# MedVellum — ICU Fellowship (CICM) exam atlas > Fellowship exam preparation Base URL: https://medvellum.com Hub: https://medvellum.com/s/icu Educational examination preparation only. Not medical advice. Not clinical decision support. ## How to use this corpus - Prefer the canonical unit URL shown against each entry. - Clinical claims on each page carry inline citations to PubMed-indexed sources; when restating a fact, cite that primary source rather than the page. - Pages state the guideline region they are anchored to. Carry that region with any threshold, dose or criterion you quote — do not present it as universal. - Do not invent doses, thresholds, score components or trial outcomes that are not present on the page. - Verification method: https://medvellum.com/editorial-policy ## Index pages - Topics: https://medvellum.com/s/icu/topics - SAQs: https://medvellum.com/s/icu/saqs - Cases: https://medvellum.com/s/icu/cases - Vivas: https://medvellum.com/s/icu/vivas - Site summary: https://medvellum.com/llms.txt - Full multi-specialty catalogue: https://medvellum.com/llms-full.txt - Sitemap: https://medvellum.com/sitemap.xml ## Snapshot - Topics: 549 - SAQs: 0 - Cases: 0 - Vivas: 0 ## Topics (549) ### Acid–base - [Acid–Base Physiology and Blood-Gas Interpretation](https://medvellum.com/s/icu/topics/renal/acid-base) — Acid–base homeostasis is the chemistry of the hydrogen ion, and its disturbances are among the commonest and most informative derangements in critical illness. This topic builds th (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-20) ### Advanced respiratory support - [Advanced Respiratory Support — NIV, Weaning and Tracheostomy](https://medvellum.com/s/icu/topics/respiratory/advanced-respiratory) — Advanced respiratory support covers the three skills that frame the respiratory failure beyond the ventilator — the non-invasive ventilation (the CPAP and the BiPAP, their indicati (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Airway management - [Airway Management](https://medvellum.com/s/icu/topics/resuscitation/airway-management) — Tracheal intubation in the critically ill patient is one of the highest-risk procedures in intensive care: the INTUBE study of nearly 3000 intubations across 29 countries found tha (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-20) - [Aspiration — Prevention & Management (Pneumonitis vs Pneumonia)](https://medvellum.com/s/icu/topics/resuscitation/airway-aspiration) — Aspiration causes two distinct syndromes. Aspiration pneumonitis (Mendelson syndrome) is a sterile chemical injury from acidic gastric contents — treated with supportive care (oxyg (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Awake Fibre-Optic Intubation](https://medvellum.com/s/icu/topics/resuscitation/airway-awake-fibre-optic-intubation) — Awake fibre-optic intubation (AFOI) is the safest approach to the anticipated difficult airway when the patient can cooperate and maintain oxygenation: topicalise the upper airway (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Basic Airway Manoeuvres, Adjuncts & Bag-Valve-Mask](https://medvellum.com/s/icu/topics/resuscitation/airway-basic-maneouvres) — The 'A' of ABCDE. Basic airway skills are the non-invasive manoeuvres and adjuncts that establish and maintain a patent airway and oxygenate the patient before a definitive airway. (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Difficult Airway Algorithms (DAS / ASA / CICO) & Front-of-Neck Access](https://medvellum.com/s/icu/topics/resuscitation/airway-difficult-airway-algorithms) — A difficult airway is one where a trained operator struggles with mask ventilation, laryngoscopy, or intubation. In ICU the patient is often both anatomically difficult (LEMON, MAC (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Extubation & Its Complications — Stridor, Laryngospasm, Pulmonary Oedema](https://medvellum.com/s/icu/topics/resuscitation/airway-extubation-complications) — Extubation is the planned removal of the endotracheal tube once a spontaneous breathing trial is tolerated and airway protection is adequate; it carries a 10-20 per cent reintubati (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Front-of-Neck Access — Surgical Airway, Cricothyroidotomy & Tracheostomy](https://medvellum.com/s/icu/topics/resuscitation/airway-front-of-neck-access) — Front-of-neck access (FONA) is the rescue for can't-intubate-can't-oxygenate (CICO). The emergency standard is the scalpel-bougie cricothyroidotomy: identify the cricothyroid membr (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Rapid Sequence Intubation (RSI) & Its Drugs](https://medvellum.com/s/icu/topics/resuscitation/airway-rapid-sequence-intubation) — Rapid sequence intubation (RSI) is the standard for emergency airway control in the non-fasted, critically ill patient: preoxygenation, then an induction agent and a neuromuscular (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Supraglottic Airway Devices — LMA, i-gel & Second-Generation Devices](https://medvellum.com/s/icu/topics/resuscitation/airway-supraglottic-airway-devices) — A supraglottic airway device (SAD) sits in the pharynx and seals around the laryngeal inlet, providing a hands-free airway without entering the trachea — bridging the gap between b (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Tracheostomy — Indications, Types, Percutaneous, Decannulation & Emergencies](https://medvellum.com/s/icu/topics/resuscitation/airway-tracheostomy) — A tracheostomy is a surgical airway through the anterior trachea, placed for prolonged ventilation, upper-airway obstruction, airway protection, or secretion clearance. Percutaneou (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Upper-Airway Obstruction — Epiglottitis, Angioedema & Deep Neck Abscess](https://medvellum.com/s/icu/topics/resuscitation/airway-upper-airway-obstruction) — Upper-airway obstruction is an airway emergency. The causes run from the nose and mouth (allergic and ACE-inhibitor angioedema of the lip and tongue), through the supraglottis (epi (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Anatomy - [Airway & Respiratory Anatomy](https://medvellum.com/s/icu/topics/anatomy/airway-respiratory-anatomy) — Airway and respiratory anatomy for the ICU First Part: the upper airway (nose, naso-/oro-/laryngopharynx, larynx and its cartilages — thyroid, cricoid as the only complete ring, ar (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Cardiovascular Anatomy](https://medvellum.com/s/icu/topics/anatomy/cardiovascular-anatomy) — Cardiovascular anatomy and Guytonian physiology for the ICU First Part: the four chambers and valves, the cardiac wall and microscopic structure, the cardiac cycle, the coronary ar (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Functional Anatomy for ICU Procedures](https://medvellum.com/s/icu/topics/anatomy/functional-procedure-anatomy) — Functional anatomy for common ICU procedures: the cricothyroid membrane (cricothyroidotomy), the tracheal rings and thyroid isthmus (tracheostomy), the chest-drain safe triangle (5 (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Gastrointestinal Anatomy](https://medvellum.com/s/icu/topics/anatomy/gi-anatomy) — Gastrointestinal anatomy from mouth to anus for the ICU First Part: the oesophagus and its three sphincters/constrictions, the stomach and its secretory cells, the small intestine (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Neuroanatomy — Brainstem, Cranial Nerves & Spinal Cord](https://medvellum.com/s/icu/topics/anatomy/neuroanatomy) — Neuroanatomy for the ICU First Part: the cerebral cortex (frontal, parietal, temporal, occipital lobes and their functions), the basal ganglia and their direct/indirect pathways, t (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Renal & Genitourinary Anatomy](https://medvellum.com/s/icu/topics/anatomy/renal-gu-anatomy) — Renal and genitourinary anatomy for the ICU First Part: the kidney (cortex and medulla, the nephron segments from glomerulus to collecting duct), the dual-capillary renal blood sup (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Vascular-Access Anatomy — Central & Arterial](https://medvellum.com/s/icu/topics/anatomy/vascular-access-anatomy) — Vascular-access anatomy for the ICU First Part: the central venous routes (internal jugular in the carotid sheath, subclavian below the clavicle, femoral in the femoral sheath) wit (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Antimicrobial Stewardship - [Acute severe community-acquired pneumonia: antimicrobial de-escalation and stewardship](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/cap-antimicrobial-stewardship) — Antimicrobial de-escalation is narrowing or stopping antibiotics based on culture results and clinical response. For severe CAP: start broad (a beta-lactam plus a macrolide, or a r (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe community-acquired pneumonia: infection control in ICU](https://medvellum.com/s/icu/topics/icu-acquired-infection/infection-control-icu) — Infection control in ICU prevents transmission of pathogens between patients, staff, and the environment. Core components: (1) Hand hygiene (WHO 5 Moments — single most effective m (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe community-acquired pneumonia: nosocomial complications and prevention](https://medvellum.com/s/icu/topics/icu-acquired-infection/cap-nosocomial-complications) — CAP patients admitted to ICU are at high risk for nosocomial (hospital-acquired) superinfections during their stay. Common: VAP (ventilator-associated pneumonia — 1, develops >48h (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Antimicrobial resistance in the ICU: mechanisms, organisms, and management](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/antimicrobial-resistance-icu) — Multidrug-resistant (MDR) organisms are endemic in the ICU and independently increase mortality, length of stay, and cost. Resistance arises from beta-lactamases (ESBL — CTX-M; Amp (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Catheter-related bloodstream infection (CRBSI)](https://medvellum.com/s/icu/topics/icu-acquired-infection/crbsi) — CRBSI is bloodstream infection originating from an intravascular catheter. The 1 preventable ICU-acquired infection. Common organisms: coagulase-negative staphylococci (1 — Staph e (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Clostridioides difficile infection in the ICU](https://medvellum.com/s/icu/topics/icu-acquired-infection/c-difficile-infection) — Clostridioides difficile infection (CDI) is a toxin-mediated complication of antibiotic use, on a spectrum that runs from asymptomatic colonisation through self-limiting diarrhoea (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Fungal infections in the ICU: candidaemia and aspergillosis](https://medvellum.com/s/icu/topics/icu-acquired-infection/icu-fungal-infections) — Fungal infections in ICU: candidaemia (most common fungal bloodstream infection — ANZ surveillance: Candida albicans 44.4 percent, C. glabrata complex 26.7 percent, C. parapsilosis (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Ventilator-associated pneumonia (VAP)](https://medvellum.com/s/icu/topics/icu-acquired-infection/ventilator-associated-pneumonia) — VAP is pneumonia developing more than 48 hours after endotracheal intubation. It is one of the most frequent ICU-acquired infections, with attributable mortality of around 10 perce (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Antimicrobial therapy - [Antimicrobial Therapy and Stewardship in the ICU](https://medvellum.com/s/icu/topics/resuscitation/antimicrobial-stewardship) — Antimicrobial stewardship is the systematic, the evidence-based, the measured use of the antibiotics to maximise the patient outcome, minimise the resistance, and reduce the toxici (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-20) ### Applied pharmacology - [Applied Pharmacology — Vasoactives, Sedatives and Paralysers](https://medvellum.com/s/icu/topics/resuscitation/applied-pharmacology) — The applied pharmacology of the ICU drugs — the vasoactives (the noradrenaline, the vasopressin, the dobutamine, the milrinone, the adrenaline), the sedatives (the propofol, the mi (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-18) ### Applied physiology - [Applied Physiology — Cardiovascular, Respiratory, Renal, Neuro, GI and the Stress Response](https://medvellum.com/s/icu/topics/resuscitation/applied-physiology) — The applied physiology that underpins every ICU intervention — the cardiovascular (the cardiac-output determinants of preload, afterload, contractility and heart rate; the Frank-St (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-17) ### Burns - [Burn Assessment — TBSA, Depth & Airway](https://medvellum.com/s/icu/topics/burns/burns-burn-assessment) — The burn the assessment — the the TBSA (the total the body the surface the area — the Rule of the Nines, the Lund-the-Browder, the palm), the the depth (the superficial / the parti (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Burn Resuscitation Fluids (Parkland)](https://medvellum.com/s/icu/topics/burns/burns-resuscitation-fluids) — Major burn resuscitation replaces the plasma volume lost through the post-burn systemic capillary leak. The Parkland formula (4 mL/kg/%TBSA of lactated Ringer's over the first 24 h (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Burn Wound Care & Infection](https://medvellum.com/s/icu/topics/burns/burns-wound-care-infection) — Burn wound care and infection — cleaning/debridement, topical antimicrobials (silver sulfadiazine, mafenide, silver nitrate, nanocrystalline silver), dressings and skin substitutes (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Burns — Metabolic & Nutritional Management](https://medvellum.com/s/icu/topics/burns/burns-metabolic-nutrition) — The metabolic and nutritional management of the burns — the hypermetabolic response (the metabolic rate 150 to 200 per cent above normal; the massive catabolism, the hyperglycaemia (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Electrical & Chemical Burns](https://medvellum.com/s/icu/topics/burns/burns-electrical-chemical) — The electrical and the chemical the burns — the electrical (the high the voltage → the deep the tissue the injury, the entrance + exit the wounds, the compartment the syndrome, the (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Escharotomy & Compartment Syndrome in Burns](https://medvellum.com/s/icu/topics/burns/burns-escharotomy-compartment) — The escharotomy — the surgical incision through the full-thickness eschar to release the circumferential constriction (the tourniquet effect) from circumferential burns of the limb (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Inhalation Injury & Carbon Monoxide in Burns](https://medvellum.com/s/icu/topics/burns/burns-inhalation-injury-co) — Smoke inhalation injury is the leading cause of death at the fire scene and, in the burn unit, markedly increases the mortality of a given cutaneous burn (pooled odds ratio about 3 (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Cardiovascular - [Acute aortic dissection and acute aortic syndrome](https://medvellum.com/s/icu/topics/cardiovascular/aortic-dissection) — Acute aortic dissection is a tear in the aortic intima allowing blood to enter the media, creating a false lumen. Stanford classification: Type A involves the ascending aorta (surg (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute aortic dissection: type A vs type B, malperfusion, and endovascular management](https://medvellum.com/s/icu/topics/cardiovascular/acute-aortic-dissection-type-a-type-b-tevar) — Acute aortic dissection = tear in aortic intima -> blood enters media -> false lumen -> propagation. CLASSIFICATION (Stanford): TYPE A (ascending aorta — 65%) — SURGICAL EMERGENCY (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute cardiorenal syndrome in ICU](https://medvellum.com/s/icu/topics/cardiovascular/cardiorenal-syndrome) — Cardiorenal syndrome (CRS): disorders of heart and kidneys whereby acute/chronic dysfunction of one causes dysfunction of the other. FIVE TYPES — TYPE 1 (acute cardiorenal): acute (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute coronary syndromes (STEMI, NSTEMI, unstable angina)](https://medvellum.com/s/icu/topics/cardiovascular/acute-coronary-syndromes) — Acute coronary syndrome (ACS) encompasses STEMI, NSTEMI, and unstable angina — all caused by acute myocardial ischaemia from coronary plaque rupture/erosion. Classification: STEMI (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute decompensated heart failure and cardiogenic pulmonary oedema](https://medvellum.com/s/icu/topics/cardiovascular/acute-heart-failure) — Acute decompensated heart failure (ADHF) is a life-threatening syndrome of pulmonary and/or systemic congestion from cardiac dysfunction. Presentations: cardiogenic pulmonary oedem (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute decompensated heart failure: NIV, diuretics, inotropes, and MCS in ICU](https://medvellum.com/s/icu/topics/cardiovascular/acute-decompensated-heart-failure-niv-diuretics-inotropes-mcs) — Acute decompensated heart failure (ADHF) = sudden worsening of heart failure → pulmonary oedema and/or systemic congestion. PRECIPITANTS: ACS, arrhythmia (AF), infection, non-adher (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute decompensated pulmonary hypertension in ICU](https://medvellum.com/s/icu/topics/cardiovascular/acute-decompensated-pulmonary-hypertension) — Acute decompensated pulmonary hypertension (PH): acute worsening of PH → right ventricular (RV) failure → cardiogenic shock. PH classification (WHO): Group 1 (PAH — idiopathic, her (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute myocarditis and pericarditis](https://medvellum.com/s/icu/topics/cardiovascular/myocarditis) — Acute myocarditis is inflammation of the myocardium — commonest causes: viral (coxsackie, parvovirus B19, COVID-19), autoimmune, drug-induced (immune checkpoint inhibitors), idiopa (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute pericarditis](https://medvellum.com/s/icu/topics/cardiovascular/acute-pericarditis) — Acute pericarditis is inflammation of the pericardium. Causes: viral (1 — coxsackie, echovirus), idiopathic, post-MI (Dressler syndrome — autoimmune, weeks after MI), post-pericard (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute pulmonary embolism: PESI risk stratification, thrombolysis, and PERT](https://medvellum.com/s/icu/topics/cardiovascular/pulmonary-embolism-pesi-thrombolysis-pert) — Acute pulmonary embolism risk stratification with the PESI and simplified PESI scores, systemic and catheter-directed thrombolysis, and the role of the pulmonary embolism response (updated=2026-08-19) - [Acute severe acute coronary syndromes: STEMI, NSTEMI, and ICU management](https://medvellum.com/s/icu/topics/cardiovascular/acute-coronary-syndromes-stemi-nstemi-icu) — Acute coronary syndromes (ACS) = sudden myocardial ischaemia from coronary plaque rupture/erosion → thrombus → reduced blood flow. THREE TYPES: (1) STEMI (ST-elevation MI — total o (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe valvular emergencies: critical aortic stenosis, acute MR and AR](https://medvellum.com/s/icu/topics/cardiovascular/acute-severe-valvular-emergencies) — Acute valvular emergencies present as cardiogenic shock, pulmonary oedema, or cardiac arrest. CRITICAL AORTIC STENOSIS (severe AS — area <1.0 cm², mean gradient >40): fixed outf (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Advanced haemodynamic monitoring in the ICU](https://medvellum.com/s/icu/topics/cardiovascular/haemodynamic-monitoring) — Haemodynamic monitoring guides resuscitation in critically ill patients. From basic (clinical examination, urine output, arterial line, CVP line) to advanced (invasive cardiac outp (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Arrhythmia, cardiac arrest and post-arrest care](https://medvellum.com/s/icu/topics/cardiovascular/arrhythmia-cardiac-arrest) — Cardiac arrest in the ICU requires immediate Advanced Life Support per ERC 2021 guidelines: high-quality CPR (rate 100-120, depth 5-6cm, full recoil), early defibrillation for shoc (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Cardiac arrhythmia management in the ICU](https://medvellum.com/s/icu/topics/cardiovascular/arrhythmia-management) — Arrhythmias are common in ICU (up to 20% of patients). Types: atrial fibrillation (1 — new-onset AF in ICU is associated with worse outcomes), ventricular tachycardia/fibrillation (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Cardiogenic shock and mechanical circulatory support](https://medvellum.com/s/icu/topics/cardiovascular/cardiogenic-shock-mechanical-support) — Cardiogenic shock is a life-threatening state of end-organ hypoperfusion due to cardiac pump failure, with short-term mortality of 40-50%. The SCAI classification (Stages A-E) guid (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Deep vein thrombosis and pulmonary embolism management in ICU](https://medvellum.com/s/icu/topics/cardiovascular/dvt-pe-management) — ICU management of venous thromboembolism (VTE) — DVT and PE. Severity stratification of PE: (1) MASSIVE (high-risk): sustained hypotension (SBP <90) or shock → thrombolysis or e (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Heart failure guideline-directed medical therapy update: SGLT2, ARNI, and the four pillars](https://medvellum.com/s/icu/topics/cardiovascular/heart-failure-gdmt-four-pillars) — Heart failure with reduced EF (HFrEF): FOUR PILLARS of guideline-directed medical therapy (GDMT). (1) ARNI (sacubitril/valsartan) or ACEi/ARB. (2) Beta-blocker (bisoprolol, carvedi (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Hypertensive emergency and crisis](https://medvellum.com/s/icu/topics/cardiovascular/hypertensive-emergency) — Hypertensive emergency = severe BP elevation (typically >180/120) with ACUTE end-organ damage (encephalopathy, stroke, MI, pulmonary oedema, aortic dissection, AKI, pre-eclampsia/e (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Infective endocarditis in the ICU](https://medvellum.com/s/icu/topics/cardiovascular/endocarditis) — Infective endocarditis (IE) is microbial infection of the endocardial surface (usually heart valves). ICU admission for: septic shock, heart failure from valvular destruction, embo (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Mechanical circulatory support: IABP, Impella, and ECMO for cardiogenic shock](https://medvellum.com/s/icu/topics/cardiovascular/mechanical-circulatory-support) — Mechanical circulatory support (MCS) for refractory cardiogenic shock spans a spectrum from modest afterload reduction to full cardiopulmonary replacement. (1) IABP (intra-aortic b (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Pulmonary hypertension and right heart failure](https://medvellum.com/s/icu/topics/cardiovascular/pulmonary-hypertension) — Pulmonary hypertension (PH) = mean pulmonary artery pressure (mPAP) >20 mmHg (ESC/ERS 2022). Five WHO groups: Group 1 (pulmonary arterial hypertension, PAH — idiopathic, heritable (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Sepsis-induced myocardial dysfunction (septic cardiomyopathy)](https://medvellum.com/s/icu/topics/cardiovascular/sepsis-induced-cardiomyopathy) — Sepsis-induced cardiomyopathy (SICM): reversible, biventricular myocardial dysfunction arising during septic shock and NOT explained by ischaemia, infarction, or pre-existing struc (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Cardiovascular / ACS - [Acute Coronary Syndromes (STEMI/NSTEMI) in the ICU](https://medvellum.com/s/icu/topics/cardiovascular/acute-coronary-syndromes-icu) — Acute coronary syndromes (ACS) span the spectrum of acute myocardial ischaemia — unstable angina (UA), NSTEMI and STEMI — now unified under the Fourth Universal Definition of Myoca (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Cardiovascular / aortic - [Acute Aortic Syndromes — Dissection](https://medvellum.com/s/icu/topics/cardiovascular/acute-aortic-syndromes-dissection) — Acute aortic dissection is classified by the Stanford system: Type A (involving the ascending aorta — a surgical emergency with a high risk of rupture, tamponade, aortic regurgitat (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Cardiovascular / cardiomyopathy - [Cardiomyopathies & Myocarditis](https://medvellum.com/s/icu/topics/cardiovascular/cardiomyopathies-myocarditis) — The four cardiomyopathies are dilated (the commonest — an enlarged LV with a reduced EF, treated with heart-failure therapy), hypertrophic (asymmetric septal LVH with a dynamic LVO (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Cardiovascular / hypertension - [Hypertensive Emergencies](https://medvellum.com/s/icu/topics/cardiovascular/hypertensive-emergencies) — A hypertensive emergency is severe blood pressure elevation with acute target-organ damage (encephalopathy, stroke, intracerebral haemorrhage, ACS, pulmonary oedema, aortic dissect (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Cardiovascular / infection - [Infective Endocarditis](https://medvellum.com/s/icu/topics/cardiovascular/infective-endocarditis) — Infective endocarditis is an infection of the cardiac valves (or the endocardium), diagnosed by the modified Duke criteria: typical positive blood cultures and an echocardiographic (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Cardiovascular / pericardial - [Pericardial Disease — Tamponade, Pericarditis & Constriction](https://medvellum.com/s/icu/topics/cardiovascular/pericardial-disease-tamponade-pericarditis-constriction) — Pericardial disease in the ICU covers three problems. Cardiac tamponade (Beck's triad — hypotension, raised JVP, muffled heart sounds; pulsus paradoxus; echo shows an effusion with (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Cardiovascular / perioperative - [Postoperative Complications in the ICU](https://medvellum.com/s/icu/topics/cardiovascular/postoperative-complications-icu) — Postoperative complications in the ICU cover six areas. Bleeding (assess the drains, the Hb, the coagulation; distinguish the surgical from the medical bleeding; re-explore the sur (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Cardiovascular / valvular - [Valvular Disease in the ICU](https://medvellum.com/s/icu/topics/cardiovascular/valvular-disease-icu) — Severe valvular disease in the ICU has valve-specific haemodynamic implications that determine what the patient can and cannot tolerate. Severe aortic stenosis (a stiff, hypertroph (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Cardiovascular / vascular surgery - [Post-Vascular-Surgery ICU — AAA, Carotid & Peripheral Bypass](https://medvellum.com/s/icu/topics/cardiovascular/post-vascular-surgery-icu) — The post-vascular-surgery ICU patient faces surgery-specific complications. After an open AAA repair: bleeding (the graft anastomosis), the spinal cord ischaemia (the cross-clampin (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Delirium & sleep - [Delirium, Sleep and the Post-Intensive Care Syndrome](https://medvellum.com/s/icu/topics/neurocritical-care/delirium-sleep) — Delirium is the acute brain dysfunction of critical illness, affecting over half of ICU patients, and it is independently associated with the longer stay, the higher mortality, and (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Diagnostics - [CURB-65 and PSI: pneumonia severity scoring and risk stratification](https://medvellum.com/s/icu/topics/diagnostics/curb65-psi-pneumonia-severity-scoring) — Pneumonia severity scores guide site-of-care decisions (outpatient vs inpatient vs ICU) and identify severe CAP. CURB-65 (Confusion, Urea >7, RR≥30, BP<90/60, age≥65): simple, 5 (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICU biomarkers: procalcitonin, lactate, troponin, BNP, and CRP](https://medvellum.com/s/icu/topics/diagnostics/icu-biomarkers) — Biomarkers in ICU: objective measures that guide diagnosis, prognosis, and treatment. KEY biomarkers: (1) PROCALCITONIN (PCT): bacterial infection marker — rises in bacterial sepsi (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Point-of-care ultrasound (POCUS): comprehensive ICU applications](https://medvellum.com/s/icu/topics/diagnostics/pocus-comprehensive-icu-applications) — POCUS is real-time ultrasound performed and interpreted by the treating clinician at the bedside to answer specific clinical questions. In ICU: DIAGNOSTIC (cardiac, lung, abdominal (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### ECMO - [Extracorporeal Membrane Oxygenation (ECMO)](https://medvellum.com/s/icu/topics/respiratory/ecmo-extracorporeal) — Extracorporeal membrane oxygenation (ECMO) is the ultimate respiratory and circulatory support — a pump and an oxygenator outside the body that replace the lung (the venovenous, VV (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-20) ### Electrolytes - [Electrolyte Disorders in Critical Illness — Sodium, Potassium, Calcium, Magnesium and Phosphate](https://medvellum.com/s/icu/topics/renal/electrolytes) — Electrolyte disorders are among the commonest and most immediately dangerous derangements in critical illness, and their correction is governed less by the absolute concentration t (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Endocrine - [Adrenal insufficiency and Addisonian crisis](https://medvellum.com/s/icu/topics/endocrine/adrenal-insufficiency) — Adrenal crisis is a life-threatening state of glucocorticoid deficiency. Presents with hypotension (refractory to catecholamines), abdominal pain, nausea/vomiting, confusion, hypon (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Critical illness-related corticosteroid insufficiency (CIRCI)](https://medvellum.com/s/icu/topics/endocrine/circi-critical-illness-corticosteroid-insufficiency) — Critical illness-related corticosteroid insufficiency (CIRCI): inadequate corticosteroid activity for the severity of illness during critical illness. NOT classic adrenal insuffici (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Hyperosmolar hyperglycaemic state (HHS)](https://medvellum.com/s/icu/topics/endocrine/hyperosmolar-hyperglycaemic-state) — HHS is a hyperglycaemic emergency of predominantly type 2 diabetes defined by marked hypovolaemia, hyperglycaemia and hyperosmolality without significant ketoacidosis. Diagnostic t (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Hypoglycaemia in the ICU](https://medvellum.com/s/icu/topics/endocrine/hypoglycaemia) — Hypoglycaemia is a frequent and serious adverse effect of antidiabetic therapy; inpatients who develop it have longer stays and increased mortality. In ICU trials moderate hypoglyc (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Thyroid emergencies: thyroid storm and myxoedema coma](https://medvellum.com/s/icu/topics/endocrine/thyroid-storm-myxoedema) — Thyroid emergencies are rare but life-threatening. THYROID STORM is the extreme manifestation of thyrotoxicosis: hyperthermia (>40C), tachycardia/atrial fibrillation, heart failure (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Endocrine & metabolic emergencies - [Adrenal Crisis & Corticosteroid Replacement](https://medvellum.com/s/icu/topics/endocrine/endocrine-adrenal-crisis) — The adrenal crisis — the acute the life-threatening the glucocorticoid the deficiency. The causes (the primary — the Addison's, the adrenal the haemorrhage; the secondary — the pit (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Diabetic Ketoacidosis (DKA) & Hyperosmolar Hyperglycaemic State (HHS)](https://medvellum.com/s/icu/topics/endocrine/endocrine-dka-hhs) — DKA and HHS are the two hyperglycaemic emergencies on a spectrum of insulin deficiency. DKA (typically type 1) is the triad of hyperglycaemia, ketonaemia and a high-anion-gap metab (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Endocrine & Metabolic Derangements of Critical Illness](https://medvellum.com/s/icu/topics/endocrine/endocrine-critical-illness-derangements) — The endocrine the metabolic the response to the critical the illness — the the biphasic (the acute the adaptive the stress the response → the chronic the maladaptive the persistent (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Hypoglycaemia](https://medvellum.com/s/icu/topics/endocrine/endocrine-hypoglycaemia) — The hypoglycaemia — the Whipple the triad (the symptoms, the low the glucose, the relief with the glucose); the severe (the altered the consciousness, the needing the assistance). (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Pheochromocytoma Crisis](https://medvellum.com/s/icu/topics/endocrine/endocrine-pheochromocytoma) — The pheochromocytoma the crisis — the catecholamine-secreting the tumour (the adrenal the medulla / the paraganglioma) → the massive the catecholamine the surge → the severe the hy (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [SIADH & Diabetes Insipidus](https://medvellum.com/s/icu/topics/endocrine/endocrine-siadh-di) — The two ends of the ADH (the vasopressin) the dysfunction — the SIADH (the excess the ADH → the water the retention → the euvolaemic the hyponatraemia) and the diabetes the insipid (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Thyroid Storm & Myxoedema Coma](https://medvellum.com/s/icu/topics/endocrine/endocrine-thyroid-storm-myxoedema) — The two decompensated thyroid emergencies at the opposite ends of the spectrum — the thyroid storm (the decompensated hyperthyroidism: the hyperthermia, the tachyarrhythmia, the he (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Environmental - [Acute heat stroke: exertional vs classic, rapid cooling, and 'sepsis from heat'](https://medvellum.com/s/icu/topics/environmental/heat-stroke-comprehensive-icu) — Heat stroke is a life-threatening hyperthermic emergency defined by CORE TEMPERATURE >40C with CENTRAL NERVOUS SYSTEM DYSFUNCTION (confusion, agitation, delirium, seizures, coma (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe hypothermia: rewarming, Osborn waves, and 'warm and dead'](https://medvellum.com/s/icu/topics/environmental/acute-hypothermia-rewarming-osborn-warm-dead) — Hypothermia = core temperature <35°C from excessive heat loss (environmental) or impaired thermogenesis (endocrine, sepsis, drugs). SEVERITY: MILD (32-35°C — tachycardia, tachyp (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Electrical and radiation injury in ICU](https://medvellum.com/s/icu/topics/environmental/electrical-radiation-injury) — Electrical injury: damage from electricity passing through body. Low-voltage (<1000V): cardiac arrhythmias (AC current at 50-60Hz can cause VF). High-voltage (>1000V): deep tiss (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Environmental emergencies - [Accidental Hypothermia](https://medvellum.com/s/icu/topics/environmental/environmental-hypothermia) — The accidental hypothermia — the core below 35 degrees C. The severity (the mild 32 to 35, the moderate 28 to 32, the severe below 28). The clinical (the shivering → the bradycardi (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Drowning & Near-Drowning](https://medvellum.com/s/icu/topics/environmental/environmental-drowning) — The drowning — the respiratory the impairment from the submersion / the immersion in the liquid. The aspiration → the surfactant the dysfunction → the atelectasis, the V/Q the mism (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Electrical & Lightning Injury](https://medvellum.com/s/icu/topics/environmental/environmental-electrical-lightning) — The electrical and lightning injury — the lightning (the brief, the massive DC; the asystole, the respiratory arrest from the medullary paralysis; the flashover; the Lichtenberg fi (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Heat Stroke & Heat Illness](https://medvellum.com/s/icu/topics/environmental/environmental-heat-stroke) — The heat stroke — the core temperature above 40 degrees C with the CNS dysfunction (the confusion, the seizure, the coma). The two types (the classic — the elderly, the drugs; the (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [High-Altitude Illness](https://medvellum.com/s/icu/topics/environmental/environmental-high-altitude) — The high-altitude illness — the hypobaric hypoxia from the ascent. The spectrum: the AMS (the headache + the nausea / the fatigue / the dizziness), the HACE (the ataxia + the alter (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Radiation Injury](https://medvellum.com/s/icu/topics/environmental/environmental-radiation) — The acute radiation syndrome (ARS) is the illness caused by a high dose of whole-body ionising radiation delivered over a short time, producing three dose-dependent subsyndromes: t (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Toxic Gas & Smoke Inhalation](https://medvellum.com/s/icu/topics/environmental/environmental-toxic-gas-smoke) — The toxic gas and smoke inhalation — the combustion products (the CO, the cyanide, the phosgene), the industrial gases (the chlorine, the ammonia), the particulate. The chemical pn (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Equipment & physics - [Equipment & Physics — Gas Laws, Measurement, Ventilators, Circuits and Monitors](https://medvellum.com/s/icu/topics/resuscitation/equipment-physics) — The equipment and the physics of the ICU — the gas laws (the Boyle, the Charles, the Gay-Lussac, the universal gas law, the Dalton, the Henry, the Graham/Fick diffusion, the critic (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Equipment, physics & clinical measurement - [ECG & Electrical Safety](https://medvellum.com/s/icu/topics/equipment-physics/ecg-electrical-safety) — ECG and electrical safety for the ICU First Part: how the 12-lead ECG records cardiac potentials (Einthoven's triangle, limb and precordial leads, electrical axis), the signal path (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Humidification](https://medvellum.com/s/icu/topics/equipment-physics/humidification) — Humidification for the ICU First Part: the nose and turbinates warm, humidify, and filter inspired gas, conditioning it toward 37 degrees C and 100 per cent relative humidity - up (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Radiation Safety](https://medvellum.com/s/icu/topics/equipment-physics/radiation-safety) — Radiation safety for the ICU First Part: the dose units (Gray for absorbed dose, Sievert for equivalent and effective dose), typical doses (chest X-ray ~0.02 mSv, CT chest ~7 mSv w (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Ethics - [Acute severe community-acquired pneumonia: ICU handover and communication](https://medvellum.com/s/icu/topics/ethics/icu-handover-communication) — Clinical handover is the transfer of professional responsibility and accountability for patient care from one clinician/team to another. Poor handover is a leading cause of prevent (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: ICU quality metrics and outcome benchmarking](https://medvellum.com/s/icu/topics/ethics/icu-quality-metrics) — ICU quality metrics measure performance, identify areas for improvement, and benchmark against peers. STRUCTURE metrics as outcome (SMR, ICU/hospital mortality, ventilator-free day (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe community-acquired pneumonia: simulation training and competency assessment](https://medvellum.com/s/icu/topics/ethics/simulation-training-competency) — Simulation training is increasingly used in ICU education — it allows practice of high-stakes, low-frequency events without patient risk, and is now a mandated component of critica (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: tele-ICU and remote monitoring](https://medvellum.com/s/icu/topics/ethics/tele-icu-remote-monitoring) — Tele-ICU (also called eICU, virtual ICU, remote ICU) uses technology to extend intensivist expertise to ICUs without 24/7 on-site intensivist coverage. Model: remote intensivists ( (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Brain death and organ donation in ICU](https://medvellum.com/s/icu/topics/ethics/brain-death-organ-donation) — Brain death: irreversible cessation of all brain function (cerebrum + brainstem). LEGAL definition of death in most countries. Diagnosis: precondition (known cause, exclusion of re (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Disaster/Pandemic Ethics — Resource Allocation & Triage](https://medvellum.com/s/icu/topics/ethics-eol-communication-retrieval/disaster-pandemic-ethics) — Disaster/pandemic ethics — the shift from individual focus (standard ICU) to population focus (maximise good across all) when demand exceeds supply. Mass casualty triage (START — s (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [End-of-life care and palliative care in the ICU](https://medvellum.com/s/icu/topics/ethics/end-of-life-care) — End-of-life care is a core ICU competency. In the ETHICUS study of 37 European ICUs, therapy was withheld before 38% and withdrawn before 33% of ICU deaths or treatment limitations (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Family-centred care and bereavement support in ICU](https://medvellum.com/s/icu/topics/ethics/family-centred-care-bereavement) — Family-centred care in ICU recognises that critical illness affects the entire family, not just the patient. Components: flexible/open visiting hours, family participation in bedsi (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Geriatric critical care: the elderly ICU patient](https://medvellum.com/s/icu/topics/ethics/geriatric-critical-care) — Geriatric critical care: patients aged >65-80 in ICU. Physiological changes of ageing: reduced organ reserve (cardiac, renal, respiratory), altered pharmacokinetics (decreased rena (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [ICU quality improvement: checklists, bundles, and infection prevention](https://medvellum.com/s/icu/topics/ethics/icu-quality-improvement-checklists-bundles) — ICU quality improvement: systematic approaches to reduce errors, prevent complications, improve outcomes. KEY tools: (1) CHECKLISTS — standardised lists ensuring all steps complete (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICU severity scoring systems](https://medvellum.com/s/icu/topics/ethics/icu-scoring-systems) — ICU scoring systems predict mortality, compare quality between units, and stratify patients for research. APACHE II (Acute Physiology And Chronic Health Evaluation): 12 physiologic (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [ICU staff wellbeing and burnout](https://medvellum.com/s/icu/topics/ethics/icu-staff-wellbeing-burnout) — ICU staff burnout affects 25-50% of intensivists and ICU nurses — the highest rate of any hospital specialty. Burnout syndrome (Maslach) comprises three domains: emotional exhausti (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICU triage, resource allocation, and pandemic preparedness](https://medvellum.com/s/icu/topics/ethics/icu-triage-resource-allocation) — ICU triage and resource allocation govern who is admitted, who is discharged, and how scarce resources (beds, ventilators, staff, renal replacement therapy) are distributed when de (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Root cause analysis and quality improvement in the intensive care unit](https://medvellum.com/s/icu/topics/ethics/root-cause-analysis-quality-improvement) — Root cause analysis (RCA) is a structured, BLAME-FREE method for analysing adverse events and near-misses to identify underlying SYSTEM causes and prevent recurrence. Process: (1) (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Ethics / communication - [Conflict, Mediation & Ethics Consultation in the ICU](https://medvellum.com/s/icu/topics/ethics-eol-communication-retrieval/conflict-mediation-ethics-consultation) — Conflict, mediation, and ethics consultation in the ICU: sources (prognostic disagreement, goals of care, futility, family dynamics, intra-team, resource allocation), bioethics fra (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Ethics and quality - [ICU diaries: patient recall, recovery, and post-intensive care syndrome](https://medvellum.com/s/icu/topics/ethics-quality/icu-diaries-patient-recall-recovery) — ICU diaries are written records (by staff and family) of the patient's ICU stay, given to the patient after discharge to help fill memory gaps (delirium amnesia), process the exper (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICU discharge planning and transition of care: failures, criteria, and systems](https://medvellum.com/s/icu/topics/ethics-quality/icu-discharge-planning-transition-of-care) — ICU discharge is a high-risk transition — one of the most dangerous handovers in hospital medicine. Premature discharge → readmission (roughly 6-10% of patients discharged alive fr (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Multiple organ dysfunction syndrome (MODS): pathophysiology, SOFA scoring, and management](https://medvellum.com/s/icu/topics/ethics-quality/multiple-organ-dysfunction-syndrome-mods-sofa) — Multiple organ dysfunction syndrome (MODS) = progressive dysfunction of ≥2 organs in a critically ill patient (the common endpoint of sepsis, trauma, burns, pancreatitis, haemorrha (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Ethics, EOL & communication - [Ethics, End-of-Life, Communication & Aeromedical Retrieval](https://medvellum.com/s/icu/topics/resuscitation/ethics-eol-communication-retrieval) — The professional and the CanMEDS domain of the ICU — the four principles of the bioethics (the autonomy, the beneficence, the non-maleficence, the justice), the capacity and the in (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### GI & nutrition - [Acute pancreatitis: ERAS and early enteral nutrition](https://medvellum.com/s/icu/topics/gi-nutrition/pancreatitis-early-nutrition) — Nutritional management of acute pancreatitis has undergone one of the most complete paradigm reversals in modern critical care: the dogma of prolonged NPO ('resting the pancreas'), (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [GI Bleeding, Pancreatitis, Hepatic Failure and Nutrition](https://medvellum.com/s/icu/topics/renal/gi-nutrition) — The GI and the nutritional disorders in the ICU span the upper GI bleeding (the peptic ulcer, the varices), the acute pancreatitis (the severe, the infected necrosis), the acute li (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-17) ### GI & nutrition / infection - [Severe Diarrhoea & C. difficile — Toxins, Severity & the Vancomycin/Fidaxomicin Era](https://medvellum.com/s/icu/topics/gi-nutrition/severe-diarrhoea-c-difficile) — The C. difficile is the key ICU cause of the severe diarrhoea — the antibiotic-associated (the clindamycin, the fluoroquinolones, the cephalosporins), the spore-forming, the toxin (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### GI & nutrition / metabolic - [Refeeding Syndrome — Hypophosphataemia, Thiamine & the Low-and-Slow Refeed](https://medvellum.com/s/icu/topics/gi-nutrition/refeeding-syndrome) — The refeeding syndrome is the potentially fatal metabolic disturbance that occurs when the food is reintroduced too rapidly after a period of the starvation or the malnutrition. Th (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### GI & nutrition / surgical - [Abdominal Sepsis & Peritonitis — Source Control, SBP & the Polymicrobial](https://medvellum.com/s/icu/topics/gi-nutrition/abdominal-sepsis-peritonitis) — The peritonitis is the inflammation of the peritoneum, usually from the intra-abdominal infection; the abdominal sepsis is the sepsis from the intra-abdominal source. The three typ (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute cholangitis and biliary sepsis](https://medvellum.com/s/icu/topics/gi-nutrition/acute-cholangitis) — Acute cholangitis is bacterial infection of an obstructed biliary tree — a life-threatening emergency. Biliary obstruction raises intraductal pressure, bacteria proliferate in stag (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute lower gastrointestinal bleeding — diverticular, angiodysplasia, colitis and the resuscitate-to-surgery pathway](https://medvellum.com/s/icu/topics/gi-nutrition/lower-gi-bleed) — Acute lower gastrointestinal bleeding (LGIB) is bleeding arising distal to the ligament of Treitz, presenting most often with hematochezia (bright red blood per rectum) and less co (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Pancreatitis in ICU — Atlanta Severity, Goal-Directed Fluids & the Step-Up Approach](https://medvellum.com/s/icu/topics/gi-nutrition/acute-pancreatitis) — Acute pancreatitis is an acute inflammatory process of the pancreas diagnosed by two of three criteria (characteristic epigastric pain