…Protein 1.2–2.0 g/kg/day Enteral nutrition Started within 48 h where possible Thromboprophylaxis Low molecular weight heparin unless contraindicated Head of…

…Feature Venous ulcer Arterial ulcer Diabetic foot ulcer : : : : Site Gaiter area, above the medial malleolus Toes, heel, lateral malleolus, pressure points Beneath the metatarsal heads…

…non healing distal ulcer. Before compression treatment of a leg ulcer — compression in arterial insufficiency can cause necrosis. Screening in diabetes of 10 years' duration…

…Give small boluses, for example 250 to 500 mL, with immediate reassessment of the blood pressure, pulse, peripheral perfusion, mental state and chest findings. Avoid

…in pressure of < 10% of the daytime value; an independent risk marker. Treatment targets Group Systolic target Diastolic : : : Adults 18–64 years 120–130…

…Consequently, isolated systolic hypertension and widening pulse pressure are common in later life. These changes contribute to the complexity of defining an appropriate treatment target…

…the width of the loop in Figure 1. The area within the loop is the stroke work (SW) , which is discussed below. The pressure volume…

…and with a measurement interval of no more than 30 minutes throughout the 24 hours. Phenotype Office blood pressure ABPM : : : Normotension Normal Normal White coat…

…formula: MAP ≈ Diastolic Blood Pressure (DBP) + 1/3 × (Systolic Blood Pressure [SBP] – DBP) This formula accounts for the longer duration of diastole compared to systole…

…emergency department [1,3]. Step 1: confirm the blood pressure and stabilise the patient Immediate assessment 1. Assess airway, breathing, circulation and level of consciousness…

…American Society of Echocardiography 30 (4), pp. 303–371. DOI: 10.1016/j.echo.2017.01.007. – Pubmed Link Tricuspid valve stenosis Mean pressure gradient…

…to 1; a normal value is approximately 0.94–1.0. The physiological basis of FFR is that, during maximal vasodilation, distal coronary pressure is…

…for measuring pressure gradients across small openings, such as the valves. Importantly, in the setting of valvular stenosis or regurgitation, the proximal velocity (v 1 …

…pain rated as 6 or above (according to the 10 point scale) should prompt termination of the stress test (refer to Termination criteria during stress…

…Ambulatory blood pressure monitoring (ABPM): automated measurement, usually over 24 hours, at predefined intervals. Inter arm difference: a sequential systolic difference of 10 mmHg between…

…low dose Dobutamine Levosimendan Amrinone Milrinone Nitroglycerin Nitroprusside Figure 1. The approximate position of each drug according to its vasoconstrictor effect (vertical axis) and its…

…intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual for inotropes and vasopressors Drug Indications…

…hypertension, defined in the cited recommendation as blood pressure ≥140/90 mmHg. Screening is particularly pertinent in the presence of hypokalaemia or treatment resistance. Hypokalaemia…

…course of asphyxia Should ventilation be entirely inhibited (as seen in acute airway obstructions), a rapid decline in blood oxygen saturation ensues. Within 1 2…

…intra arterial catheter (A line) is warranted. Overview of vasopressors and inotropes Inotropes and vasopressors. Table 1. Drug manual for inotropes and vasopressors Drug Indications…

…narrow pulse pressure suggests a low stroke volume Capillary refill < 3 s A simple and validated marker of perfusion Lactate < 1.6 mmol…

…emergency is severe blood pressure elevation accompanied by acute hypertension mediated target organ damage (HMOD). The European definition uses BP ≥180/110 mmHg with acute…

…in the Treatment of Cardiogenic Shock (N Engl J Med 2021; 385:516 525) In a randomized, double blind study involving 192 patients with cardiogenic…

…outflow tract obstruction Caution Tachyarrhythmia or bradyarrhythmia Rate control first Blood pressure 200/110 mmHg at rest Treat first Electrolyte disturbance Correct Second or third…

…Increase by 5 10 μg/min every 5 min to desired blood pressure. Maximum dose: 100 μg/min. Time to onset of action:…

…a life threatening clinical syndrome in which increased intrapericardial pressure compresses the heart and impairs ventricular filling. It generally results from accumulation of pericardial fluid…

…factor cluster and a marker of broader metabolic dysfunction. Associated abnormalities may include increased apoB and apoC III, uric acid, fibrinogen, plasminogen activator inhibitor 1…

Cardiology Respiratory medicine Definition and Pathophysiology Pulmonary hypertension (PH) is a heterogeneous pathophysiological disorder characterized primarily by elevation of pulmonary arterial pressure. It may arise…

…and excess cardiovascular risk. The European definition requires failure to reduce office systolic and diastolic blood pressure to below 140 mmHg and 90 mmHg, respectively…

…11. Document weight, agent, dose, time of the bolus and the blood pressure before administration. 12. Prepare for the monitoring and management of intracranial haemorrhage…

…eGFR 30 mL/min. At an eGFR of 15–30 mL/min the documentation is inadequate and closer monitoring is required. Dabigatran is contraindicated at…

