Learning about the benefits of melatonin while creating my metabolic resuscitation lectures has been quite intriguing. The first time I was exposed to these beneficial antioxidant and anti-inflammatory effects was during a live lecture by Dr. Paul Marik. As of late, there have been three articles regarding utilizing melatonin in patients with COVID-19. Check here …
Colchicine for COVID-19: GRECCO-19, COLCORONA & RECOVERY
Please see the bottom of the page with the most recent update to the colchicine literature in COVID-19. This post covers the GRECCO-19, and COLCORONA, and RECOVERY Trials. I have mentioned this many times before, I like readily available, inexpensive medications such as dexamethasone and colchicine to treat our COVID patients. In this case, the …
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Bicarbonate (Carbon Dioxide/CO2) on Serum BMP & Blood Gases/ABG
When you obtain a basic metabolic panel (BMP) or complete metabolic panel (CMP), you get the usual values reported on it: Na, K, Cl, carbon dioxide (CO2), glucose, BUN, creatinine, etc. The value that seems to cause the most confusion is the "carbon dioxide/CO2". This especially happens while I'm teaching on rounds where my mind …
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3M Respirator & Filters for COVID: 7500 vs 6000 vs 6800 Series Face Masks
Today is Saturday, June 20 of 2020 for historical context (ADDENDUM: this page has been updated numerous times to facilitate the best possible information for you). It is now pretty easy for us to purchase our own 3M respirator for when we take care of COVID patients. They're available on Amazon with a bit of …
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Dexamethasone in COVID-19: Improving Survival
ADDENDUM 1/5/22: We have now been using dexamethasone for COVID-19 patients who require oxygen since summer of 2020. We have been mostly stuck on using the dose of 6mg per day in these patients simply because that's what the great authors of the RECOVERY trial group did. This isn't a dig at them, they did …
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Midodrine in the Intensive Care Unit (ICU)
Midodrine (brand name Proamatine), is an alpha-1 adrenergic agonist that is orally administered. It is used in both in the outpatient setting as well as inpatient setting to restore vascular tone and increase blood pressure. One of the benefits of this medication in the Intensive Care Unit (ICU) is that we can administer it to …
IV Vitamin C & Metabolic Resuscitation in Septic Shock: Ultimate Guide
Image by Dr. Gizzy, @physiciandoodles on Instagram. This post is a work in progress regarding everything you need to know regarding administering high-dose intravenous (IV) Vitamin C (ascorbic acid) to your critically ill patient. I will continue to work on this post regarding IV vitamin c as well as metabolic resuscitation as time allows and …
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Vasopressors in 2023
The intention of this post is going to be to take a deep dive into the states of vasopressors using the best evidence based practices available. It will be routinely updated. This is a work-in-progress blog post on vasopressors. Last updated 02/25/2022.If you find this blog post useful, and you want to cite it in …
Lactic Acid/Lactate in Sepsis & the Critically Ill: The Ultimate Guide
This post will be a compendium of all things and questions we ask ourselves regarding lactate/lactic acid in sepsis and other critically ill patients. We have become a culture where, as soon as a person hints at being sick, we check a stat lactate/lactic acid. If we understand our enemy, we won't be frightened by …
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Protek Duo Right Ventricular Assist Device (RVAD) ProtekDuo
There are few options when it comes to right ventricular support for patients who are in right heart failure from a multitude of etiologies. At the time of this writing, we are limited to two temporary percutaneous right ventricular assist devices (RVAD) to assist our patients with this problem: the Impella RP and the Protek …
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