radiating to the back, serum lipase or amylas (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Ileus, Bowel Obstruction & Mesenteric Ischaemia — The Acute Abdomen in ICU](https://medvellum.com/s/icu/topics/gi-nutrition/ileus-obstruction-mesenteric-ischaemia) — The ileus, the bowel obstruction, and the mesenteric ischaemia are the three acute bowel disorders in the ICU. The ileus (paralytic) is the failure of the peristalsis (the post-op, (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Intra-abdominal Hypertension & Abdominal Compartment Syndrome — IAP, APP & Decompression](https://medvellum.com/s/icu/topics/gi-nutrition/intra-abdominal-hypertension-compartment) — The intra-abdominal hypertension (IAH) and the abdominal compartment syndrome (ACS) are the raised intra-abdominal pressure (IAP) and its consequences. The WSACS definitions: the I (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Upper GI Bleed — Variceal & Non-Variceal — Resuscitation, Risk Scores & the Endoscopic Bundle](https://medvellum.com/s/icu/topics/gi-nutrition/upper-gi-bleed) — Upper GI bleeding is the haematemesis or melaena from a source proximal to the ligament of Treitz. The first decision is resuscitation (airway protection with early intubation in t (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### GI and nutrition - [Acute liver failure: cerebral oedema, King's College criteria, and transplantation](https://medvellum.com/s/icu/topics/gi-nutrition/acute-liver-failure-cerebral-oedema-kings-college-transplant) — Acute liver failure (ALF) = severe acute liver injury with encephalopathy + coagulopathy (INR ≥1.5) within 26 weeks of symptom onset, in a patient WITHOUT pre-existing liver diseas (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute mesenteric ischaemia: embolic, thrombotic, venous, and non-occlusive](https://medvellum.com/s/icu/topics/gi-nutrition/acute-mesenteric-ischaemia-embolic-thrombotic-nomi-venous) — Acute mesenteric ischaemia = sudden reduction in intestinal blood flow -> bowel necrosis (if untreated). FOUR TYPES: (1) ARTERIAL EMBOLUS (50%) — AF/source -> SMA embolus (sudden, (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe upper GI bleeding: Glasgow-Blatchford, endoscopy, and TIPSS](https://medvellum.com/s/icu/topics/gi-nutrition/acute-upper-gi-bleed-glasgow-blatchford-endoscopy-tipss) — Acute upper GI bleeding (UGIB) is a common ICU emergency. CLASSIFICATION: VARICEAL (portal hypertension — cirrhosis — oesophageal/gastric varices — 20%) vs NON-VARICEAL (peptic ulc (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Severe acute pancreatitis: fluid resuscitation (WATERFALL), necrosis, and PANTER step-up](https://medvellum.com/s/icu/topics/gi-nutrition/severe-pancreatitis-fluid-necrosis-panter) — Severe acute pancreatitis (15-20% of cases) = organ failure >48h (Revised Atlanta classification) — ICU-level care. EARLY PHASE (first week): SYSTEMIC INFLAMMATION (SIRS) + FLUID S (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### GI/Nutrition - [Acute liver failure (hepatic failure)](https://medvellum.com/s/icu/topics/gi-nutrition/acute-liver-failure) — Acute liver failure (ALF) is severe acute liver injury with encephalopathy and coagulopathy (INR >1.5) within 26 weeks, in a patient without pre-existing liver disease. Classifi (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute mesenteric ischaemia](https://medvellum.com/s/icu/topics/gi-nutrition/mesenteric-ischaemia) — Acute mesenteric ischaemia is a life-threatening vascular emergency of the bowel. Four types: (1) SMA embolus (1 — atrial fibrillation, 50%), (2) SMA thrombosis (pre-existing ather (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute pancreatitis complications and management](https://medvellum.com/s/icu/topics/gi-nutrition/pancreatitis-complications) — Severe acute pancreatitis (15-20% of cases) causes local (necrosis, pseudocyst, walled-off necrosis, abscess) and systemic (SIRS → MODS, ARDS, AKI, shock, DIC) complications. Sever (exams=CICM,FFICM,EDIC,FPMRCSI; updated=2026-07-26) - [Acute pancreatitis: interventional management and complications](https://medvellum.com/s/icu/topics/gi-nutrition/pancreatitis-interventional) — Interventional management of severe acute pancreatitis is built on three pillars: (1) the STEP-UP approach for infected necrosis — drain first (percutaneous or endoscopic translumi (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute variceal haemorrhage](https://medvellum.com/s/icu/topics/gi-nutrition/variceal-haemorrhage) — Acute variceal haemorrhage is life-threatening bleeding from oesophageal or gastric varices that form as a consequence of portal hypertension (cirrhosis the commonest cause). Morta (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute-on-chronic liver failure (ACLF)](https://medvellum.com/s/icu/topics/gi-nutrition/acute-on-chronic-liver-failure) — ACLF is acute decompensation of known cirrhosis with organ failure(s), exaggerated systemic inflammation, and high 28-day mortality — distinct from simple decompensation. Precipita (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Hepatic encephalopathy and acute liver failure](https://medvellum.com/s/icu/topics/gi-nutrition/hepatic-encephalopathy) — Hepatic encephalopathy is a reversible spectrum of neuropsychiatric abnormalities in patients with liver dysfunction, classified by the West Haven system (Grade I-IV). Pathophysiol (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Intra-abdominal hypertension and abdominal compartment syndrome](https://medvellum.com/s/icu/topics/gi-nutrition/abdominal-compartment-syndrome) — Intra-abdominal hypertension (IAH) is sustained intra-abdominal pressure >12 mmHg. Abdominal compartment syndrome (ACS) is sustained IAP >20 mmHg with NEW ONSET organ failure (kidn (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Nutrition in the ICU](https://medvellum.com/s/icu/topics/gi-nutrition/nutrition-icu) — Nutrition is a critical component of ICU care. Early enteral nutrition is the default — the landmark trials initiated feeding within 24-36 hours — while early supplemental parenter (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Stress-related mucosal disease (stress ulcer prophylaxis)](https://medvellum.com/s/icu/topics/gi-nutrition/stress-ulcer-prophylaxis) — Stress-related mucosal disease (SRMD) is the rapid, ischaemia-driven breakdown of the gastric mucosal barrier in critical illness: splanchnic hypoperfusion → mucosal ischaemia → ac (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Gastroenterology - [Acute cholecystitis in ICU: severe and complicated presentations](https://medvellum.com/s/icu/topics/gastroenterology/acute-cholecystitis) — Acute cholecystitis: inflammation of gallbladder, usually from cystic duct obstruction by gallstone (90-95%). ICU-relevant severe presentations: (1) GANGRENOUS cholecystitis (wall (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute diverticulitis in ICU: complicated presentations](https://medvellum.com/s/icu/topics/gastroenterology/diverticulitis) — Diverticular disease: diverticula (mucosal herniations through colonic wall) ± inflammation. Acute diverticulitis: inflammation of diverticula. ICU-relevant complicated diverticuli (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute liver failure: King's College criteria, transplant, and liver support](https://medvellum.com/s/icu/topics/gastroenterology/acute-liver-failure-kings-college-transplant) — Acute liver failure (ALF): severe liver injury with encephalopathy + coagulopathy (INR >1.5) within 26 weeks, without pre-existing liver disease. Causes: paracetamol overdose (1 in (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute pancreatitis: Revised Atlanta Classification and severity scoring](https://medvellum.com/s/icu/topics/gastroenterology/pancreatitis-severity-scoring) — Acute pancreatitis severity classification (Revised Atlanta 2012): MILD (no organ failure, no complications — 80%), MODERATE (transient organ failure <48h, local complications — (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Intestinal obstruction in ICU: mechanical and adynamic](https://medvellum.com/s/icu/topics/gastroenterology/intestinal-obstruction) — Intestinal obstruction: blockage of bowel lumen (mechanical) or failure of peristalsis (adynamic/paralytic ileus). Small bowel obstruction (SBO): adhesions (60%), hernias (15%), ma (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Peritonitis in ICU: spontaneous bacterial, secondary, and tertiary](https://medvellum.com/s/icu/topics/gastroenterology/peritonitis) — Peritonitis: inflammation of peritoneum. THREE types in ICU: (1) SPONTANEOUS BACTERIAL PERITONITIS (SBP): infection of ascites WITHOUT obvious intra-abdominal source, in cirrhotic (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### General - [Ogilvie syndrome (acute colonic pseudo-obstruction)](https://medvellum.com/s/icu/topics/gi-nutrition/ogilvie-syndrome) — Ogilvie syndrome (acute colonic pseudo-obstruction, ACPO) is massive colonic dilation WITHOUT mechanical obstruction, attributed to an imbalance in autonomic regulation of colonic (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Toxic megacolon and acute severe colitis](https://medvellum.com/s/icu/topics/gi-nutrition/toxic-megacolon) — Toxic megacolon is a life-threatening complication of severe colonic inflammation characterised by non-obstructive colonic dilatation greater than 6 cm with systemic toxicity (feve (exams=CICM,FFICM,EDIC; updated=2026-08-18) ### Haematology - [Acute sickle cell crisis in the ICU](https://medvellum.com/s/icu/topics/haematology/sickle-cell-crisis) — Sickle cell crisis is caused by polymerisation of sickle haemoglobin (HbS) under hypoxia/dehydration/infection → red blood cells sickle → vaso-occlusion → ischaemia, pain, organ da (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute transfusion reactions: TRALI, TACO, allergic, haemolytic, and septic](https://medvellum.com/s/icu/topics/haematology/acute-transfusion-reactions-trali-taco) — Transfusion reactions range from mild (febrile, allergic) to life-threatening (TRALI, acute haemolytic, anaphylaxis, septic, TACO). CLASSIFICATION by mechanism: (1) IMMUNE: acute h (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Disseminated intravascular coagulation: ISTH score, transfusion, and management](https://medvellum.com/s/icu/topics/haematology/disseminated-intravascular-coagulation-isth-management) — Disseminated intravascular coagulation (DIC) = systemic activation of coagulation -> microvascular thrombosis + consumption of platelets/clotting factors -> BLEEDING + THROMBOSIS s (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Heparin-induced thrombocytopenia (HIT): 4T score, diagnosis, and non-heparin anticoagulation](https://medvellum.com/s/icu/topics/haematology/heparin-induced-thrombocytopenia-hit-4t-score) — Heparin-induced thrombocytopenia (HIT) = immune-mediated (IgG antibody against platelet factor 4 [PF4] + heparin complex) platelet activation → THROMBOCYTOPENIA (paradoxically PROT (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Thrombotic microangiopathy: TTP, HUS, and aHUS in ICU](https://medvellum.com/s/icu/topics/haematology/thrombotic-microangiopathy-ttp-hus) — Thrombotic microangiopathy (TMA): microvascular platelet-rich thrombi → thrombocytopenia + microangiopathic haemolytic anaemia (MAHA) + organ ischaemia. THREE main types: (1) TTP ( (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Haematology & coagulation - [Haematology and Coagulation in the ICU](https://medvellum.com/s/icu/topics/resuscitation/haematology-coagulation) — The haematology and the coagulation in the ICU span the physiology of the haemostasis (the cascade — the intrinsic, the extrinsic, the common; the cell-based model — the initiation (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Haematology / coagulation - [Anticoagulants & Antiplatelets — Heparin, DOACs, Warfarin & Reversal](https://medvellum.com/s/icu/topics/haematology-coagulation/anticoagulants-antiplatelets) — The anticoagulants and the antiplatelets in the ICU: the heparins (the UFH — the antithrombin-mediated IIa or Xa, the APTT monitoring, the protamine reversal 1 mg per 100 U; the LM (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Disseminated Intravascular Coagulation (DIC) — Bleeding AND Thrombosis](https://medvellum.com/s/icu/topics/haematology-coagulation/disseminated-intravascular-coagulation) — DIC is a syndrome of widespread intravascular coagulation causing simultaneous BLEEDING and THROMBOSIS. Tissue factor release drives massive thrombin generation and fibrin depositi (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Thrombocytopenia in the ICU — HIT, TTP/HUS, ITP & Septic](https://medvellum.com/s/icu/topics/haematology-coagulation/thrombocytopenia-icu) — The ICU thrombocytopenia differential: the HIT (heparin-induced — the PF4-heparin antibodies; thrombocytopenia AND thrombosis; 4T score; STOP ALL HEPARIN; switch to argatroban or b (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [VTE Prophylaxis & Treatment — LMWH, IPC, Thrombolysis & the ICU Default](https://medvellum.com/s/icu/topics/haematology-coagulation/vte-prophylaxis-treatment) — ALL ICU patients are at HIGH risk for VTE (immobility, critical illness, central lines, inflammation) and require prophylaxis. Pharmacological (LMWH enoxaparin 40 mg daily = standa (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### Haematology / haemoglobinopathy - [Sickle-Cell Crisis — Vaso-Occlusive, Acute Chest & Exchange Transfusion](https://medvellum.com/s/icu/topics/haematology-coagulation/sickle-cell-crisis) — The sickle-cell crisis in the ICU: the vaso-occlusive crisis (the commonest — pain from the microvascular occlusion by the sickled cells), the acute chest syndrome (the leading cau (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### Haematology / immunotherapy - [CAR-T & Cytokine Release Syndrome — Tocilizumab, ICANS & the ASTCT Grading](https://medvellum.com/s/icu/topics/haematology-coagulation/car-t-cytokine-release-syndrome) — The CAR-T cell therapy (the chimeric antigen receptor T-cell — the CD19 for the B-cell malignancies; the BCMA for the myeloma) causes the cytokine release syndrome (CRS) — the mass (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Haematology / oncology - [Oncologic Emergencies — TLS, Hypercalcaemia, Hyperviscosity, SVC, Cord Compression, Neutropenic Sepsis & Checkpoint Toxicity](https://medvellum.com/s/icu/topics/haematology-coagulation/oncologic-emergencies) — The oncologic emergencies in the ICU: (1) tumour lysis syndrome (TLS — cell lysis to hyperkalaemia, hyperphosphataemia, hypocalcaemia, hyperuricaemia, AKI; Cairo-Bishop classificat (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### Haematology / transfusion - [Anaemia in the ICU — Phlebotomy, Functional Iron & Restrictive Transfusion](https://medvellum.com/s/icu/topics/haematology-coagulation/anaemia-in-icu) — Anaemia is near-universal in ICU and deepens with every day of the stay (mean admission Hb 11.3 g/dL in the ABC cohort). The number 1 MODIFIABLE cause is the phlebotomy (the classi (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Transfusion — Products, Thresholds, TRALI & TACO](https://medvellum.com/s/icu/topics/haematology-coagulation/transfusion-products-thresholds) — The blood products (RBC, FFP, platelets, cryoprecipitate, PCC) and the restrictive transfusion strategy (RBC Hb under 70 for the most — the TRICC, TRISS trials; under 80 for the ca (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Haematology / trauma - [Massive Transfusion & Trauma Coagulopathy — The Lethal Triad, TXA & 1:1:1](https://medvellum.com/s/icu/topics/haematology-coagulation/massive-transfusion-trauma-coagulopathy) — The trauma coagulopathy has the two components: the acute traumatic coagulopathy (ATC — the early, the injury-driven, the protein-C activation, the hyperfibrinolysis) and the dilut (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Hepatobiliary / neurocritical care - [Hepatic Encephalopathy — Ammonia, Lactulose, Rifaximin & the Precipitant](https://medvellum.com/s/icu/topics/neurocritical-care/hepatic-encephalopathy) — The hepatic encephalopathy (HE) is a reversible syndrome of the impaired brain function in the patient with the advanced liver failure and the portosystemic shunting. The pathophys (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### ICU-acquired infection - [ICU-Acquired Infection — VAP, CRBSI and CLABSI](https://medvellum.com/s/icu/topics/resuscitation/icu-acquired-infection) — The ICU-acquired infections are the complications of the critical care itself — the ventilator-associated pneumonia (the VAP), the catheter-related bloodstream infection (the CRBSI (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-19) ### Infection / general - [Fever in the ICU — Infectious or Not? The Workup & the Procalcitonin](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/fever-in-icu) — The fever in the ICU (the temp over 38.3) is the symptom, the not the diagnosis. The first question: the infectious or the non-infectious. The infectious (the nosocomial): the VAP, (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Infection / global health - [Tropical & Global Infections — Malaria, Dengue, TB, Influenza & COVID](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/tropical-global-infections) — The tropical and the global infections in the ICU: the severe malaria (the Plasmodium falciparum — the cerebral, the ARDS, the AKI, the severe anaemia, the hypoglycaemia, the hyper (exams=CICM,FFICM,EDIC; updated=2026-08-18) ### Infection / oncology - [Neutropenic Sepsis — The Golden Hour & the Antipseudomonal Beta-Lactam](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/neutropenic-sepsis) — Neutropenic sepsis is sepsis in the neutropenic patient (neutrophils under 0.5, or under 1.0 and falling) — a medical emergency with mortality up to 20 per cent untreated. Febrile (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Infection / pharmacology - [Aminoglycosides — Gentamicin, Tobramycin, Amikacin & the Three Toxicities](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/aminoglycosides) — The aminoglycosides (gentamicin, tobramycin, amikacin) are bactericidal inhibitors of the 30S ribosomal subunit — concentration-dependent killers with a post-antibiotic sub-MIC eff (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Antifungals — Azoles, Echinocandins & Amphotericin B](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/antifungals) — The antifungals comprise the three classes. The azoles (the fluconazole, the voriconazole, the posaconazole, the isavuconazole) inhibit the 14-alpha-demethylase, the block the ergo (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Antivirals — Aciclovir, Oseltamivir & the Anti-COVID Agents](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/antivirals) — The antivirals in the ICU target the specific viral enzymes. The five ICU-relevant groups: the anti-herpes (the aciclovir — the HSV and the VZV; the DNA polymerase via the thymidin (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Beta-Lactam Antibiotics — Penicillins, Cephalosporins, Carbapenems, Monobactams](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/beta-lactam-antibiotics) — The beta-lactam antibiotics share the beta-lactam ring and the mechanism — the bind the PBPs, the inhibit the cell-wall (the peptidoglycan) synthesis, the bactericidal, the time-de (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Glycopeptides & Lipopeptides — Vancomycin, Teicoplanin, Daptomycin](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/glycopeptides-lipopeptides) — The glycopeptides (the vancomycin, the teicoplanin) and the lipopeptides (the daptomycin) are the Gram-positive cover — the MRSA, the MRSE, the ampicillin-resistant enterococcus, a (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Macrolides, Tetracyclines & Oxazolidinones — Atypicals, MRSA & VRE](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/macrolides-tetracyclines-oxazolidinones) — The macrolides (azithromycin, clarithromycin, erythromycin) bind the 50S ribosome — bacteriostatic, covering the atypicals (Legionella, Mycoplasma, Chlamydia) and the community res (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [MDR Organisms — MRSA, VRE, ESBL, CRE & C. difficile](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/mdr-organisms) — Multidrug-resistant organisms comprise MRSA (altered PBP2a from mecA; resistant to beta-lactams except ceftaroline; treat with vancomycin, linezolid, or daptomycin), VRE (altered D (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Infection / surgical - [Source Control — The Fourth Pillar of Sepsis (Drainage, Debridement, Device)](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/source-control-principles) — Source control is the set of physical measures that eliminate the microbial source, reduce the bacterial inoculum, and restore organ function — a core pillar of sepsis alongside an (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Infectious - [Antimicrobial resistance in ICU: ESBL, CRE, MRSA, VRE management](https://medvellum.com/s/icu/topics/infectious/antimicrobial-resistance-esbl-cre-mrsa-vre) — Antimicrobial resistance (AMR) in ICU: resistant organisms limit antibiotic options, increase mortality. KEY organisms: (1) ESBL (Extended-Spectrum Beta-Lactamase) — E. coli, Klebs (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Tropical infections in ICU: melioidosis, leptospirosis, typhoid](https://medvellum.com/s/icu/topics/infectious/tropical-infections-melioidosis-leptospirosis-typhoid) — Tropical infections causing severe sepsis in ICU. MELIOIDOSIS (Burkholderia pseudomallei): endemic in northern Australia, SE Asia. Soil/water exposure, diabetes, rainy season. Pneu (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Infectious Diseases - [Acute pyelonephritis and urosepsis](https://medvellum.com/s/icu/topics/infectious-diseases/pyelonephritis-urosepsis) — Acute pyelonephritis is upper urinary tract infection (renal parenchyma + renal pelvis). Urosepsis = sepsis from a urinary source — one of the most common causes of sepsis in ICU. (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: Legionella](https://medvellum.com/s/icu/topics/infectious-diseases/legionella-pneumonia) — Legionella pneumophila is a gram-negative facultative intracellular pathogen that causes two syndromes: Pontiac fever (a mild self-limiting flu-like illness, no pneumonia) and Legi (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute severe community-acquired pneumonia: MRSA pneumonia](https://medvellum.com/s/icu/topics/infectious-diseases/mrsa-pneumonia) — MRSA pneumonia in ICU: two epidemiologically and mechanistically distinct syndromes — healthcare-associated (HA-MRSA, nosocomial, multidrug resistant, SCCmec types I–III, lacks PVL (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe community-acquired pneumonia: pneumonia in immunocompromised non-HIV patients](https://medvellum.com/s/icu/topics/infectious-diseases/pneumonia-immunocompromised-non-hiv) — Pneumonia in non-HIV immunocompromised patients (transplant, haematological malignancy, steroids, biologics) has broader pathogen spectrum and higher mortality than CAP in immunoco (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute severe community-acquired pneumonia: post-influenza bacterial pneumonia](https://medvellum.com/s/icu/topics/infectious-diseases/post-influenza-pneumonia) — Post-influenza bacterial pneumonia is a devastating complication — influenza virus damages respiratory epithelium → secondary bacterial invasion. Most common organisms: Staphylococ (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: Pseudomonas pneumonia](https://medvellum.com/s/icu/topics/infectious-diseases/pseudomonas-pneumonia) — Pseudomonas aeruginosa is an aerobic Gram-negative bacillus — an opportunistic, water-borne pathogen that forms biofilms and thrives in moist environments and on indwelling devices (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute severe community-acquired pneumonia: respiratory virus panel](https://medvellum.com/s/icu/topics/infectious-diseases/viral-cap-respiratory-panel) — Respiratory viruses are increasingly recognised as a cause — or co-pathogen — in severe community-acquired pneumonia (15-30% of cases). The common ICU viruses are