…Method Starting pressure Escalation Oxygen target : : : : : Cardiogenic pulmonary oedema CPAP 5–7.5 cmH₂O Increase in steps of 2.5 to 10–12.5 cmH₂O…

…globe — because a perforated eye must never be instrumented, have its pressure measured, or be palpated. Indications A sensation of something in the eye, watering…

…Condition Overall strategy Common first choices : : : Acute aortic syndrome Immediate rate control and rapid reduction of the systolic blood pressure towards 100 to 120 mmHg…

…pressure lowering effect. Pain relief. Delivery IV, IM, PO, transdermal Dose Injection IV: • 150 μg in 1 ml vial. Dilute with 10 ml of…

…metabolite (ester) of enalapril, an angiotensin converting enzyme (ACE) inhibitor. Enalaprilat lowers blood pressure by inhibiting ACE. Effects • The hypotensive effect of enalaprilat depends on…

…beta adrenergic receptor blocker. • Esmolol lowers blood pressure immediately (within 1 minute) • Esmolol may also be used to control supraventricular tachycardia (rate control). • Esmolol may…

…Indications Short term management of hypertension, including hypertensive emergency. Mechanism of action • Systemic Dopamine 1 (D1) receptor agonist. • Lowers blood pressure while maintaining or increasing…

…blood pressure, and decreases afterload. Nicardipine has antianginal and antihypertensive effects. Time to onset of action 5 to 15 minutes Duration of action 1.5…

…Mechanism of action Beta 1 adrenergic blocker. Effects Lowers blood pressure, reduces heart rate, myocardial oxygen consumption and myocardial contractility. Less pronounced blood pressure lowering…

…pressure lowering. Antianginal effect. Reduces afterload and preload. Effective in pulmonary edema. Can produce severe hypotension. Time to onset of action 30 seconds to 1…

…blood pressure while increasing catecholamine activity. Effects Primarily causes afterload reduction. Time to onset of action 1 to 2 minutes Duration of action 10 to…

…adherence. Selection should be individualized according to blood pressure, heart rate, left ventricular function, comorbidities, concomitant medications, potential drug interactions, the presumed mechanism of ischaemia…

…remains consequential, and historically 2–6% of patients discharged with presumed non ischaemic chest pain were subsequently found to have had an infarction. Pathophysiological Considerations…

…one killer worldwide since the 1960s. In 1948 the NHLBI initiated the Framingham Heart Study, which demonstrated that high blood pressure and high cholesterol levels…

…affect the myocardium or major vessels. 1. Acute Coronary Syndrome (ACS) / Myocardial Ischemia Pain Characteristics: Typically presents as substernal discomfort, often described as pressure, tightness…

…increases in heart rate, myocardial contractility and blood pressure. When coronary blood flow cannot increase adequately because of flow limiting disease, myocardial ischaemia may develop…

…be initiated concurrently. In patients with a confirmed indication for treatment but blood pressure in the range of 120–139/70–89 mmHg, concomitant indications…

…HbA1c) reduction, blood pressure, lipids and smoking cessation. Weight loss was considered extremely difficult across patient categories. However, the emergence of incretin based therapies, starting…

…Alveolar Plateau) : ETCO 2 is the recorded CO 2 partial pressure just before the next inspiration. Phase 0 : Indicates the beginning of the next inspiration…

…LL, Swart GL. The hemodynamic and arterial blood gas response to asphyxiation: a canine model of pulseless electrical activity. Resuscitation 1995; 30:16975. Safar P…

…responds to increased ventricular pressure/volume by increasing its contractility. The Frank Starling mechanism is amplified by the positive inotropic effects of the sympathetic stimulation…

…these can be leveraged to calculate stroke volume, cardiac output, pressure conditions, severity of stenoses and regurgitations, etc . These calculations are based on simple mathematical…

…blood pressure, and decreases afterload. Nicardipine has antianginal and antihypertensive effects. Time to onset of action 5 to 15 minutes Duration of action 1.5…

…evaluated the efficacy of a CPR adjunct and also recorded the compression rate and depth. They reported that the ideal combination was 107 compressions per…

…contents move under pressure; cellulitis instead gives a diffuse oedematous picture without a demarcated fluid collection. Ultrasound also shows the depth of the cavity and…

…Lidocaine 10 mg/mL for local anaesthesia in the awake patient — the anaesthetic also improves the chance of success by counteracting vascular spasm. Pressure monitoring…

…saw, protective sheeting Hot water gives faster setting and more heat production — a risk of burns Document the distal neurovascular status before casting : sensation, motor…

…dialysis catheter, not an ordinary triple lumen catheter). Measurement of central venous pressure and central venous oxygen saturation. Repeated blood sampling during intensive care. Exhausted…

…aspiration, pressure sores, loss of function, longer length of stay, institutional care, readmission, cognitive decline and increased mortality [3,4]. Do this first 1. Assess…