologists craving my conceptions of ‘venous excess’ [1].  These words will address this model, concisely and – I pray – clearly. The Myth of Venous Return The roots of venous excess took hold within the fertile soil of [… read more]

Oct 192017
 
ICU Physiology in 1000 Words: Fighter Pilots!

Jon-Emile S. Kenny MD [@heart_lung] with illustrations by Carla M. Canepa MD Pilots of high-performance, tactical fighter jets each have continuous positive airway pressure [i.e. CPAP] masks as a part of their flight suit.  Strikingly, beyond the clinically-commonplace airway pressure of 5-15 cm of H2O, a fighter pilot may endure a mask-applied pressure of 90 [… read more]

Jul 222017
 
ICU Physiology in 1000 Words: IVC Collapse, Revisited – Part 1

Jon-Emile S. Kenny MD [@heart_lung] Three years ago I wanted to share my physiology website heart-lung.org; I needed a topic to stoke some interest, so I sent a brief essay to Matt here at pulmccm.org.  In it, I briefly described inspiratory IVC collapse and its relationship to volume status and volume responsiveness.  With this, the [… read more]

Apr 062017
 
Free Online Hemodynamic Physiology Modules: an update & request

Jon-Emile S. Kenny MD [@heart_lung] “Oh, East is East and West is West, and never the twain shall meet …” -Kipling Last year, I began adding physiology modules to heart-lung.org as a part of a Master’s Degree I am undertaking at the Karolinska Institutet in Stockholm, Sweden.  The goal of these modules has been to encourage [… read more]

Jan 242017
 
2016 Surviving Sepsis Guidelines: A Review and Analysis

By Jon-Emile S. Kenny [@heart_lung] PulmCCM is not affiliated with or endorsed by the Society of Critical Care Medicine or the Surviving Sepsis Campaign. Click here to read the Surviving Sepsis Guidelines. “I am at the moment writing a lengthy indictment against our century.  When my brain begins to reel from my literary labors, I make [… read more]

Aug 252016
 
FAQ: How To Study for the Critical Care Medicine Board Examination?

Jon-Emile S. Kenny [@heart_lung] “Let the wild rumpus start!” -Maurice Sendak Many of you are preparing for the Critical Care Medicine Board Examination; thank you to those who have downloaded my free review notes.  I often receive a question or two about the exam and how germane my notes were, in retrospect.  This is a [… read more]

Jul 302016
 
IDSA Guidelines 2016: HAP, VAP & It’s the End of HCAP as We Know It (And I Feel Fine)

Jon-Emile S. Kenny [@heart_lung] “It is important to realize that guidelines cannot always account for individual variation among patients.  They are not intended to supplant physician judgement with respect to particular patients or special clinical situations.” -IDSA/ATS Guidelines 2016 A 73 year old man is admitted from a nursing home for an NSTEMI and is [… read more]

Jan 212016
 
That Fallible IVC

Jon-Emile S. Kenny [@heart_lung] A 58 year old man with ethanol-related cirrhosis is admitted to the floor with anuria and a rising creatinine.  Over the day, serial ultrasounds of his interior vena cava [IVC] consistently reveal that it is diminutive and collapsing.  He receives many liters of crystalloid without much change in his urine output.  [… read more]

Jan 252015
 

Hot off the blog-press is PulmCCM’s new Educational Resources section. This exciting new endeavor will be a forum for sharing your knowledge with the world. If you’ve created a useful educational clinical resource, why limit your audience to your colleagues at your local institution? Increase your impact exponentially by posting your work on PulmCCM where thousands can learn and benefit. [… read more]