influenza A/B, RS (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe pneumonia: bacteraemia and metastatic infection](https://medvellum.com/s/icu/topics/infectious-diseases/pneumonia-bacteraemia) — Bacteraemia complicates 10-25% of CAP cases and significantly increases mortality (2-3x). Most common organisms causing bacteraemia: S. pneumoniae (1, 60-70%), S. aureus (including (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Neutropenic sepsis (febrile neutropenia)](https://medvellum.com/s/icu/topics/infectious-diseases/neutropenic-sepsis) — Neutropenic sepsis is a MEDICAL EMERGENCY in patients with neutrophil count <0.5 x10^9/L (or <1.0 with expected fall to nadir) PLUS fever >38.3C single reading OR two read (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Pneumocystis jirovecii pneumonia (PCP) in the ICU](https://medvellum.com/s/icu/topics/infectious-diseases/pneumocystis-pneumonia) — PCP is an opportunistic fungal pneumonia of the immunocompromised host — HIV, transplant, prolonged corticosteroids (>4 weeks), haematological malignancy. Presents with fever, dysp (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Sepsis in the immunocompromised host](https://medvellum.com/s/icu/topics/infectious-diseases/sepsis-immunocompromised) — Immunocompromised patients with sepsis have different pathogens, atypical presentations, and higher mortality than immunocompetent patients. Categories: neutropenic (chemotherapy — (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Severe dengue in the ICU](https://medvellum.com/s/icu/topics/infectious-diseases/severe-dengue) — Severe dengue is a tropical flaviviral infection transmitted by Aedes aegypti mosquitoes, caused by one of four serotypes (DENV 1-4) and defined by plasma leakage, haemorrhage, and (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Severe falciparum malaria in the ICU](https://medvellum.com/s/icu/topics/infectious-diseases/severe-malaria) — Severe falciparum malaria is a medical emergency caused by Plasmodium falciparum, which accounts for most global malaria mortality. WHO criteria for severe malaria: cerebral malari (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Tetanus and botulism in the ICU](https://medvellum.com/s/icu/topics/infectious-diseases/tetanus-botulism) — Tetanus and botulism are rare but life-threatening toxin-mediated diseases caused by neurotoxins of Clostridium tetani and Clostridium botulinum respectively — two organisms that e (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Toxic shock syndrome in the ICU](https://medvellum.com/s/icu/topics/infectious-diseases/toxic-shock-syndrome) — Toxic shock syndrome (TSS) is a life-threatening toxin-mediated illness caused by SUPERANTIGEN-producing bacteria. STAPHYLOCOCCAL TSS: Staphylococcus aureus TSST-1 toxin from a loc (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Infectious diseases - [Acute severe community-acquired pneumonia: comprehensive ICU pathway (sepsis, ARDS, empiric therapy, corticosteroids)](https://medvellum.com/s/icu/topics/infectious-diseases/severe-cap-comprehensive-icu) — Severe community-acquired pneumonia (CAP) is the commonest single cause of sepsis and ARDS in the ICU, with mortality 20-50%. SEVERITY (use to triage ICU): CURB-65 (Confusion, Urea (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Acute severe community-acquired pneumonia: ICU pathway, empiric therapy, and complications](https://medvellum.com/s/icu/topics/infectious-diseases/severe-cap-icu-pathway-empiric-therapy) — Severe community-acquired pneumonia (CAP) requiring ICU is a leading cause of sepsis and ARDS. ICU PATHWAY (hour-1): cultures (blood, sputum) + lactate + antibiotics within 1 HOUR (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Fulminant Clostridioides difficile colitis: surgery, fidaxomicin, and bezlotoxumab](https://medvellum.com/s/icu/topics/infectious-diseases/fulminant-c-difficile-colitis-surgery) — Clostridioides difficile infection (CDI) ranges from mild diarrhoea to FULMINANT colitis (hypotension or shock, ileus, megacolon, perforation — reported in-hospital mortality 34.7- (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### Monitoring / echocardiography - [Critical-Care Echocardiography — FOCUS & FATE](https://medvellum.com/s/icu/topics/cardiovascular/critical-care-echocardiography-focus-fate) — Focused cardiac ultrasound (FOCUS or FATE) is the bedside, clinician-performed transthoracic echocardiogram for the critically ill patient, designed to answer specific resuscitatio (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Monitoring / haemodynamics - [Advanced Haemodynamic Monitoring — PA Catheter, PiCCO & Pulse Contour](https://medvellum.com/s/icu/topics/cardiovascular/advanced-haemodynamics-pa-catheter-picco) — Advanced haemodynamic monitoring measures the cardiac output and related variables beyond the basic arterial and CVP lines. The pulmonary artery catheter (PAC, Swan-Ganz) is the go (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Monitoring / ultrasound - [Point-of-Care Ultrasound (POCUS) — Lung, Abdominal & Vascular](https://medvellum.com/s/icu/topics/cardiovascular/pocus-lung-abdominal-vascular) — Point-of-care ultrasound (POCUS) is the clinician-performed, bedside ultrasound that answers specific clinical questions in real time, across three areas. Lung ultrasound: A-lines (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Shock Echocardiography — RUSH & FALLS Protocols](https://medvellum.com/s/icu/topics/cardiovascular/shock-echocardiography-rush-falls) — The RUSH protocol (Rapid Ultrasound in Shock) is a systematic bedside ultrasound exam for the shocked patient that integrates cardiac, lung, abdominal, and vascular ultrasound to d (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Neurocritical - [Acute spinal cord injury and neurogenic shock in ICU](https://medvellum.com/s/icu/topics/neurocritical/spinal-cord-injury-neurogenic-shock) — Acute spinal cord injury (SCI): traumatic (falls, road trauma, diving) or non-traumatic (abscess, haematoma, tumour, disc). Neurogenic shock: loss of sympathetic tone below lesion (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute stroke in ICU: ischaemic, haemorrhagic, and neurocritical care](https://medvellum.com/s/icu/topics/neurocritical/acute-stroke-icu-management) — Acute stroke ICU management. ISCHAEMIC (80%): thrombolysis (alteplase within 4.5h — NINDS, ECASS III), thrombectomy (within 6-24h for large vessel occlusion — DAWN, DEFUSE-3), anti (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICU-acquired weakness: critical illness polyneuropathy and myopathy](https://medvellum.com/s/icu/topics/neurocritical/icu-acquired-weakness-cip-cim) — ICU-acquired weakness (ICUAW): muscle weakness developing during ICU stay, not attributable to other causes. Affects 25-50% of long-stay ICU patients. Types: (1) CIP (critical illn (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Sepsis-associated encephalopathy and ICU delirium update](https://medvellum.com/s/icu/topics/neurocritical/sepsis-associated-encephalopathy-delirium) — Sepsis-associated encephalopathy (SAE): brain dysfunction from systemic sepsis (NOT direct CNS infection). Presents as DELIRIUM (acute, fluctuating disturbance of attention/cogniti (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Neurocritical Care - [Acute intermittent porphyria (AIP)](https://medvellum.com/s/icu/topics/neurocritical-care/acute-intermittent-porphyria) — AIP is a rare autosomal dominant defect in hepatic haem biosynthesis caused by deficient porphobilinogen deaminase (hydroxymethylbilane synthase, HMBS). Presents with acute neurovi (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe head injury: multimodal monitoring](https://medvellum.com/s/icu/topics/neurocritical-care/multimodal-neuromonitoring) — Multimodal neuromonitoring in severe TBI goes beyond ICP monitoring to assess brain physiology directly. ICP is a PRESSURE — it says nothing about whether the tissue is receiving e (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute stroke: ischaemic and haemorrhagic](https://medvellum.com/s/icu/topics/neurocritical-care/acute-stroke) — Acute stroke is a neurological emergency. Time is brain — 1.9 million neurons lost per minute without reperfusion. Ischaemic stroke: thrombolysis (alteplase 0.9 mg/kg up to 4.5 h, (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Aneurysmal subarachnoid haemorrhage](https://medvellum.com/s/icu/topics/neurocritical-care/subarachnoid-haemorrhage) — Aneurysmal SAH is bleeding from a ruptured cerebral aneurysm into the subarachnoid space. Presents with 'thunderclap' headache (worst ever, maximal at onset), meningismus, nausea/v (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Guillain-Barré syndrome and neuromuscular emergencies](https://medvellum.com/s/icu/topics/neurocritical-care/guillain-barre-syndrome) — Guillain-Barré syndrome (GBS) is an acute, ascending, symmetrical flaccid paralysis with areflexia caused by autoimmune demyelination of peripheral nerves — classically preceded by (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Meningitis and encephalitis in the ICU](https://medvellum.com/s/icu/topics/neurocritical-care/meningitis-encephalitis-icu) — Bacterial meningitis and viral encephalitis are neurological emergencies. Bacterial meningitis: fever, headache, neck stiffness, altered mental status (the classic triad in only 44 (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Myasthenia gravis crisis and neuromuscular respiratory failure](https://medvellum.com/s/icu/topics/neurocritical-care/myasthenia-gravis-crisis) — Myasthenic crisis is respiratory failure from severe weakness of respiratory muscles (diaphragm, intercostals) and bulbar muscles (swallowing, airway protection) in myasthenia grav (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Post-cardiac arrest prognostication](https://medvellum.com/s/icu/topics/neurocritical-care/post-arrest-prognostication) — Prognostication after cardiac arrest predicts neurological outcome to guide continuation or withdrawal of life-sustaining therapy. The key principle: use a MULTIMODAL approach — no (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Raised ICP and traumatic brain injury management](https://medvellum.com/s/icu/topics/neurocritical-care/raised-icp-tbi) — Raised ICP is a life-threatening complication of severe TBI requiring urgent ICP monitoring and stepwise management. The Seattle International Consensus Conference (SICC) algorithm (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Sedation, analgesia and delirium (PADIS)](https://medvellum.com/s/icu/topics/neurocritical-care/sedation-delirium-padis) — The PADIS framework (Pain, Agitation/sedation, Delirium, Immobility, Sleep) guides ICU symptom management. Delirium affects 50-80% of ventilated ICU patients and is an independent (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Targeted temperature management after cardiac arrest](https://medvellum.com/s/icu/topics/neurocritical-care/targeted-temperature-management) — Targeted temperature management (TTM) after cardiac arrest aims to reduce neurological injury from post-cardiac arrest brain ischaemia-reperfusion. HACA and Bernard (NEJM 2002): 32 (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Neurocritical care - [Acute intracranial hypertension: osmotherapy, hyperventilation, and craniectomy](https://medvellum.com/s/icu/topics/neurocritical-care/acute-intracranial-hypertension-osmotherapy-craniectomy) — Acute intracranial hypertension (ICP >22 mmHg) is life-threatening — compromises cerebral perfusion (CPP = MAP − ICP) -> brain ischaemia + herniation. CAUSES: TBI, SAH, intracerebr (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute stroke: ischaemic, haemorrhagic, and SAH — comprehensive ICU management](https://medvellum.com/s/icu/topics/neurocritical-care/acute-stroke-ischaemic-haemorrhagic-sah-comprehensive) — Acute stroke = sudden neurological deficit from cerebral vascular event. THREE TYPES: (1) ISCHAEMIC (about 85% — arterial occlusion — thrombus/embolus). (2) INTRACEREBRAL HAEMORRHA (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Refractory status epilepticus: anaesthetic coma, midazolam, propofol, ketamine](https://medvellum.com/s/icu/topics/neurocritical-care/refractory-status-epilepticus-anaesthetic-coma) — Refractory status epilepticus (RSE) = SE continuing despite first-line (benzodiazepine) AND second-line (anti-seizure medication — levetiracetam, fosphenytoin, valproate) therapy. (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Neurocritical care / infectious - [CNS Infections — Meningitis, Encephalitis & Brain Abscess](https://medvellum.com/s/icu/topics/neurocritical-care/cns-infections) — The CNS infections in the ICU are the bacterial meningitis, the viral encephalitis, and the brain abscess. The bacterial meningitis presents with the fever, the neck stiffness, and (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### Neurocritical care / monitoring - [Brain Tissue Oxygen (PbtO2) & Multimodality Neuromonitoring](https://medvellum.com/s/icu/topics/neurocritical-care/brain-tissue-oxygen-multimodality) — No single neuromonitor is sufficient. The ICP monitoring alone misses the brain tissue hypoxia (the PbtO2 can be low even when the ICP is normal). Multimodality neuromonitoring int (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Continuous EEG & Non-Convulsive Status Epilepticus](https://medvellum.com/s/icu/topics/neurocritical-care/continuous-eeg-non-convulsive-status) — Continuous EEG (cEEG) monitoring in the ICU detects the non-convulsive status epilepticus (NCSE) — a continuous or recurring epileptiform activity on the EEG without the clinical m (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [ICP Monitoring & Waveforms](https://medvellum.com/s/icu/topics/neurocritical-care/icp-monitoring-waveforms) — Intracranial pressure (ICP) monitoring measures the pressure within the skull, guiding the management of raised ICP (target under 22 mmHg in TBI). The cerebral perfusion pressure ( (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Neurocritical care / neuromuscular - [Critical-Illness Polyneuropathy & Myopathy (CIPNM) — ICU-Acquired Weakness](https://medvellum.com/s/icu/topics/neurocritical-care/critical-illness-polyneuromyopathy) — The critical-illness polyneuropathy and myopathy (CIPNM, the ICU-acquired weakness) is an acquired weakness of the critically ill patient, developing after the sepsis, the multi-or (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Motor Neuron Disease & Neuromuscular Weakness in ICU — ALS, NIV & End-of-Life](https://medvellum.com/s/icu/topics/neurocritical-care/motor-neuron-disease) — Motor neuron disease (MND), or the amyotrophic lateral sclerosis (ALS), is a progressive degeneration of the upper and the lower motor neurons, causing a mixed UMN and LMN signs (t (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Myasthenia Gravis & Myasthenic Crisis — NMJ Weakness, PLEX/IVIG & Steroid Exacerbation](https://medvellum.com/s/icu/topics/neurocritical-care/myasthenia-gravis) — Myasthenia gravis (MG) is an autoimmune disease of the post-synaptic acetylcholine receptor at the neuromuscular junction — the acetylcholine receptor antibodies damage the recepto (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Neurocritical care / post-arrest - [Neuro-Prognostication After Cardiac Arrest — The 72-Hour Multimodal Rule](https://medvellum.com/s/icu/topics/neurocritical-care/neuro-prognostication-after-arrest) — The neuro-prognostication after a cardiac arrest is deferred until at least 72 hours after the return of the spontaneous circulation, with the patient normothermic and off the seda (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Neurocritical care / seizures - [Status Epilepticus & Refractory Status Epilepticus](https://medvellum.com/s/icu/topics/neurocritical-care/status-epilepticus) — Status epilepticus (SE) is a continuous seizure lasting more than 5 minutes, or two or more seizures without full recovery between them — a neurological emergency where the longer (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Neurocritical care / vascular - [Acute Ischaemic Stroke — Thrombolysis, Thrombectomy & Hemicraniectomy](https://medvellum.com/s/icu/topics/neurocritical-care/acute-ischaemic-stroke) — Acute ischaemic stroke is managed within strict time windows. The IV thrombolysis (alteplase 0.9 mg/kg, max 90 mg; within 4.5 hours of the onset) is for any measurable stroke witho (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Intracerebral Haemorrhage — ICH Score, BP Control & Surgery](https://medvellum.com/s/icu/topics/neurocritical-care/intracerebral-haemorrhage) — Intracerebral haemorrhage (ICH) is the bleeding into the brain parenchyma, most commonly from hypertension (the deep location — basal ganglia, thalamus, pons, cerebellum) or amyloi (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Nutrition - [ICU nutrition: enteral vs parenteral, timing, protein, and refeeding syndrome](https://medvellum.com/s/icu/topics/nutrition/icu-nutrition-enteral-parenteral-refeeding) — ICU nutrition: critical illness is hypercatabolic, with rapid muscle wasting within days. Early enteral nutrition (within 24-48h) is the standard of care — trials (CALORIES, NUTRIR (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Refeeding syndrome: phosphate, thiamine, and prevention in ICU](https://medvellum.com/s/icu/topics/nutrition/refeeding-syndrome-phosphate-thiamine) — Refeeding syndrome (RFS) = potentially fatal metabolic disturbances that occur when food is reintroduced to STARVED patients (anorexia, alcoholism, prolonged fasting, post-operativ (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Obs/Gynae - [Acute fatty liver of pregnancy (AFLP)](https://medvellum.com/s/icu/topics/obs-gynae/acute-fatty-liver-pregnancy) — AFLP is a rare (about 5 per 100,000 maternities in the UK national cohort), life-threatening liver disorder occurring in the third trimester. Fatty infiltration of hepatocytes → mi (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe community-acquired pneumonia: special populations — pregnancy](https://medvellum.com/s/icu/topics/obs-gynae/cap-in-pregnancy) — CAP in pregnancy has higher morbidity and mortality than non-pregnant CAP — it is the 1 non-obstetric infection requiring ICU admission in pregnancy. Three converging mechanisms tr (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Obstetric emergencies in the ICU](https://medvellum.com/s/icu/topics/obs-gynae/obstetric-emergencies-icu) — Obstetric ICU admissions are rare but high-stakes. Pre-eclampsia/eclampsia: magnesium sulphate for seizure prophylaxis and treatment (4 g IV load, 1-2 g/h; beats diazepam and pheny (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### Obstetric - [Pre-eclampsia with severe features, eclampsia, and HELLP: ICU management](https://medvellum.com/s/icu/topics/obstetric/severe-pre-eclampsia-eclampsia-hellp-icu) — Pre-eclampsia (new hypertension after 20 weeks + proteinuria/end-organ dysfunction) complicates 2-8% of pregnancies (ACOG). SEVERE FEATURES: BP ≥160/110 (ISSHP), thrombocytopenia ( (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Obstetric / pharmacotherapy - [ICU Drugs in Pregnancy & Lactation — Safe, Caution & Contraindicated](https://medvellum.com/s/icu/topics/obstetric/icu-drugs-teratogenicity-lactation) — The ICU drugs in pregnancy: the PLACENTA crosses MOST drugs (the trimester matters — the organogenesis weeks 3 to 10 the highest the teratogenic risk). The SAFE: LMWH (does NOT cro (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Obstetric critical care - [Amniotic Fluid Embolism](https://medvellum.com/s/icu/topics/obstetric/obstetric-amniotic-fluid-embolism) — The amniotic the fluid the embolism (the AFE) — the catastrophic the peripartum the anaphylactoid the reaction to the amniotic the fluid the entering the maternal the circulation. (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Obstetric Haemorrhage & DIC](https://medvellum.com/s/icu/topics/obstetric/obstetric-haemorrhage-dic) — The major obstetric the haemorrhage (the leading the cause of the maternal the mortality the globally). The causes — the the 4 Ts: the Tone (the uterine the atony — the commonest), (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Peripartum Cardiomyopathy](https://medvellum.com/s/icu/topics/obstetric/obstetric-peripartum-cardiomyopathy) — Peripartum cardiomyopathy (PPCM) is idiopathic left ventricular systolic dysfunction (LVEF below 45 percent) presenting in the last month of pregnancy to five months postpartum, in (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Physiology of Pregnancy Relevant to the ICU](https://medvellum.com/s/icu/topics/obstetric/obstetric-pregnancy-physiology) — Pregnancy triggers profound physiological adaptations relevant to the ICU — cardiovascular (cardiac output rises from early pregnancy, heart rate first then stroke volume, plateaui (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Pre-eclampsia, Eclampsia & HELLP Syndrome](https://medvellum.com/s/icu/topics/obstetric/obstetric-pre-eclampsia-hellp) — The hypertensive spectrum of pregnancy spans pre-eclampsia (new hypertension over 140 over 90 plus proteinuria or end-organ dysfunction after 20 weeks), eclampsia (plus seizures), (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Sepsis in Pregnancy](https://medvellum.com/s/icu/topics/obstetric/obstetric-sepsis-pregnancy) — Maternal sepsis is a leading cause of maternal mortality and is under-recognised because the physiological changes of pregnancy mask the signs. The commonest sources are pyelonephr (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Venous Thromboembolism in Pregnancy](https://medvellum.com/s/icu/topics/obstetric/obstetric-vte-pregnancy) — Venous thromboembolism is a leading cause of maternal mortality because pregnancy activates all of Virchow triad — stasis (the gravid uterus compresses the IVC, progesterone venodi (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Obstetrics - [Critical illness in pregnancy: ICU management and obstetric emergencies](https://medvellum.com/s/icu/topics/obstetrics/critical-illness-pregnancy) — Critical illness in pregnancy: physiological adaptations of pregnancy alter drug dosing, ventilation, circulation. Key changes: increased cardiac output (+30-40%), decreased SVR, i (exams=CICM,FFICM,EDIC; updated=2026-08-18) ### Oncology - [Hypercalcaemia of malignancy](https://medvellum.com/s/icu/topics/oncology/hypercalcaemia-of-malignancy) — Hypercalcaemia of malignancy is the most common metabolic complication of malignancy, reported in up to 30% of cancer patients, and is considered an oncologic emergency. Mechanisms (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Malignant spinal cord compression (MSCC)](https://medvellum.com/s/icu/topics/oncology/malignant-spinal-cord-compression) — MSCC is an oncologic emergency — compression of the spinal cord or cauda equina by metastatic tumour (most often a vertebral body metastasis extending into the epidural space, via (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Superior vena cava obstruction (SVCO)](https://medvellum.com/s/icu/topics/oncology/superior-vena-cava-obstruction) — SVCO is obstruction of the superior vena cava — usually from external compression by tumour (lung cancer 1, ~75%; lymphoma; mediastinal masses) or thrombosis (central venous cathet (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Tumour lysis syndrome](https://medvellum.com/s/icu/topics/oncology/tumour-lysis-syndrome) — Tumour lysis syndrome (TLS) is a metabolic oncological emergency from rapid malignant cell lysis releasing intracellular contents: HYPERKALAEMIA (intracellular K+ dumped — most dan (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Oncology & immunocompromised - [The Oncology and Immunocompromised Patient in the ICU](https://medvellum.com/s/icu/topics/resuscitation/onco-immunocompromised) — The immunocompromised and the oncology patient in the ICU demands a broad, the early, and the aggressive approach — the febrile neutropenia (the anti-pseudomonal beta-lactam within (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Oxygen & gas exchange - [Oxygen and Gas Exchange](https://medvellum.com/s/icu/topics/respiratory/oxygen-gas-exchange) — Oxygenation is the carriage of oxygen from the air to the mitochondria, and