TAVI is more expensive than a traditional AVR, doubles your risk of stroke and major vascular events, and outcome benefits are far from established. There is also a financial scandal reminiscent of the Manny Rivers affair, argues this analysis in the BMJ. Cheers to Mark L for sending this in.

TAVI – risky and costly Van Brabandt BMJ 12


Liver Transplantation NEJM 12

A treasure trove of ICU related resources, all in one place. We’re too good to you.

Fancy a career in ICU?

See Jon’s presentation, given to RPA junior doctors at the RMO Careers day. Warning….presentation contains CICM and RPA promotional material.

You may never want to leave…

Because I think it would be great fun putting a PAC in almost everyone.  Damn Evidence Based Medicine.  Anyway, check out this amazing video from AJRCCM.  I wonder how they did it?


Acute Renal Success!!

rpaicu —  August 30, 2012 — Leave a comment

On Thu, Aug 30, 2012 at 3:22 PM, Mark Lucey <marklucey> wrote:

I think these are 2 really great articles explaining not only the patho-physiological mechanisms of AKI, especially “pre-renal” dysfunction and ATN, but also the interesting relationship between cardiac output, circulating volume, blood pressure, renal blood flow and glomerular filtration. Acute Renal Success is a concept that has been around for a long time, as you can see from Boylan’s article, but I never really thought about this beofre I came across the article a number of years ago. For me, it deals with what I call “physiological” oliguria! Our great challenge in this area, I think, is to recognise when “physiological” oliguria becomes pathological.

(Mark L)

Mechanisms of Acute Renal Failure.pdf

Acute Renal Success – the unexpected logic of oliguria in acute renal failure.pdf

Bye Bye Balloon?

expensivecare —  August 30, 2012 — Leave a comment

Early release 300 patient RCT in the NEJM from a study presented at the European Society of Cardiology this week.  No benefit with IABP in patients with cardiogenic shock undergoing/about to undergo revascularisation.

Intraaortic Balloon Support for Myocardial Infarction with Cardiogenic Shock