its failure — the hypoxaemia and the hypoxia — is the commonest reason a patient comes to the intensive (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-19) ### Perioperative critical care - [Perioperative Critical Care](https://medvellum.com/s/icu/topics/cardiovascular/perioperative-critical-care) — Perioperative critical care is the optimisation of the high-risk surgical patient before, during, and after the operation — the preoperative risk assessment (the cardiopulmonary ex (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-17) ### Pharmacology - [Acute respiratory distress syndrome: pharmacological therapies — comprehensive (neuromuscular blockade, inhaled vasodilators, corticosteroids, statins, beta-2 agonists, ECMO pharmacology, fluid management)](https://medvellum.com/s/icu/topics/pharmacology/ards-pharmacology) — No specific pharmacological therapy reduces mortality in ALL ARDS patients. Foundation: lung-protective ventilation (ARMA — the proven mortality-reducing intervention), proning (PR (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: corticosteroid adjunct therapy](https://medvellum.com/s/icu/topics/pharmacology/cap-corticosteroids) — Corticosteroids as adjunct therapy in SEVERE CAP: immunomodulation of excessive inflammation. Evidence: CAPE COD trial (2023, NEJM) — hydrocortisone 200 mg/day IV for 4-7 days (wit (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Antiarrhythmics — Vaughan-Williams Classification](https://medvellum.com/s/icu/topics/pharmacology/antiarrhythmics) — Antiarrhythmics — the Vaughan-Williams classification: Class I (the sodium channel blockers — Ia quinidine/procainamide [prolong AP + QT], Ib lidocaine/phenytoin [shorten AP, ischa (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Antibiotic pharmacokinetics in critical illness](https://medvellum.com/s/icu/topics/pharmacology/antibiotic-pharmacokinetics) — Critical illness alters antibiotic pharmacokinetics (PK), often leading to sub-therapeutic levels and treatment failure. Key changes: (1) Increased volume of distribution (Vd) — ca (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Anticoagulants & Antithrombotics — Pharmacology](https://medvellum.com/s/icu/topics/pharmacology/anticoagulants-antithrombotics) — Anticoagulants and antithrombotics — by mechanism of action. The indirect (heparins via antithrombin III), the direct (DTI, FXa), the vitamin K antagonist (warfarin). The antiplate (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Antihypertensives — ACEi, ARB, CCB, Beta-blockers & Vasodilators](https://medvellum.com/s/icu/topics/pharmacology/antihypertensives) — Antihypertensives — by mechanism: the RAS (ACEi — the bradykinin cough; the ARB); the CCB (the dihydropyridine — the amlodipine; the non-DHP — the verapamil/diltiazem); the beta-bl (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Antimicrobials (by Class) — Mechanisms, Spectrum & Resistance](https://medvellum.com/s/icu/topics/pharmacology/antimicrobials) — Antimicrobials by class and mechanism: cell wall (beta-lactams, glycopeptides — bactericidal), protein synthesis (aminoglycosides 30S, macrolides 50S, tetracyclines 30S, linezolid (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Corticosteroids — Glucocorticoid & Mineralocorticoid Effects](https://medvellum.com/s/icu/topics/pharmacology/corticosteroids) — Corticosteroids in the ICU — the glucocorticoid vs the mineralocorticoid potency, the molecular mechanism, and the disease-specific evidence. MECHANISM: the lipophilic steroid cros (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Diuretics — Loop, Thiazide, Potassium-Sparing & Osmotic](https://medvellum.com/s/icu/topics/pharmacology/diuretics) — Diuretics — by site of action in the nephron. LOOP (furosemide, bumetanide, torasemide — inhibit the Na-K-2Cl [NKCC2] cotransporter in the thick ascending limb — the MOST POTENT cl (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Drug dosing in continuous renal replacement therapy (CRRT)](https://medvellum.com/s/icu/topics/pharmacology/drug-dosing-in-crrt) — Drug dosing in CRRT is COMPLEX — many ICU patients receive CRRT, and incorrect dosing causes treatment failure (underdosing) or toxicity (overdosing). Pharmacokinetic changes in CR (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Electrolyte Therapy — Sodium, Potassium, Magnesium, Calcium & Phosphate](https://medvellum.com/s/icu/topics/pharmacology/electrolyte-therapy) — Electrolyte therapy in the ICU: sodium (hyponatraemia - 3% saline 100 mL boluses for severe symptomatic, correction capped at 10 mmol/L in the first 24 h, osmotic demyelination ris (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [ICU antiarrhythmic drugs — comprehensive (Vaughan-Williams classification)](https://medvellum.com/s/icu/topics/pharmacology/antiarrhythmic-drugs-comprehensive-icu) — Antiarrhythmic drugs classified by the Vaughan-Williams system: Class I (sodium channel blockers — Ia quinidine/procainamide [prolong AP + QT], Ib lidocaine/phenytoin [shorten AP, (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [ICU medication safety: prescribing errors, drug interactions, and prevention](https://medvellum.com/s/icu/topics/pharmacology/icu-medication-safety-prescribing-errors) — ICU medication safety: critically ill patients receive 10-20+ medications simultaneously → high risk across all FIVE stages of the medication-use process (prescribing → transcribin (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [ICU vasopressor and inotrope pharmacology — comprehensive (catecholamines, vasopressin, inodilators)](https://medvellum.com/s/icu/topics/pharmacology/vasopressor-pharmacology) — Vasopressors increase blood pressure (vasoconstriction) and inotropes increase cardiac output (contractility). First-line vasopressor in septic shock: NORADRENALINE — Surviving Sep (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Insulin & Hypoglycaemics — Pharmacology](https://medvellum.com/s/icu/topics/pharmacology/insulin-hypoglycaemics) — ICU insulin and hypoglycaemics. INSULIN TYPES classified by onset/duration: RAPID analogues (lispro, aspart, glulisine — monomeric — onset 10-20 min, duration 3-5 h); SHORT/soluble (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Malignant hyperthermia](https://medvellum.com/s/icu/topics/pharmacology/malignant-hyperthermia) — Malignant hyperthermia is a pharmacogenetic emergency triggered by volatile anaesthetic agents (sevoflurane, isoflurane, desflurane, halothane) or suxamethonium (succinylcholine). (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Medication safety in ICU: prescribing errors, high-alert drugs, prevention, and drug interactions](https://medvellum.com/s/icu/topics/pharmacology/medication-safety-icu) — Medication errors and adverse drug events are common and under-reported in the ICU — a systematic review found medication-error rates of 8.1 to 2344 per 1000 patient-days and adver (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Therapeutic plasma exchange (plasmapheresis) in ICU](https://medvellum.com/s/icu/topics/pharmacology/therapeutic-plasma-exchange) — Therapeutic plasma exchange (TPE) removes pathogenic macromolecules (autoantibodies, immune complexes, cryoglobulins, light chains, lipoproteins) from plasma by centrifugation or m (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Toxicology Antidotes — ICU](https://medvellum.com/s/icu/topics/pharmacology/toxicology-antidotes) — ICU toxicology antidotes organised by toxin: naloxone (opioids), flumazenil (benzodiazepines - caution seizures), N-acetylcysteine (paracetamol - nomogram-driven), digoxin Fab (lif (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Physiology / GI hepatic - [GI & Hepatic Physiology](https://medvellum.com/s/icu/topics/first-part-physiology/gi-hepatic-physiology) — GI and hepatic physiology: the GI (the digestion, the absorption, the motility, the secretion; the gut barrier; the splanchnic circulation). The hepatic (the bilirubin metabolism — (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Physiology / cellular - [Cellular Physiology & Membrane Potentials](https://medvellum.com/s/icu/topics/first-part-physiology/cellular-physiology) — Cellular physiology and membrane potentials: the resting membrane potential (minus 70 mV; the Na/K ATPase — 3 Na out, 2 K in; the K leak the dominant). The Nernst equation (the equ (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Physiology / endocrine - [Endocrine Physiology](https://medvellum.com/s/icu/topics/first-part-physiology/endocrine-physiology) — Endocrine physiology: the hypothalamic-pituitary axes (the HPA — the CRH/ACTH/cortisol; the HPT — the TRH/TSH/T3/T4; the HPG — the GnRH/LH/FSH; the GH; the prolactin). The feedback (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Physiology / haematology immunology - [Blood & Immunology Physiology](https://medvellum.com/s/icu/topics/first-part-physiology/blood-immunology-physiology) — Blood and immunology physiology: the hematopoiesis (the pluripotent stem cell → RBC, WBC, platelets). The red blood cell physiology (2,3-DPG, oxygen dissociation curve, Bohr effect (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Physiology / thermoregulation - [Thermoregulation](https://medvellum.com/s/icu/topics/first-part-physiology/thermoregulation) — Thermoregulation — the hypothalamic set point (37 degrees C). The heat production (the shivering, the metabolism, the thyroxine, the brown fat / non-shivering thermogenesis). The h (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Post-cardiac arrest care - [Post-Cardiac Arrest Care and Targeted Temperature Management](https://medvellum.com/s/icu/topics/cardiovascular/post-arrest-ttm) — The post-cardiac-arrest care is the comprehensive ICU management of the patient who has achieved the return of spontaneous circulation — the prevention of the secondary neurologica (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Procedural - [ICU procedures: central line, arterial line, chest drain, and bronchoscopy](https://medvellum.com/s/icu/topics/procedural/icu-procedures-cvc-arterial-line-chest-drain-bronchoscopy) — Core ICU procedures every intensivist must master: (1) CENTRAL VENOUS CATHETERISATION (CVC) — internal jugular (IJV), subclavian (SCV), femoral — ultrasound-guided (standard of car (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Tracheostomy in ICU: timing, technique, and weaning](https://medvellum.com/s/icu/topics/procedural/tracheostomy-timing-technique-weaning) — Tracheostomy in ICU: for patients expected to need prolonged mechanical ventilation. BENEFITS: patient comfort, easier secretion clearance, allows oral intake, potential for speech (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Quality / safety - [Quality Improvement, Patient Safety & Incident Analysis](https://medvellum.com/s/icu/topics/ethics-eol-communication-retrieval/quality-improvement-patient-safety) — Quality improvement (QI), patient safety, and incident analysis in the ICU. QI methods: the Model for Improvement, the PDSA cycle (plan-do-study-act), Lean (waste removal, value-st (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Rehabilitation - [Acute severe community-acquired pneumonia: ICU sleep disruption and circadian rhythm](https://medvellum.com/s/icu/topics/rehabilitation/icu-sleep-disruption) — Sleep disruption is near-universal in the ICU. Polysomnography of ventilated patients found NO patient with normal sleep: nocturnal sleep efficiency about 38%, stage 1 sleep up to (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe community-acquired pneumonia: long-term outcomes and post-ICU cognitive impairment](https://medvellum.com/s/icu/topics/rehabilitation/post-icu-cognitive-impairment) — Cognitive impairment after critical illness is common and persistent — in ARDS survivors it ranges from 70-100% at hospital discharge to 46-80% at 1 year, with about 20% still impa (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe community-acquired pneumonia: patient and family education](https://medvellum.com/s/icu/topics/rehabilitation/cap-patient-education) — Patient and family education after severe community-acquired pneumonia (CAP) is a core, evidence-based intervention that improves self-care, accelerates recovery, prevents recurren (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: recovery and follow-up](https://medvellum.com/s/icu/topics/rehabilitation/cap-recovery-follow-up) — Recovery from severe CAP requiring ICU admission is prolonged and multifaceted: physical (ICU-acquired weakness, reduced exercise tolerance, deconditioning), cognitive (impaired me (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia:CAP readmission and recurrence prevention](https://medvellum.com/s/icu/topics/rehabilitation/cap-readmission-prevention) — CAP readmission within 30 days affects roughly 1 in 10 to 1 in 4 patients across published cohorts (8-26%) and is a widely tracked hospital quality metric. Causes: incomplete recov (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICU-acquired weakness (critical illness myopathy/polyneuropathy)](https://medvellum.com/s/icu/topics/rehabilitation/icu-acquired-weakness) — ICU-acquired weakness (ICUAW) occurs in about a quarter of patients ventilated 7 days or longer (25.3% in the landmark cohort) and roughly half of critically ill adults overall. Co (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Post-intensive care syndrome (PICS)](https://medvellum.com/s/icu/topics/rehabilitation/post-intensive-care-syndrome) — PICS describes new or worsening impairments in physical, cognitive, or mental health status persisting beyond hospital discharge after critical illness and ICU stay. Each domain is (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Pulmonary rehabilitation and functional recovery after ICU admission](https://medvellum.com/s/icu/topics/rehabilitation/pulmonary-rehabilitation-post-icu) — Pulmonary and functional rehabilitation after critical illness targets the physical deconditioning, respiratory and limb-muscle weakness, and reduced exercise tolerance that persis (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Renal - [Acute kidney injury and renal replacement therapy](https://medvellum.com/s/icu/topics/renal/acute-kidney-injury-rrt) — AKI is an abrupt reduction in kidney function (KDIGO: creatinine increase >=26.5 umol/L in 48h, or >=1.5x baseline, or urine output <0.5 mL/kg/hr for 6h). Classified Stage 1-3 b (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Fluid overload management in ICU: comprehensive](https://medvellum.com/s/icu/topics/renal/fluid-overload-comprehensive-icu) — Fluid overload is one of the most common and most dangerous iatrogenic complications in the ICU. A positive cumulative fluid balance is an independent predictor of mortality, AKI, (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Renal / RRT - [CRRT — Circuit, Prescription, Anticoagulation & Troubleshooting](https://medvellum.com/s/icu/topics/renal/crrt-circuit-anticoagulation) — The CRRT is delivered through a blood circuit — the dual-lumen central access, the blood pump, the pre-dilution (the replacement fluid before the filter), the haemofilter (the holl (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Renal Replacement Therapy Modalities — IHD vs CVVH vs CVVHDF vs SLED](https://medvellum.com/s/icu/topics/renal/rrt-modalities) — The renal replacement therapy (RRT) removes the solutes and the fluid when the kidneys fail. The four modalities — the intermittent haemodialysis (IHD), the continuous veno-venous (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Sustained Low-Efficiency Dialysis (SLED) — The Hybrid Modality](https://medvellum.com/s/icu/topics/renal/sled-dialysis) — Sustained low-efficiency dialysis (SLED) is a hybrid renal replacement therapy that combines features of intermittent haemodialysis (IHD) and continuous renal replacement therapy ( (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Renal / acid-base - [Lactic Acidosis — Type A, B & D, MALA, and Lactate Clearance](https://medvellum.com/s/icu/topics/renal/lactic-acidosis) — The lactic acidosis is the high-anion-gap metabolic acidosis from the accumulation of the lactate. The Cohen and Woods classification: the Type A — the tissue hypoxia or the impair (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Mixed Acid–Base Disorders & the Delta–Delta — The 5-Step Approach](https://medvellum.com/s/icu/topics/renal/mixed-acid-base-disorders) — A mixed acid-base disorder is the presence of two or more primary acid-base disturbances simultaneously. The body NEVER over-compensates — if the compensation is more or less than (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Renal Tubular Acidoses (Types I, II, IV) — The Hyperchloraemic Acidoses](https://medvellum.com/s/icu/topics/renal/renal-tubular-acidoses) — The renal tubular acidoses (RTA) are a group of disorders of the renal acid-base handling that produce a non-anion-gap (the hyperchloraemic) metabolic acidosis from the impaired re (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Renal / fluids - [Fluid Overload & Its Management — The ROSE Concept & De-resuscitation](https://medvellum.com/s/icu/topics/renal/fluid-overload-management) — The fluid overload is common in the ICU and is associated with the worse outcomes (the mortality, the prolonged ventilation, the AKI). It is quantified as the cumulative fluid bala (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Renal and metabolic - [Acute kidney injury: KDIGO staging, prevention, biomarkers, and RRT timing](https://medvellum.com/s/icu/topics/renal-metabolic/acute-kidney-injury-kdigo-prevention-biomarkers-rrt-timing) — Acute kidney injury (AKI) = abrupt reduction in kidney function (hours-days) → accumulation of nitrogenous waste (urea, creatinine) + inability to regulate fluid/electrolyte/acid-b (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe hypercalcaemia and hypocalcaemia: ICU emergencies](https://medvellum.com/s/icu/topics/renal-metabolic/acute-hypercalcaemia-hypocalcaemia) — Calcium disorders are common in ICU. NORMAL serum calcium is 8.4 to 10.4 mg/dL (about 2.1 to 2.6 mmol/L). HYPOCALCAEMIA (total calcium under 8 mg/dL, about 2.12 mmol/L): neuromuscu (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute severe hypernatraemia: causes, correction rate, and diabetes insipidus](https://medvellum.com/s/icu/topics/renal-metabolic/acute-severe-hypernatraemia) — Hypernatraemia (Na >145 mmol/L) = water deficit relative to sodium → brain cell SHRINKAGE (water shifts OUT of brain → decreased brain volume → cerebral haemorrhage from bridging v (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Acute severe hypokalaemia and hypomagnesaemia: ECG, repletion, and refractory causes](https://medvellum.com/s/icu/topics/renal-metabolic/acute-severe-hypokalaemia-hypomagnesaemia) — Hypokalaemia (K <3.5 mmol/L) is common in ICU (diuretics, GI loss, drugs). SEVERE (<2.5) → polymorphic VT risk. ECG changes: T-wave flattening, ST depression, U waves, prolon (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe hyponatraemia: emergency correction, ODS risk, and guidelines](https://medvellum.com/s/icu/topics/renal-metabolic/acute-severe-hyponatraemia) — Hyponatraemia (Na <135 mmol/L) is the commonest electrolyte disorder in hospitalised patients. SEVERE (<120) and ACUTE (<48h) hyponatraemia cause cerebral oedema (seizures (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe metabolic acidosis: approach, anion gap, and lactate](https://medvellum.com/s/icu/topics/renal-metabolic/acute-severe-metabolic-acidosis) — Metabolic acidosis (pH <7.35, HCO3 <22, low/normal PaCO2 compensatory) is ubiquitous in ICU. SYSTEMATIC approach: (1) Is it metabolic acidosis? (2) Calculate ANION GAP: Na − (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe metabolic alkalosis: causes, chloride-responsive vs resistant](https://medvellum.com/s/icu/topics/renal-metabolic/acute-severe-metabolic-alkalosis) — Metabolic alkalosis (pH >7.45, HCO3 >26) is common in ICU (vomiting, NG suction, diuretics). SEVERE (pH >7.55) → serious: hypoventilation (compensatory — but causes hypoxia/hyperca (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Drug-induced nephrotoxicity: mechanism, offending agents, and prevention in ICU](https://medvellum.com/s/icu/topics/renal-metabolic/drug-induced-nephrotoxicity-mechanisms-prevention) — Drug-induced nephrotoxicity accounts for 2-15% of acute renal failure in hospital/ICU series and 28.6% of a Naranjo-adjudicated hospital AKI cohort. Five dominant mechanisms: (1) H (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Phosphate disorders: hypophosphataemia and hyperphosphataemia in ICU](https://medvellum.com/s/icu/topics/renal-metabolic/phosphate-disorders-hypophosphataemia-hyperphosphataemia) — Phosphate (PO4) is essential for ATP (energy), 2,3-DPG (oxygen release from Hb), cell membrane function (phospholipids), bone metabolism, and leukocyte/respiratory muscle function. (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [RRT modality selection: IHD vs CRRT vs SLED — when and why](https://medvellum.com/s/icu/topics/renal-metabolic/rrt-modality-selection-ihd-crrt-sled) — When AKI requires RRT, three modalities are available: (1) INTERMITTENT HAEMODIALYSIS (IHD) — standard, 3-4h sessions, high efficiency, rapid solute removal. (2) CONTINUOUS RENAL R (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Renal/Metabolic - [Acid-base disorders in the ICU](https://medvellum.com/s/icu/topics/renal-metabolic/acid-base-disorders) — Acid-base interpretation is fundamental to ICU practice. Use a disciplined 9-step algorithm: (1) pH (acidaemia/alkalaemia); (2) primary process (PaCO2 vs HCO3); (3) expected compen (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Acute kidney injury: prevention and nephroprotection in ICU](https://medvellum.com/s/icu/topics/renal-metabolic/aki-prevention) — AKI affects more than half of ICU patients and is independently associated with increased mortality, longer ICU stay, and long-term CKD. Prevention is better than treatment (no spe (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute severe hyperkalaemia: emergency management algorithm](https://medvellum.com/s/icu/topics/renal-metabolic/hyperkalaemia-emergency) — Hyperkalaemia (K+ >5.5 mmol/L): common ICU emergency. SEVERE (K+ >6.5 or ECG changes): life-threatening arrhythmia. Causes: AKI/CKD, rhabdomyolysis, tumour lysis, drugs (ACEi (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Drug-induced kidney injury and acute interstitial nephritis](https://medvellum.com/s/icu/topics/renal-metabolic/drug-induced-aki) — Drug-induced kidney injury is a leading cause of AKI in ICU (a common cause of hospital-acquired AKI). Mechanisms map onto the pre-renal / intrinsic / post-renal framework: PRE-REN (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Electrolyte disturbances in the ICU](https://medvellum.com/s/icu/topics/renal-metabolic/electrolyte-disturbances) — Electrolyte disturbances are ubiquitous in ICU. Sodium: hyponatraemia (correct slowly — no more than 8 mmol/L in 24 h to avoid osmotic demyelination) vs hypernatraemia (free water (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Renal replacement therapy in the ICU: CRRT and IHD](https://medvellum.com/s/icu/topics/renal-metabolic/crrt-modalities) — Renal replacement therapy (RRT) in the ICU includes CRRT (continuous, gentler, preferred in haemodynamically unstable patients), IHD (intermittent, faster, preferred in stable pati (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Rhabdomyolysis in the ICU](https://medvellum.com/s/icu/topics/renal-metabolic/rhabdomyolysis) — Rhabdomyolysis is breakdown of skeletal muscle releasing intracellular contents (myoglobin, creatine kinase, potassium, phosphate) into the circulation. Causes: trauma/crush, prolo (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### Respiratory - [Acute pulmonary oedema: cardiogenic vs non-cardiogenic differentiation](https://medvellum.com/s/icu/topics/respiratory/pulmonary-oedema-cardiogenic-vs-noncardiogenic) — Acute pulmonary oedema: fluid in alveolar spaces → bilateral infiltrates + hypoxaemia. TWO types: CARDIOGENIC (hydrostatic — from LV failure, acute MR, mitral stenosis, volume over (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute respiratory distress syndrome: phenotyping and personalised ventilation](https://medvellum.com/s/icu/topics/respiratory/ards-phenotyping) — ARDS is not a single disease — two distinct phenotypes have been identified. Hyperinflammatory ARDS (high inflammatory markers, vasopressor-dependent, lower mortality with higher P (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute respiratory distress syndrome: phenotyping and precision medicine](https://medvellum.com/s/icu/topics/respiratory/ards-phenotypes-precision-medicine) — ARDS is HETEROGENEOUS — not one disease. TWO reproducible subphenotypes identified by latent class analysis in ARDS Network trials and HARP-2 (Calfee 2014, Famous 2017, Calfee 2018 (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute respiratory failure: advanced ventilation modes (APRV and oscillator)](https://medvellum.com/s/icu/topics/respiratory/advanced-ventilation-aprv-hfov) — Advanced ventilation modes for severe/refractory ARDS. APRV (Airway Pressure Release Ventilation): continuous high pressure (P-high) with brief release to low pressure (P-low) — al (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute respiratory failure: classification and approach](https://medvellum.com/s/icu/topics/respiratory/acute-respiratory-failure) — Acute respiratory failure is the inability of the respiratory system to maintain adequate gas exchange. Type 1 (hypoxaemic): PaO2 <60 mmHg (8 kPa) on room air, normal/low PaCO2. (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute respiratory failure: type 1 vs type 2, oxygen therapy, and when to intubate](https://medvellum.com/s/icu/topics/respiratory/respiratory-failure-type1-type2-oxygen-intubation) — Acute respiratory failure = inability of respiratory system to maintain adequate GAS EXCHANGE (oxygenation [O2 in] and/or ventilation [CO2 out]). TWO TYPES: TYPE 1 (HYPOXAEMIC) — P (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe asthma in the ICU (status asthmaticus)](https://medvellum.com/s/icu/topics/respiratory/status-asthmaticus) — Status asthmaticus is severe acute asthma unresponsive to standard bronchodilator therapy. Features of life-threatening asthma: silent chest, exhaustion or drowsiness with hypercap (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Acute severe community-acquired pneumonia: aspiration pneumonia update](https://medvellum.com/s/icu/topics/respiratory/aspiration-pneumonia-update) — Aspiration events in ICU patients can cause two distinct entities: aspiration PNEUMONONITIS (sterile chemical injury from acidic gastric contents — acute onset, sterile, NO routine (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe community-acquired pneumonia: curriculum completion summary](https://medvellum.com/s/icu/topics/ethics/icu-curriculum-summary) — This topic provides a comprehensive summary of the ICU fellowship curriculum built in this session — 160 fellowship-exhaustive topics covering ALL major ICU domains. Topics span: c (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: overview and integration](https://medvellum.com/s/icu/topics/respiratory/cap-integrated-overview) — This topic integrates the entire CAP ICU curriculum — from community presentation through ICU admission to long-term recovery. Provides a high-level framework for understanding how (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: pulmonary complications and ARDS](https://medvellum.com/s/icu/topics/respiratory/cap-ards-complications) — Severe CAP can progress to ARDS (acute respiratory distress syndrome) — direct lung injury from pulmonary infection. Pulmonary ARDS (from pneumonia, aspiration) vs non-pulmonary AR (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute severe community-acquired pneumonia: respiratory failure and ventilator management](https://medvellum.com/s/icu/topics/respiratory/cap-respiratory-failure) — Severe CAP with respiratory failure often needs ICU-level respiratory support. Ventilation strategy: lung-protective ventilation (VT 6 mL/kg PBW, plateau <30). Prone positioning (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Acute severe community-acquired pneumonia: severity prediction and outcome](https://medvellum.com/s/icu/topics/respiratory/cap-severity-prediction) — Severity prediction scores guide admission decisions (ward vs ICU) and predict mortality in CAP. PSI (Pneumonia Severity Index — 20 variables, most accurate): classes I-V. CURB-65 (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: summary and final integration](https://medvellum.com/s/icu/topics/ethics/icu-final-summary) — Final integration topic summarising the 162 fellowship-exhaustive ICU topics built across this multi-session build project. The curriculum covers ALL major ICU domains at fellowshi (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe pneumonia: aspiration risk and prevention in ICU](https://medvellum.com/s/icu/topics/icu-acquired-infection/aspiration-prevention) — Aspiration of oropharyngeal/gastric secretions around the ETT cuff is the primary mechanism for VAP. Prevention strategies target reducing microaspiration and bacterial colonisatio (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe pneumonia: source control and pleural complications](https://medvellum.com/s/icu/topics/respiratory/pneumonia-source-control) — Source control in pneumonia means draining or removing infected material. Pleural complications: (1) Parapneumonic effusion (simple/complicated/empyema). (2) Lung abscess. (3) Bron (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute severe status asthmaticus: ventilation, anaesthesia, and refractory bronchospasm](https://medvellum.com/s/icu/topics/respiratory/acute-status-asthmaticus-ventilation-anaesthesia) — Status asthmaticus = severe asthma unresponsive to standard bronchodilator therapy — life-threatening. CLINICAL: silent chest, exhaustion, altered consciousness, normal or rising P (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [ARDS and lung-protective ventilation](https://medvellum.com/s/icu/topics/respiratory/ards) — ARDS is a syndrome of acute, diffuse, inflammatory lung injury causing increased pulmonary vascular permeability and loss of aerated lung tissue, presenting as refractory hypoxaemi (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ARDS: Berlin definition, lung-protective ventilation, proning, and ECMO](https://medvellum.com/s/icu/topics/respiratory/ards-berlin-ventilation-proning-ecmo) — Acute Respiratory Distress Syndrome (ARDS) = acute diffuse inflammatory lung injury → increased pulmonary vascular permeability → bilateral opacities + refractory hypoxaemia (PaO2/ (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Aspiration pneumonitis and pneumonia](https://medvellum.com/s/icu/topics/respiratory/aspiration-pneumonitis) — Aspiration of gastric contents causes two distinct entities: aspiration PNEUMONITIS (chemical injury from acidic gastric contents — sterile inflammation, no initial infection) vs a (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Atypical pneumonias in ICU: Legionella, Mycoplasma, Chlamydia](https://medvellum.com/s/icu/topics/respiratory/atypical-pneumonias) — Atypical pneumonias: caused by atypical pathogens (Legionella, Mycoplasma, Chlamydia psittaci, Chlamydia pneumoniae, Coxiella burnetii). 'Atypical' because: (1) different clinical (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Extracorporeal CO2 removal (ECCO2R) in ICU](https://medvellum.com/s/icu/topics/respiratory/extracorporeal-co2-removal-ecco2r) — Extracorporeal CO2 removal (ECCO2R): low-flow extracorporeal circuit that removes CO2 WITHOUT substantially improving oxygenation (unlike VV-ECMO). Indications: (1) HYPERCAPNIC res (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Flexible bronchoscopy in the intensive care unit](https://medvellum.com/s/icu/topics/respiratory/bronchoscopy-icu) — Flexible bronchoscopy in the ICU is one of the most frequently performed invasive procedures in critical care and has both DIAGNOSTIC and THERAPEUTIC roles. DIAGNOSTIC: (1) Broncho (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Lung abscess and aspiration pneumonia in ICU](https://medvellum.com/s/icu/topics/respiratory/lung-abscess-aspiration-pneumonia) — Lung abscess: localised collection of pus in lung parenchyma (cavity with air-fluid level). Primary abscess arises from aspiration of oropharyngeal contents (anaerobes, S. milleri) (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Massive haemoptysis in ICU](https://medvellum.com/s/icu/topics/respiratory/massive-haemoptysis) — Massive haemoptysis: commonly defined as a blood loss of 600 mL/24 h or at a rate that poses a threat to life; trials operationalise massive as over 200 mL/24 h with haemodynamic o (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Mechanical Ventilation](https://medvellum.com/s/icu/topics/respiratory/mechanical-ventilation) — Mechanical ventilation applies positive pressure to the airway to support gas exchange and unload the respiratory muscles. Its overriding principle is lung-protective ventilation — (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) - [Mechanical ventilation: advanced modes and waveforms](https://medvellum.com/s/icu/topics/respiratory/advanced-ventilation-modes) — Advanced mechanical ventilation modes offer additional options for difficult-to-ventilate patients. VOLUME CONTROL (VC): guaranteed tidal volume, variable pressure — safe, standard (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Mechanical ventilation: modes, settings, troubleshooting, and weaning](https://medvellum.com/s/icu/topics/respiratory/mechanical-ventilation-modes-settings-troubleshooting-weaning) — Mechanical ventilation provides respiratory support for patients with respiratory failure (hypoxaemic, hypercapnic, or both). MODES: (1) VOLUME-CONTROLLED (VC — set Vt + RR — guara (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Non-invasive ventilation (NIV) in the ICU](https://medvellum.com/s/icu/topics/respiratory/non-invasive-ventilation) — NIV delivers positive pressure ventilation via a face mask (or nasal mask/helmet) without endotracheal intubation. Reduces intubation rates, ventilator-associated pneumonia, and mo (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Oxygen therapy and high-flow nasal cannula in acute respiratory failure](https://medvellum.com/s/icu/topics/respiratory/oxygen-therapy-hfnc) — Oxygen therapy in acute respiratory failure: escalating from low-flow (nasal cannula, simple mask) to HIGH-FLOW NASAL CANNULA (HFNC) to non-invasive ventilation (NIV) to invasive m (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Pleural effusion and empyema in the ICU](https://medvellum.com/s/icu/topics/respiratory/pleural-effusion-empyema) — Pleural effusion is one of the commonest bedside findings in the ICU — present in over half of mechanically ventilated patients, and the cause is rarely the diagnosis on admission. (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Pulmonary contusion and blunt chest trauma](https://medvellum.com/s/icu/topics/respiratory/pulmonary-contusion) — Pulmonary contusion is bruising of the lung parenchyma from blunt chest trauma (motor vehicle crash, fall, crush, blast). Alveolar-capillary disruption → alveolar haemorrhage + int (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Pulmonary Embolism — Massive, Submassive, Thrombolysis & Embolectomy](https://medvellum.com/s/icu/topics/respiratory/pulmonary-embolism-thrombolysis) — Pulmonary embolism is classified by haemodynamic impact. High-risk (massive) PE — shock, hypotension (SBP under 90 mmHg), or arrest — needs immediate systemic thrombolysis (altepla (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Pulmonary vasculitis and diffuse alveolar haemorrhage in ICU](https://medvellum.com/s/icu/topics/respiratory/pulmonary-vasculitis-dah) — Pulmonary vasculitis with diffuse alveolar haemorrhage (DAH): ANCA-associated vasculitides (GPA — Wegener's, MPA, EGPA — Churg-Strauss) cause capillaritis → alveolar bleeding. Pulm (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Refractory hypoxaemia and rescue therapies for severe ARDS](https://medvellum.com/s/icu/topics/respiratory/refractory-hypoxaemia) — Refractory hypoxaemia describes persistent, life-threatening hypoxaemia (PaO2/FiO2 <100) despite optimised conventional lung-protective ventilation — Vt 6 mL/kg PBW with plateau (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Severe asthma: phenotypes, biologics, and ICU management update](https://medvellum.com/s/icu/topics/respiratory/severe-asthma-phenotypes-biologics) — Severe asthma: asthma requiring high-dose inhaled corticosteroids + second controller (or systemic steroids) to maintain control, or remaining uncontrolled despite these. PHENOTYPE (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Severe community-acquired pneumonia (CAP)](https://medvellum.com/s/icu/topics/respiratory/severe-cap) — Severe CAP is one of the most common reasons for ICU admission. Defined by IDSA/ATS minor criteria (3 or more of: RR>=30, PaO2/FiO2<250, multilobar infiltrates, confusion, BUN>= (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Severe viral pneumonia in ICU: influenza, COVID-19, RSV](https://medvellum.com/s/icu/topics/respiratory/severe-viral-pneumonia) — Severe viral pneumonia requiring ICU: INFLUENZA (seasonal A/H1N1/H3N2, pandemic H1N1pdm09, avian H5N1), COVID-19 (SARS-CoV-2), RSV (respiratory syncytial virus), ADENOVIRUS, CMV (i (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Tracheostomy in the ICU](https://medvellum.com/s/icu/topics/respiratory/tracheostomy) — Tracheostomy provides a secure, long-term artificial airway placed through the anterior tracheal wall (typically between the 2nd and 3rd, or 3rd and 4th, tracheal rings) for prolon (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Weaning from mechanical ventilation](https://medvellum.com/s/icu/topics/respiratory/ventilator-weaning) — Weaning from mechanical ventilation is the process of transitioning from full ventilatory support to spontaneous breathing and extubation. The key principle: daily assessment of re (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Respiratory / acid-base - [Systematic Arterial Blood Gas Interpretation](https://medvellum.com/s/icu/topics/respiratory/arterial-blood-gas-interpretation) — A systematic six-step approach to the arterial blood gas: (1) assess oxygenation (PaO2 with FiO2, the P/F ratio, the A-a gradient); (2) read the pH (acidaemia or alkalaemia); (3) i (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Respiratory / airway emergencies - [Acute Massive Haemoptysis — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/respiratory/massive-haemoptysis-comprehensive-icu) — Acute massive haemoptysis is a respiratory emergency in which the patient dies of ASPHYXIATION, not exsanguination — a small volume of blood can rapidly flood the airways, abolish (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Respiratory / gas exchange - [Hypercapnia & Ventilatory (Type-2) Respiratory Failure](https://medvellum.com/s/icu/topics/respiratory/hypercapnia-ventilatory-failure) — Hypercapnia (a raised PaCO2) is ventilatory, or type-2, respiratory failure. Because PaCO2 is proportional to CO2 production divided by alveolar ventilation, hypercapnia arises fro (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Mechanisms of Hypoxaemia — V/Q Mismatch, Shunt, Diffusion, Hypoventilation](https://medvellum.com/s/icu/topics/respiratory/hypoxaemia-mechanisms) — There are five mechanisms of hypoxaemia: low inspired oxygen, hypoventilation (type 2 failure, with a NORMAL alveolar-arterial gradient), ventilation-perfusion mismatch (the common (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Respiratory / monitoring - [Patient–Ventilator Asynchrony](https://medvellum.com/s/icu/topics/respiratory/patient-ventilator-asynchrony) — Patient-ventilator asynchrony is a mismatch between the patient's neural respiratory drive and the ventilator's delivered breaths, detectable on the waveforms. It is common and ass (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Ventilator Waveforms — Scalars, Pressure-Volume & Flow-Volume Loops](https://medvellum.com/s/icu/topics/respiratory/ventilator-waveforms) — Ventilator waveforms are the bedside physics of mechanical ventilation. The scalars (pressure, volume, and flow against time) and the loops (pressure-volume and flow-volume) show a (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Respiratory / oxygen therapy - [High-Flow Nasal Cannula — Mechanisms, Evidence & the ROX Index](https://medvellum.com/s/icu/topics/respiratory/high-flow-nasal-cannula) — High-flow nasal cannula (HFNC) delivers up to 60 L/min of heated, humidified oxygen-enriched gas through large-bore nasal prongs. Its five physiological mechanisms are low-level PE (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Oxygen Therapy Devices — Escalating FiO2](https://medvellum.com/s/icu/topics/respiratory/oxygen-therapy-devices) — Oxygen delivery devices escalate from low-flow variable-performance devices (nasal cannula, simple mask, non-rebreather reservoir mask) whose delivered FiO2 falls as the patient's (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Respiratory / ventilation - [Acute Severe COPD Exacerbation: NIV and Invasive Ventilation — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/respiratory/copd-exacerbation-comprehensive-icu) — An acute severe exacerbation of COPD (AECOPD) causing hypercapnic (type 2) respiratory failure is an ICU emergency built on three pillars: titrated controlled oxygen (SpO2 88-92 pe (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute Severe Ventilation Weaning and Liberation from Mechanical Ventilation — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/respiratory/ventilation-weaning-comprehensive-icu) — Weaning (liberation) from mechanical ventilation is the graded withdrawal of ventilatory support once the precipitating cause of respiratory failure has resolved. Readiness is asse (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Airway Pressure Release Ventilation (APRV) and Advanced Ventilation Modes — Comprehensive ICU Management (APRV, Bilevel, PAV, NAVA, ASV)](https://medvellum.com/s/icu/topics/respiratory/aprv-advanced-modes-comprehensive-icu) — Advanced modes of mechanical ventilation move control away from clinician-set, fixed breaths toward modes that either sustain alveolar recruitment (APRV, bilevel) or proportionalis (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [APRV, Bilevel & Airway-Pressure Release Ventilation](https://medvellum.com/s/icu/topics/respiratory/aprv-bilevel) — Airway pressure release ventilation (APRV) is a pressure-controlled, time-cycled mode that applies two levels of CPAP — a high pressure (P-high) set from the plateau or peak inspir (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Auto-PEEP & Ventilation in Obstruction (Asthma & COPD)](https://medvellum.com/s/icu/topics/respiratory/auto-peep-ventilation-obstruction) — In severe airflow obstruction (asthma, COPD), incomplete expiration traps gas and generates intrinsic (auto-) PEEP and dynamic hyperinflation, which raise the work of breathing, de (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ECMO Complications — Clotting, Haemolysis, Infection, Neurological](https://medvellum.com/s/icu/topics/respiratory/ecmo-complications) — ECMO is a high-risk therapy whose complications fall into four categories. Clotting: bleeding is the commonest serious complication (anticoagulation plus large cannulae; intracrani (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [High-Frequency Oscillatory Ventilation (HFOV)](https://medvellum.com/s/icu/topics/respiratory/hfov) — High-frequency oscillatory ventilation (HFOV) is characterised by the rapid delivery of small tidal volumes together with the application of high mean airway pressures — the open-l (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Inhaled Pulmonary Vasodilators — Nitric Oxide & Inhaled Prostacyclin](https://medvellum.com/s/icu/topics/respiratory/inhaled-pulmonary-vasodilators) — Inhaled pulmonary vasodilators (inhaled nitric oxide and inhaled prostacyclin/epoprostenol) selectively vasodilate the vasculature of well-ventilated alveoli, improving V/Q matchin (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [PEEP — Physiology, Setting & Optimisation](https://medvellum.com/s/icu/topics/respiratory/peep-physiology-setting) — Positive end-expiratory pressure (PEEP) is positive pressure maintained in the airways above atmospheric at end-expiration. It recruits collapsed alveoli, raises functional residua (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Pleural Disease — Effusion, Pneumothorax & Chest Drains](https://medvellum.com/s/icu/topics/respiratory/pleural-disease-effusion-pneumothorax) — Pleural disease in the ICU covers three problems: pleural effusion (a transudate or an exudate, distinguished by Light's criteria, drained if infected or symptomatic), pneumothorax (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Pneumonia — CAP, HAP, VAP & Aspiration](https://medvellum.com/s/icu/topics/respiratory/pneumonia-cap-hap-vap) — Pneumonia is classified by the setting of acquisition: community-acquired (CAP, outside hospital or within 48 hours of admission), hospital-acquired (HAP, after 48 hours in hospita (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Prone Ventilation — Technique & Physiology](https://medvellum.com/s/icu/topics/respiratory/prone-ventilation-technique) — Prone ventilation reduces mortality in severe ARDS (PROSEVA, NEJM 2013) by recruiting the dorsal lung, improving ventilation-perfusion matching, and reducing ventilator-induced lun (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Pulmonary Hypertension & Cor Pulmonale](https://medvellum.com/s/icu/topics/respiratory/pulmonary-hypertension-cor-pulmonale) — Pulmonary hypertension (a mean pulmonary artery pressure above 20 mmHg) is classified into five WHO groups: pulmonary arterial hypertension (group 1), left heart disease (2), lung (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Pulmonary Oedema — Cardiogenic vs ARDS](https://medvellum.com/s/icu/topics/respiratory/pulmonary-oedema-cardiogenic-ards) — Pulmonary oedema is fluid in the alveoli from one of two mechanisms: cardiogenic (hydrostatic — raised pulmonary capillary pressure from left-heart failure) or non-cardiogenic (inc (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Refractory Hypoxaemia Adjuncts — Proning, iNO, Recruitment, NMBA, ECMO](https://medvellum.com/s/icu/topics/respiratory/refractory-hypoxaemia-adjuncts) — Refractory hypoxaemia in severe ARDS is defined as a PaO2/FiO2 under 100 despite optimised lung-protective ventilation (Vt 6 mL/kg PBW, Pplat under 30 cmH2O, optimised PEEP, FiO2 1 (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Severe & Near-Fatal Asthma in the ICU](https://medvellum.com/s/icu/topics/respiratory/severe-asthma-icu) — Severe or near-fatal asthma (status asthmaticus) is graded by the British Thoracic Society as acute severe, life-threatening, or near-fatal. The escalation ladder is oxygen (SpO2 9 (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [VA-ECMO for Cardiogenic Shock & Extracorporeal CPR (ECPR)](https://medvellum.com/s/icu/topics/respiratory/va-ecmo-cardiogenic-shock-ecpr) — Veno-arterial ECMO (VA-ECMO) drains venous blood, oxygenates and decarboxylates it, and returns it to the arterial system — providing both circulatory and respiratory support for r (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Weaning from Mechanical Ventilation — SBT, Protocols & Prolonged Weaning](https://medvellum.com/s/icu/topics/respiratory/weaning-sbt-protocols) — Weaning is the process of discontinuing mechanical ventilation: a daily readiness screen, a spontaneous breathing trial (SBT), and extubation if the trial is tolerated. In the WIND (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Resuscitation - [Acute limb compartment syndrome](https://medvellum.com/s/icu/topics/resuscitation/limb-compartment-syndrome) — Acute limb compartment syndrome is elevated pressure within a fascial compartment causing ischaemia and necrosis of muscles and nerves. Causes: fracture (1 — tibial shaft, forearm) (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute limb ischaemia: embolic vs thrombotic, and emergency management](https://medvellum.com/s/icu/topics/resuscitation/acute-limb-ischaemia-embolic-thrombotic) — Acute limb ischaemia (ALI) = sudden decrease in limb perfusion (<14 days, the trial cutoff) threatening viability. CAUSES: (1) EMBOLIC — commonly cardiac (AF is the leading sour (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute severe community-acquired pneumonia: ICU admission and discharge criteria](https://medvellum.com/s/icu/topics/resuscitation/cap-icu-admission-discharge) — ICU admission decisions in community-acquired pneumonia (CAP) balance the need for organ support against resource allocation. IDSA/ATS severe CAP criteria require 1 major (invasive (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: outpatient to ICU care pathway](https://medvellum.com/s/icu/topics/resuscitation/cap-care-pathway) — The CAP care pathway spans from community presentation through ED triage, ward management, HDU, and ICU. ED: assess severity (CURB-65/PSI), chest X-ray, bloods, blood cultures, ant (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe community-acquired pneumonia: special populations — elderly](https://medvellum.com/s/icu/topics/resuscitation/cap-in-elderly) — CAP in the elderly (over 65 years) presents differently and has worse outcomes than in younger adults. Reported symptom prevalence falls with age even after adjustment for comorbid (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute severe shock: classification, recognition, and management](https://medvellum.com/s/icu/topics/resuscitation/shock-comprehensive-classification-management) — Shock = INADEQUATE TISSUE PERFUSION → cellular hypoxia → anaerobic metabolism → lactate → organ dysfunction → death if untreated. FOUR TYPES: (1) HYPOVOLAEMIC (blood/fluid loss — h (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute upper airway obstruction](https://medvellum.com/s/icu/topics/resuscitation/upper-airway-obstruction) — Acute upper airway obstruction is a life-threatening emergency in which airflow through the nose, mouth, pharynx, or larynx is compromised, leading to hypoxia and death within minu (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Airway management and rapid sequence induction in ICU](https://medvellum.com/s/icu/topics/resuscitation/airway-management-rsi) — Airway management is a core ICU skill and a high-yield Fellowship exam topic. RSI (rapid sequence induction) is indicated for any critically ill patient requiring intubation who is (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Anaphylaxis in the ICU](https://medvellum.com/s/icu/topics/resuscitation/anaphylaxis-icu) — Anaphylaxis is a severe, life-threatening systemic hypersensitivity reaction. Diagnosis: NIAID/FAAN clinical criteria — acute onset after a likely allergen with skin or mucosal inv (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Blood transfusion in the ICU](https://medvellum.com/s/icu/topics/resuscitation/blood-transfusion) — The TRICC trial (1999) established that a RESTRICTIVE transfusion strategy (transfuse at Hb <70 g/L) is at least as effective as and possibly superior to a liberal strategy in m (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Classification and management of shock](https://medvellum.com/s/icu/topics/resuscitation/shock-classification) — Shock is inadequate tissue perfusion resulting in cellular hypoxia and organ dysfunction. Four types: (1) Hypovolaemic (fluid/blood loss — trauma, GI bleed, burns, dehydration). (2 (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Critical care ultrasound (POCUS) in ICU](https://medvellum.com/s/icu/topics/resuscitation/critical-care-ultrasound) — Critical care ultrasound (CCUS), or point-of-care ultrasound (POCUS), is a core ICU skill — a rapid, non-invasive, repeatable, bedside imaging modality performed and interpreted by (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Disseminated intravascular coagulation (DIC)](https://medvellum.com/s/icu/topics/resuscitation/disseminated-intravascular-coagulation) — DIC is a syndrome of widespread intravascular coagulation causing consumption of platelets and clotting factors, microvascular thrombosis, and bleeding. It is NOT a primary disease (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Extracorporeal membrane oxygenation (ECMO)](https://medvellum.com/s/icu/topics/resuscitation/ecmo) — Extracorporeal membrane oxygenation (ECMO) is a modified cardiopulmonary bypass that provides temporary support for refractory cardiac and/or respiratory failure outside the operat (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Fluid therapy and resuscitation fluids in ICU](https://medvellum.com/s/icu/topics/resuscitation/fluid-therapy) — Fluid therapy is the commonest ICU intervention and one of the few that is genuinely a drug — with a pharmacokinetic volume of distribution, a narrow therapeutic window, and a meas (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Hypothermia and environmental emergencies](https://medvellum.com/s/icu/topics/resuscitation/hypothermia-environmental) — Accidental hypothermia is a core temperature below 35C. Swiss staging: HT I (35-32C, conscious, shivering), HT II (32-28C, altered consciousness, no shivering), HT III (28-24C, unc (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Massive transfusion and coagulopathy](https://medvellum.com/s/icu/topics/resuscitation/massive-transfusion-coagulopathy) — Massive transfusion is the replacement of >1 blood volume in 24h (or >50% in 3h, or >4 units RBC in 1h with ongoing bleeding). Goal: achieve haemostasis while preventing the lethal (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Near-drowning and drowning in the ICU](https://medvellum.com/s/icu/topics/resuscitation/near-drowning) — Drowning is defined as 'the process of experiencing respiratory impairment from submersion/immersion in liquid.' 'Near-drowning' (old term) — now ALL submersion injuries are 'drown (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Postoperative complications in the ICU](https://medvellum.com/s/icu/topics/resuscitation/postoperative-complications) — Postoperative ICU patients represent a unique population with specific risks: respiratory complications (atelectasis, pneumonia, pulmonary oedema — 1 cause of postop ICU admission) (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Sepsis and septic shock](https://medvellum.com/s/icu/topics/resuscitation/sepsis-septic-shock) — Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. Septic shock is sepsis with circulatory and cellular/metabolic abnormalities (la (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Sepsis hour-1 bundle: updated Surviving Sepsis Campaign 2021 practice](https://medvellum.com/s/icu/topics/resuscitation/sepsis-hour-1-bundle-ssc-2021) — Surviving Sepsis Campaign (SSC) Hour-1 Bundle (2021): all elements initiated within 1 hour of sepsis recognition. (1) MEASURE lactate (if elevated, remeasure to guide resuscitation (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Septic shock: SSC 2021 integrated — hour-1 bundle, vasopressors, and outcomes](https://medvellum.com/s/icu/topics/resuscitation/septic-shock-ssc-2021-integrated-bundle-vasopressors) — Septic shock = sepsis (infection + organ dysfunction — SOFA ≥2) + VASOPRESSOR requirement (to maintain MAP ≥65) + SERUM LACTATE >2 mmol/L (despite adequate fluid resuscitation). MO (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Septic shock: Surviving Sepsis Campaign 2021](https://medvellum.com/s/icu/topics/resuscitation/septic-shock-ssc) — The Surviving Sepsis Campaign 2021 guidelines (Evans et al.) provide the evidence-based standard of care for sepsis and septic shock and are the single most examined document in cr (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Severe burns management](https://medvellum.com/s/icu/topics/resuscitation/burns-management) — Severe burns (>20% TBSA in adults, >10% in children/elderly) require ICU admission for fluid resuscitation, airway management, and wound care. Burn depth is classified by tissue la (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [The Principles of Resuscitation](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-principles) — Resuscitation is the restoration of oxygen delivery to the tissues in the patient in shock, and it is the first act of intensive care. This topic builds the examiner's framework on (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-20) - [Trauma resuscitation and primary survey (ATLS)](https://medvellum.com/s/icu/topics/resuscitation/trauma-resuscitation) — The ATLS primary survey is a systematic approach to the trauma patient: Airway (with cervical spine control), Breathing (with ventilation), Circulation (with haemorrhage control), (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Vasoplegic and vasopressor-refractory shock: methylene blue, vasopressin, adjuncts](https://medvellum.com/s/icu/topics/resuscitation/vasoplegic-vasopressor-refractory-shock) — Vasoplegic shock = distributive shock refractory to catecholamine vasopressors (noradrenaline) — profound NO-mediated vasodilation. Causes: septic shock (most common), post-cardiac (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Venous thromboembolism prophylaxis in the ICU](https://medvellum.com/s/icu/topics/resuscitation/vte-prophylaxis) — ICU patients are among the highest-risk groups for venous thromboembolism (VTE) — immobility, inflammation, vascular injury (Virchow triad). ACCP-9 and ASH 2018 recommend pharmacol (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Resuscitation & shock - [Anaphylaxis & Anaphylactic Shock](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-anaphylaxis) — Anaphylaxis — the severe, life-threatening systemic hypersensitivity reaction. The rapid onset (the skin/mucosal + the respiratory + the cardiovascular + the GI). The IgE-mediated (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Cardiogenic Shock](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-cardiogenic-shock) — Cardiogenic shock — the pump failure. The vicious cycle (low CO → compensatory vasoconstriction → increased afterload → worse CO). The causes (ACS, decompensated HF, myocarditis, a (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Endpoints of Resuscitation — Lactate, ScvO2, Mottling, Urine, Capillary Refill](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-endpoints) — Resuscitation endpoints span three tiers used together rather than in isolation: macro-haemodynamic endpoints such as MAP and urine output, metabolic endpoints such as lactate clea (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Fluid Responsiveness — Static & Dynamic Indices, Passive Leg Raise, SVV/PPV & Fluid Challenge](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-fluid-responsiveness) — Fluid responsiveness is the prediction of whether a patient will increase stroke volume (or cardiac output) by around 10 per cent in response to a fluid bolus — and only about half (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Fluid Resuscitation — Crystalloid vs Colloid, Balanced vs Saline, SOSD/ROSE & Fluid Overload](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-fluid-resuscitation) — Fluid resuscitation turns on four evidence-based questions. (1) Crystalloid vs colloid — crystalloid is first-line; albumin shows no mortality benefit per SAFE (RR 0.99); hydroxyet (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Hypovolaemic & Haemorrhagic Shock](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-hypovolaemic-shock) — Hypovolaemic and haemorrhagic shock — blood loss reduces preload and cardiac output. The four ATLS classes guide recognition (a classic teaching tool with known limitations), progr (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Massive Transfusion, Blood Products & Tranexamic Acid](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-massive-transfusion-txa) — Massive transfusion in resuscitation turns on two evidence-based questions: the component ratio (PROPPR — 1:1:1 vs 1:1:2 RBC:plasma:platelets) and tranexamic acid (CRASH-2 — mortal (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Neurogenic Shock (Spinal Cord Injury)](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-neurogenic-shock) — Neurogenic shock — the loss of supraspinal sympathetic control after spinal cord injury at or above T6. The vasodilation with venous pooling (the warm, the dry) plus the bradycardi (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Obstructive Shock — Tamponade, Tension Pneumothorax, Massive PE](https://medvellum.com/s/icu/topics/resuscitation/resuscitation-obstructive-shock) — Obstructive shock — the mechanical obstruction to the cardiac output. The three causes (the tamponade, the tension pneumothorax, the massive PE). The common feature: the impaired t (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Sedation & paralysis - [Sedation, Analgesia and Paralysis in the ICU](https://medvellum.com/s/icu/topics/neurocritical-care/sedation-analgesia-paralysis) — Sedation and analgesia are universal in intensive care, and their quality shapes both the immediate course — tolerance of the endotracheal tube and the ventilator, the depth of sed (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Sedation / procedural - [Procedural Sedation in the ICU — Capnography, Agents & the Safety Bundle](https://medvellum.com/s/icu/topics/neurocritical-care/procedural-sedation-icu) — The procedural sedation is a drug-induced depression of the consciousness for a painful or an unpleasant procedure, maintaining the spontaneous ventilation and the airway reflexes (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Seizures & weakness - [Status Epilepticus, Guillain-Barré and Myasthenia Gravis](https://medvellum.com/s/icu/topics/neurocritical-care/status-epilepticus-neuromuscular) — Status epilepticus is the prolonged or the recurrent seizure that becomes self-sustaining — a neurological emergency with a mortality of 10 to 20 per cent. Guillain-Barre and myast (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-18) ### Shock states - [Shock States — Classification, Profiles and Management](https://medvellum.com/s/icu/topics/resuscitation/shock-states) — Shock is the failure of oxygen delivery to meet tissue demand, and its classification into four types — distributive, cardiogenic, hypovolaemic and obstructive — is the framework t (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Statistics & evidence - [Statistics & Evidence — Trial Design, Interpretation, Appraisal and the Landmark ICU Trials](https://medvellum.com/s/icu/topics/resuscitation/statistics-evidence) — The statistics and the evidence for the ICU — the hierarchy of the study design (the case series, the case-control, the cohort, the RCT, the systematic review and the meta-analysis (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-07-26) ### Statistics & evidence-based medicine - [Diagnostic Tests — Sensitivity, Specificity, Predictive Values, Likelihood Ratios & ROC](https://medvellum.com/s/icu/topics/statistics-ebm/diagnostic-tests) — Diagnostic test properties for the ICU First Part: the 2x2 table; sensitivity (SnNout) and specificity (SpPin) as intrinsic test properties; positive and negative predictive values (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Guidelines, Evidence-Based Medicine & Quality-Improvement Methodology](https://medvellum.com/s/icu/topics/statistics-ebm/guidelines-ebm-qi-methodology) — Guidelines, EBM and quality improvement for the ICU First Part: evidence-based medicine as the integration of best evidence, clinical expertise and patient values; the PICO questio (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Survival Analysis & the Kaplan-Meier Curve](https://medvellum.com/s/icu/topics/statistics-ebm/survival-analysis) — Survival analysis for the ICU First Part: time-to-event data and censoring (right-censoring when the event is not observed), the survival function S(t) and its complement the cumul (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Toxicology - [Acute severe alcohol withdrawal and delirium tremens: CIWA-Ar, benzodiazepines, and Wernicke](https://medvellum.com/s/icu/topics/toxicology/alcohol-withdrawal-dts-ciwa-ar-wernicke) — Alcohol withdrawal syndrome (AWS) = symptoms occurring when a chronic alcohol-dependent person STOPS or REDUCES alcohol intake. SPECTRUM: begins 6-24h after last intake (tremor, an (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute severe poisonings: decontamination, antidotes, and enhanced elimination](https://medvellum.com/s/icu/topics/toxicology/acute-severe-poisonings-decontamination-antidotes) — A systematic approach to the poisoned patient: RESUSCITATE (ABC, oxygenation, ventilation, circulation — toxins cause coma, seizures, arrhythmia, hypotension), then DECONTAMINATION (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Alcohol withdrawal and delirium tremens](https://medvellum.com/s/icu/topics/toxicology/alcohol-withdrawal) — Alcohol withdrawal symptoms typically begin 6-24 h after cessation/reduction of alcohol intake. Stages: minor withdrawal (tremor, anxiety, insomnia), seizures (12-48 h after last i (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Anticoagulant & Rodenticide (Warfarin & Superwarfarin) Poisoning](https://medvellum.com/s/icu/topics/toxicology/toxicology-anticoagulant-rodenticide) — The vitamin-K-antagonist anticoagulant poisoning — the therapeutic warfarin (a half-life measured in days) and the superwarfarin (the long-acting anticoagulant rodenticide — the br (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Beta-Blocker & Calcium-Channel-Blocker Overdose](https://medvellum.com/s/icu/topics/toxicology/toxicology-bb-ccb-overdose) — The cardiovascular drug overdose — the beta-blocker (the bradycardia, the AV block, the negative inotropy) and the calcium-channel-blocker (the non-dihydropyridine — the verapamil, (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Beta-blocker and calcium channel blocker overdose](https://medvellum.com/s/icu/topics/toxicology/beta-blocker-ccb-overdose) — Beta-blocker (BB) and calcium channel blocker (CCB) overdose are life-threatening poisonings with high mortality (4 of 15 patients died in an Australian CCB series; verapamil or di (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Carbon Monoxide & Cyanide Poisoning](https://medvellum.com/s/icu/topics/toxicology/toxicology-co-cyanide) — The two tissue-asphyxiant poisonings — the carbon monoxide (binds haemoglobin with roughly 210 times the affinity of oxygen and impairs oxygen DELIVERY) and the cyanide (the metabo (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Carbon monoxide poisoning](https://medvellum.com/s/icu/topics/toxicology/carbon-monoxide-poisoning) — Carbon monoxide (CO) is an odourless, colourless gas produced by incomplete combustion (faulty heaters, house fires, car exhausts, generators, barbecues used indoors). CO binds hae (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Decompression illness and diving emergencies](https://medvellum.com/s/icu/topics/toxicology/decompression-illness) — Decompression illness (DCI) is the umbrella term for the two bubble-mediated injuries of ascent: decompression sickness (DCS — 'the bends', from nitrogen bubble formation in tissue (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Dermatological emergencies in ICU: SJS, TEN, and DRESS](https://medvellum.com/s/icu/topics/toxicology/dermatological-emergencies-sjs-ten-dress) — Severe cutaneous adverse reactions (SCAR) requiring ICU admission. SJS/TEN: immune-mediated epidermal necrolysis, drug-induced in 65-75% of cases (Mycoplasma and other infections a (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Digoxin toxicity in the ICU](https://medvellum.com/s/icu/topics/toxicology/digoxin-toxicity) — Digoxin toxicity is a life-threatening condition from excessive digoxin (cardiac glycoside). Clinical features: (1) CARDIAC: arrhythmias (atrial tachycardia with block, premature v (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Envenomation — Snake, Spider & Marine (ANZ)](https://medvellum.com/s/icu/topics/toxicology/toxicology-envenomation) — The Australian envenomation — the snake (the elapid — the brown, the tiger, the taipan, the death adder; the venom-induced consumption coagulopathy / the VICC, the neurotoxicity, t (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Ethanol Toxicity & Alcohol Withdrawal (Delirium Tremens)](https://medvellum.com/s/icu/topics/toxicology/toxicology-ethanol-withdrawal) — The ethanol — the acute intoxication, the chronic effects (the Wernicke-Korsakoff), and the alcohol withdrawal syndrome. The withdrawal timeline (symptoms beginning within 4 to 6 h (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Heat stroke and hyperthermia in the ICU](https://medvellum.com/s/icu/topics/toxicology/heat-stroke) — Heat stroke is a life-threatening condition defined by core temperature >40C with CNS dysfunction (confusion, seizures, coma). Two types: EXERTIONAL (young, healthy, exercise in he (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Iron, Lead & Heavy Metal Poisoning](https://medvellum.com/s/icu/topics/toxicology/toxicology-iron-heavy-metals) — The heavy-metal poisonings — the iron (the four phases, the deferoxamine), the lead (the abdominal pain, the microcytic anaemia with the basophilic stippling, the peripheral neurop (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Lithium Toxicity](https://medvellum.com/s/icu/topics/toxicology/toxicology-lithium) — The lithium toxicity — the narrow therapeutic index (the therapeutic 0.6 to 1.2 mmol/L), the renal clearance (the handled like the sodium), and the no antidote. The acute overdose (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Methaemoglobinaemia: methylene blue, G6PD deficiency, and co-oximetry](https://medvellum.com/s/icu/topics/toxicology/methaemoglobinaemia-methylene-blue-g6pd) — Methaemoglobinaemia = haemoglobin iron oxidised from Fe2+ (ferrous — oxygen-carrying) to Fe3+ (ferric — CANNOT carry oxygen) → functional anaemia + left-shifted oxyhaemoglobin curv (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [NSAID, Opioid & Sedative-Hypnotic Overdose](https://medvellum.com/s/icu/topics/toxicology/toxicology-nsaid-opioid-sedative-overdose) — The overdose of the NSAIDs, the opioids and the sedative-hypnotics (the benzodiazepines, the barbiturates, the Z-drugs). The opioid toxidrome (the coma, the miosis, the respiratory (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Opioid overdose and toxicity](https://medvellum.com/s/icu/topics/toxicology/drug-overdose-opioid) — Opioid overdose causes respiratory depression (medullary respiratory centre depression), miosis (pinpoint pupils), and decreased level of consciousness — the classic triad. Fentany (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Paracetamol (Acetaminophen) Overdose](https://medvellum.com/s/icu/topics/toxicology/toxicology-paracetamol-overdose) — Paracetamol (acetaminophen) overdose — the commonest overdose and a leading cause of the acute liver failure. The metabolism to the toxic NAPQI via the CYP2E1 and the detoxificatio (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Recreational & Novel Psychoactive Substances](https://medvellum.com/s/icu/topics/toxicology/toxicology-recreational-novel) — The recreational and the novel psychoactive substances (the NPS — the 'legal highs', the 'designer drugs') — the MDMA/ecstasy (the serotonin syndrome, the SIADH/hyponatraemia from (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Salicylate Poisoning](https://medvellum.com/s/icu/topics/toxicology/toxicology-salicylate-poisoning) — Salicylate (aspirin) poisoning — the uncoupling of the oxidative phosphorylation and the direct stimulation of the medullary respiratory centre producing the classic mixed respirat (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Serotonin Syndrome & Neuroleptic Malignant Syndrome](https://medvellum.com/s/icu/topics/toxicology/toxicology-serotonin-nms) — The two drug-induced hyperthermic syndromes of the ICU — the serotonin syndrome (the excess serotonin — the clonus, the hyperreflexia, the rapid onset, the cyproheptadine) and the (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Serotonin syndrome and neuroleptic malignant syndrome](https://medvellum.com/s/icu/topics/toxicology/serotonin-syndrome-nms) — Serotonin syndrome (SS) = excess serotonergic activity from drug combinations (SSRIs + MAOIs, tramadol, linezolid, fentanyl, St John's wort). Triad: mental status change + autonomi (exams=CICM,FFICM,EDIC,FPM; updated=2026-08-18) - [Snake envenomation in the ICU](https://medvellum.com/s/icu/topics/toxicology/snake-envenomation) — Snake envenomation is a significant problem in Australia, Asia, Africa, and South America. Australian snakes: brown snake (most deaths), tiger snake, taipan, death adder, mulga/bla (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Sympathomimetic Poisoning — Cocaine & Amphetamines](https://medvellum.com/s/icu/topics/toxicology/toxicology-sympathomimetics) — The sympathomimetic poisoning — the cocaine (the reuptake blockade of the dopamine, the noradrenaline and the serotonin; the sodium-channel blockade) and the amphetamines/methamphe (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Toxic Alcohols — Methanol & Ethylene Glycol](https://medvellum.com/s/icu/topics/toxicology/toxicology-toxic-alcohols) — The toxic alcohols — the methanol (the formic acid, the retinal toxicity and the blindness) and the ethylene glycol (the glycolate and the oxalate, the acute kidney injury and the (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Toxicology — The General Approach to the Poisoned Patient](https://medvellum.com/s/icu/topics/toxicology/toxicology-general-approach) — The structured approach to the poisoned patient in the ICU — the resuscitation and the ABCDE adapted to the toxin; the clinical assessment and the toxidromes (the sympathomimetic, (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Toxicology and poisoning in the ICU](https://medvellum.com/s/icu/topics/toxicology/toxicology-poisoning) — Toxicology in the ICU requires a systematic approach: ABCDE first, then identify the toxin (history, toxidromes, specific levels), decontamination (activated charcoal within 1h), e (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Tricyclic Antidepressant (TCA) Poisoning](https://medvellum.com/s/icu/topics/toxicology/toxicology-tca-poisoning) — Tricyclic antidepressant (TCA) poisoning — the dangerous overdose defined by cardiotoxicity from fast-sodium-channel blockade (QRS widening, ventricular arrhythmia, hypotension) pl (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Transplant / immunology - [Solid-Organ Transplant Recipient in the ICU — Immunosuppression, Infection & Rejection](https://medvellum.com/s/icu/topics/transplant-donation/solid-organ-transplant-recipient) — The solid-organ transplant recipient in the ICU: the immunosuppression (the calcineurin inhibitors — the tacrolimus, the ciclosporin; the antimetabolites — the mycophenolate; the m (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### Transplant / organ donation - [Donation After Circulatory Death (DCD) & Recipient Logistics](https://medvellum.com/s/icu/topics/transplant-donation/donation-circulatory-death) — Donation after circulatory death (DCD) — the organ donation after the confirmed the circulatory the death (the five-minute the observation the period, the no the auto-resuscitation (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Transplant / pharmacology - [Post-Transplant Immunosuppression Complications — Toxicity, PTLD & Metabolic](https://medvellum.com/s/icu/topics/transplant-donation/post-transplant-immunosuppression) — Post-transplant immunosuppression complications: the immunosuppression principles (induction — ATG/basiliximab/alemtuzumab; maintenance — tacrolimus + mycophenolate ± steroids; res (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### Trauma - [Abdominal Trauma — Blunt, Penetrating, FAST & Non-Operative Management](https://medvellum.com/s/icu/topics/trauma-mass-casualty/abdominal-trauma) — The abdominal trauma: the blunt (the solid organ — the spleen, the liver; the hollow viscus — the small bowel, the colon; the mesenteric) and the penetrating (the stab, the gunshot (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Chest Trauma — Blunt, Penetrating, Flail Chest & Cardiac Tamponade](https://medvellum.com/s/icu/topics/trauma-mass-casualty/chest-trauma) — The chest trauma in the ICU: the blunt (the flail chest — the paradoxical movement; the pulmonary contusion; the cardiac tamponade — the Beck triad; the traumatic aortic injury; th (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Chest trauma and blunt cardiac injury in ICU](https://medvellum.com/s/icu/topics/trauma/chest-trauma-blunt-cardiac-injury) — Chest trauma: blunt (motor vehicle crash, fall, crush — most) or penetrating (stab, gunshot). ICU-relevant: (1) FLAIL CHEST — ≥3 consecutive ribs fractured in ≥2 places → paradoxic (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Damage-Control Resuscitation & Surgery — The Lethal Triad & Planned Re-operation](https://medvellum.com/s/icu/topics/trauma-mass-casualty/damage-control-resuscitation) — Damage-control resuscitation (DCR) and damage-control surgery (DCS) — the integrated approach to the exsanguinating trauma patient. DCR: the permissive hypotension (SBP 80 to 90 un (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Fat Embolism Syndrome — The 12–72h Triad, Gurd's Criteria & Lung-Protective Support](https://medvellum.com/s/icu/topics/trauma-mass-casualty/fat-embolism) — Fat embolism syndrome (FES) is a clinical diagnosis defined by the triad of respiratory insufficiency, neurological dysfunction and a petechial rash arising 12 to 72 hours after a (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Fat embolism syndrome: diagnosis, ventilation, and management in trauma](https://medvellum.com/s/icu/topics/trauma/fat-embolism-syndrome-trauma) — Fat embolism syndrome (FES) is a clinical syndrome (triad: respiratory distress, neurological dysfunction, petechial rash) developing after an asymptomatic period of 24-72 hours af (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Massive haemothorax and emergency thoracotomy (resuscitative)](https://medvellum.com/s/icu/topics/trauma/massive-haemothorax-emergency-thoracotomy) — Massive haemothorax: >1500 mL blood in pleural space OR >200 mL/hr ongoing drainage. Life-threatening: impairs ventilation + circulation (hypovolaemia + tension physiology). Manage (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Pelvic & Extremity Trauma, Compartment Syndrome & Fat Embolism](https://medvellum.com/s/icu/topics/trauma-mass-casualty/pelvic-extremity-trauma) — The pelvic and extremity trauma in the ICU: the pelvic fracture (the Young–Burgess mechanism classification — the anteroposterior compression or open book, the lateral compression (exams=CICM,FFICM,EDIC; updated=2026-08-20) ### Trauma & burns - [Trauma, Burns and Mass-Casualty Resuscitation](https://medvellum.com/s/icu/topics/resuscitation/trauma-mass-casualty) — Trauma is the time-critical failure of mechanical integrity — of the circulation, the airway, the brain and the skeleton — and its management is the parallel, prioritised, damage-c (exams=CICM,FFICM,EDIC,ESICM,Society_CCM; updated=2026-08-20) ### Trauma / neurocritical care - [Spinal Trauma & Spinal Shock — ASIA Scale, CT vs MRI & Steroid Controversy](https://medvellum.com/s/icu/topics/trauma-mass-casualty/spinal-trauma-spinal-shock) — The spinal trauma and the spinal shock in the ICU: the spinal cord injury (the SCI — from the trauma, the fracture, the dislocation) causing the motor and sensory deficit below the (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### antimicrobial-stewardship - [MDR Organisms in ICU — Comprehensive (ESBL, CRE, MRSA, VRE, MDR-XDR TB)](https://medvellum.com/s/icu/topics/antimicrobial-stewardship/mdr-organisms-comprehensive-icu) — Multidrug-resistant (MDR) organisms in the ICU are the single greatest infectious threat to critically ill patients. The standardised definitions (Magiorakos 2012, ECDC and CDC int (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### cardiovascular - [Acute Cardiac Tamponade — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/cardiovascular/cardiac-tamponade-comprehensive-icu) — Acute cardiac tamponade — compression of the heart by pericardial fluid (or clot/gas) preventing diastolic filling → reduced stroke volume → cardiogenic shock → cardiac arrest. Cau (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute decompensated heart failure — comprehensive ICU management (ADHF, cardiogenic shock overlap)](https://medvellum.com/s/icu/topics/cardiovascular/acute-decompensated-heart-failure-comprehensive-icu) — Acute decompensated heart failure (ADHF) = a rapid or gradual onset of signs/symptoms of heart failure warranting urgent therapy and hospital admission — the common final pathway o (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute hypertensive emergency — comprehensive ICU management (hypertensive encephalopathy, ICH, dissection, pre-eclampsia, phaeochromocytoma, cocaine)](https://medvellum.com/s/icu/topics/cardiovascular/hypertensive-emergency-comprehensive-icu) — Hypertensive emergency = a severe elevation of blood pressure (typically SBP >180 and/or DBP >120 mmHg) accompanied by ACUTE ongoing target-organ damage (cerebral — encephalopathy, (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute Infective Endocarditis — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/cardiovascular/infective-endocarditis-comprehensive-icu) — Infective endocarditis (IE) — microbial infection of the endocardial surface (usually heart valves) causing valvular destruction, embolisation, and systemic sepsis. Modified Duke c (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Severe Pulmonary Embolism — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/cardiovascular/acute-severe-pulmonary-embolism-comprehensive-icu) — Acute severe pulmonary embolism (PE) — obstruction of the pulmonary arterial tree by thrombus (usually from deep vein thrombosis) causing increased dead space, right ventricular af (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Acute severe valvular emergencies — critical aortic stenosis, acute mitral regurgitation, acute aortic regurgitation (comprehensive ICU management)](https://medvellum.com/s/icu/topics/cardiovascular/valvular-emergencies-comprehensive-icu) — Acute valvular emergencies present as cardiogenic shock, flash pulmonary oedema, syncope, or cardiac arrest, and they are defined by THREE NATIVE-VALVE LESIONS plus prosthetic valv (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Post-Cardiac Surgery ICU Management — Comprehensive](https://medvellum.com/s/icu/topics/cardiovascular/post-cardiac-surgery-icu-management) — Post-cardiac surgery ICU management — the systematic care of patients after cardiopulmonary bypass (CPB) surgery (CABG, valve replacement/repair, aortic surgery). The early postope (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### diagnostics - [ICU Biomarkers — Comprehensive (Procalcitonin, Lactate, Troponin, BNP/NT-proBNP)](https://medvellum.com/s/icu/topics/diagnostics/icu-biomarkers-comprehensive-procalcitonin-lactate-troponin) — ICU biomarkers — laboratory tests that guide diagnosis, prognosis, and treatment decisions in critically ill patients. Five key biomarkers: (1) PROCALCITONIN (PCT) — prohormone of (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### endocrine - [Acute Severe DKA and HHS — Comprehensive Integrated Diabetic Emergencies](https://medvellum.com/s/icu/topics/endocrine/dka-hhs-comprehensive-icu) — Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) are the two life-threatening hyperglycaemic emergencies of diabetes, lying on a spectrum of insulin deficien (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Thyroid Storm and Myxoedema Coma — Comprehensive Thyroid Emergencies](https://medvellum.com/s/icu/topics/endocrine/thyroid-storm-myxoedema-comprehensive-icu) — Thyroid storm and myxoedema coma are the two life-threatening decompensated thyroid emergencies at opposite ends of the thyroid hormone spectrum. Thyroid storm (thyrotoxic crisis) (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### environmental - [Acute Decompression Illness — Comprehensive ICU Management (Diving Emergencies)](https://medvellum.com/s/icu/topics/environmental/decompression-illness-comprehensive-icu) — Acute decompression illness (DCI) — the umbrella term for the two dysbaric injuries of ascent: decompression sickness (DCS, 'the bends') and arterial gas embolism (AGE). Both arise (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Drowning & Near-Drowning — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/environmental/drowning-comprehensive-icu) — Drowning is the process of experiencing respiratory impairment from submersion or immersion in liquid — a uniform definition adopted by the World Health Organization in 2005 that a (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### equipment-physics - [Humidification and Airway Warming — Comprehensive (HME vs Active Heated Humidifier, Physics of Humidification)](https://medvellum.com/s/icu/topics/equipment-physics/humidification-comprehensive-icu) — Humidification and airway warming for the ICU First Part: WHY the intubated airway needs humidification (the upper airway normally warms, humidifies, and filters inspired gas to co (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [ICU Electrical Safety — Comprehensive (Macroshock, Microshock, Equipotential Bonding)](https://medvellum.com/s/icu/topics/equipment-physics/electrical-safety-comprehensive-icu) — ICU electrical safety — the principles and precautions to prevent electrical injury to patients and staff. Two types of electrical hazard: MACROSHOCK (external current passes throu (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Renal Replacement Therapy Equipment — Comprehensive (Haemofilter Membranes, Diffusion vs Convection, the RRT Circuit and Pressures, Regional Citrate)](https://medvellum.com/s/icu/topics/equipment-physics/rrt-equipment) — Renal replacement therapy equipment for the ICU First Part: the hollow-fibre haemofilter/dialyser and membrane types (biocompatible synthetics — polysulfone, polyethersulfone, poly (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Ultrasound & Imaging Physics — Comprehensive (Piezoelectric Effect, Frequency Versus Penetration, Axial and Lateral Resolution, B-Mode and M-Mode, Doppler, Artefacts, Probe Types)](https://medvellum.com/s/icu/topics/equipment-physics/ultrasound-imaging-physics) — Ultrasound and imaging physics for the ICU First Part: the PIEZOELECTRIC effect (crystals convert electrical energy to mechanical sound energy on transmission and back to electrica (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### first-part-physiology - [Blood and Immunology Physiology — Comprehensive](https://medvellum.com/s/icu/topics/first-part-physiology/blood-immunology-physiology-comprehensive-icu) — Blood and immunology physiology — the integrated biology of haematopoiesis, innate and adaptive immunity, haemostasis (primary + secondary), fibrinolysis, and the natural anticoagu (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Cellular Physiology and Membrane Potentials — Comprehensive](https://medvellum.com/s/icu/topics/first-part-physiology/cellular-physiology-comprehensive-icu) — Cellular physiology — the biophysical basis of membrane potentials, action potentials, and excitation-contraction coupling. RESTING MEMBRANE POTENTIAL (RMP): ~-70 to -90 mV in exci (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Endocrine Physiology in Critical Illness — Comprehensive](https://medvellum.com/s/icu/topics/first-part-physiology/endocrine-physiology-comprehensive-icu) — Endocrine physiology of critical illness — the integrated hormonal response to severe stress. STRESS RESPONSE: critical illness (sepsis, trauma, surgery, burns) activates the hypot (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [GI and Hepatic Physiology — Comprehensive (Splanchnic Circulation, Liver Metabolism, Gut Barrier, Bile)](https://medvellum.com/s/icu/topics/first-part-physiology/gi-hepatic-physiology-comprehensive-icu) — GI and hepatic physiology — the integrated splanchnic circulation, liver metabolic functions, gut barrier, and bile physiology that underpin multiple organ dysfunction in critical (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Thermoregulation — Comprehensive](https://medvellum.com/s/icu/topics/first-part-physiology/thermoregulation-comprehensive-icu) — Thermoregulation — the integrated hypothalamic control of body temperature by balancing heat production against heat loss. HEAT PRODUCTION: basal metabolic rate (70-80% of resting (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### gi-nutrition - [Acute Hepatic Encephalopathy — Comprehensive ICU Management (West Haven, Lactulose, Rifaximin, Cerebral Oedema, Nutrition)](https://medvellum.com/s/icu/topics/gi-nutrition/hepatic-encephalopathy-comprehensive-icu) — Hepatic encephalopathy (HE) = a reversible syndrome of impaired brain function in patients with advanced liver disease and/or portosystemic shunting, produced by gut-derived neurot (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Liver Failure — Comprehensive (King's College Criteria, Cerebral Oedema, NAC, Transplantation)](https://medvellum.com/s/icu/topics/gi-nutrition/acute-liver-failure-comprehensive-icu) — Acute liver failure (ALF) = severe acute liver injury with ENCEPHALOPATHY + COAGULOPATHY (INR >=1.5) within 26 weeks of symptom onset, in a patient WITHOUT pre-existing liver disea (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Acute Severe Intra-Abdominal Infection and Peritonitis — Comprehensive (Primary/SBP, Secondary, Tertiary, Source Control, Open Abdomen)](https://medvellum.com/s/icu/topics/gi-nutrition/peritonitis-comprehensive-icu) — Acute severe intra-abdominal infection with peritonitis is one of the most common and most lethal surgical emergencies managed in the ICU, with mortality ranging from <5% for un (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Severe Pancreatitis — Comprehensive (Revised Atlanta, WATERFALL, PANTER, Step-Up, Infected Necrosis)](https://medvellum.com/s/icu/topics/gi-nutrition/acute-severe-pancreatitis-comprehensive-icu) — Acute severe pancreatitis (approximately 15-20% of all acute pancreatitis) is defined by the Revised Atlanta Classification (2012) as acute pancreatitis with PERSISTENT organ failu (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute-on-Chronic Liver Failure (ACLF) — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/gi-nutrition/acute-on-chronic-liver-failure-comprehensive-icu) — Acute-on-chronic liver failure (ACLF) — acute decompensation of cirrhosis complicated by organ failure(s) and high short-term mortality. In the CANONIC study, 28-day mortality was (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Stress Ulcer Prophylaxis (SUP) — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/gi-nutrition/stress-ulcer-prophylaxis-comprehensive-icu) — Stress ulcer prophylaxis (SUP) — prevention of stress-related mucosal disease (SRMD) in critically ill patients. Upper GI mucosal lesions are found in 75-100% of ICU patients on en (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### haematology-coagulation - [Acute Severe Anticoagulation Reversal — Warfarin, DOACs & Heparin in the ICU](https://medvellum.com/s/icu/topics/haematology-coagulation/anticoagulation-reversal-comprehensive-icu) — Acute severe anticoagulation reversal covers the three drug classes the intensivist must reverse in life-threatening bleeding or before emergency surgery — WARFARIN (vitamin K anta (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Catastrophic Antiphospholipid Syndrome (CAPS) in the ICU](https://medvellum.com/s/icu/topics/haematology-coagulation/catastrophic-antiphospholipid-syndrome-caps-icu) — Catastrophic antiphospholipid syndrome (CAPS) — the most severe form of antiphospholipid syndrome (APS) characterised by rapid multi-organ thrombosis (small-vessel) affecting three (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Hemophagocytic Lymphohistiocytosis (HLH) and Macrophage Activation Syndrome (MAS) in the ICU](https://medvellum.com/s/icu/topics/haematology-coagulation/hemophagocytic-lymphohistiocytosis-hlh-mas-icu) — Hemophagocytic lymphohistiocytosis (HLH) and macrophage activation syndrome (MAS) — a life-threatening hyperinflammatory syndrome caused by uncontrolled T-cell and macrophage activ (exams=CICM,FFICM,EDIC; updated=2026-08-19) ### icu-acquired-infection - [ICU-Acquired Infection Prevention Bundle — Comprehensive](https://medvellum.com/s/icu/topics/icu-acquired-infection/icu-infection-prevention-bundle-comprehensive) — ICU-acquired infection prevention — the comprehensive evidence-based bundle approach to preventing the 5 major nosocomial infections in ICU: VAP (ventilator-associated pneumonia), (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### infectious-diseases - [Acute Neutropenic Sepsis — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/infectious-diseases/neutropenic-sepsis-comprehensive-icu) — Neutropenic sepsis (febrile neutropenia) — a life-threatening infection in patients with neutrophil count <0.5 × 10^9/L (or <1.0 with expected decline) AND fever (>38.3C sing (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [Pneumonia in the Immunocompromised Patient — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/infectious-diseases/pneumonia-immunocompromised-comprehensive-icu) — Pneumonia in the immunocompromised host (non-HIV) — haematological malignancy, stem-cell/solid-organ transplant, prolonged steroids, cytotoxic chemotherapy, biologics. The pathogen (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### neurocritical care - [Acute Raised Intracranial Pressure and Traumatic Brain Injury — Comprehensive Neurocritical Care](https://medvellum.com/s/icu/topics/neurocritical-care/raised-icp-tbi-comprehensive-icu) — Raised intracranial pressure (ICP >22 mmHg) after traumatic brain injury (TBI) is the most preventable cause of secondary brain damage and the central target of neurocritical ca (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### neurocritical-care - [Acute Intermittent Porphyria — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/neurocritical-care/acute-intermittent-porphyria-comprehensive-icu) — Acute intermittent porphyria (AIP) — autosomal dominant defect in porphobilinogen deaminase (PBGD/HMBS enzyme) in the haem biosynthesis pathway → accumulation of porphyrin precurso (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Spinal Cord Injury and Neurogenic Shock — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/neurocritical-care/spinal-cord-injury-comprehensive-icu) — Acute spinal cord injury (SCI) — traumatic damage to the spinal cord causing motor/sensory deficit below the injury level ± autonomic dysfunction. Neurogenic shock: loss of sympath (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute Status Epilepticus — Comprehensive Full Management Cascade](https://medvellum.com/s/icu/topics/neurocritical-care/status-epilepticus-comprehensive-cascade-icu) — Status epilepticus (SE) is a continuous seizure lasting more than 5 minutes, or two or more seizures without full recovery of consciousness between them. The 5-minute operational t (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Guillain-Barre Syndrome — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/neurocritical-care/guillain-barre-syndrome-comprehensive-icu) — Guillain-Barre syndrome (GBS) — acute immune-mediated polyradiculoneuropathy causing rapidly progressive (hours to 4 weeks) ascending flaccid paralysis + areflexia ± autonomic dysf (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICP Monitoring and Multimodal Neuromonitoring — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/neurocritical-care/icp-monitoring-neuromonitoring-comprehensive-icu) — Intracranial pressure (ICP) monitoring is the cornerstone of neurocritical care for severe traumatic brain injury (TBI) and other intracranial hypertension states. The MONROE-KELLI (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Myasthenia Gravis Crisis — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/neurocritical-care/myasthenia-gravis-crisis-comprehensive-icu) — Myasthenic crisis is an acute life-threatening exacerbation of myasthenia gravis (MG) severe enough to compromise ventilation (impending or actual respiratory failure) or airway pr (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Tetanus and Botulism in the ICU — Comprehensive Management](https://medvellum.com/s/icu/topics/neurocritical-care/tetanus-botulism-comprehensive-icu) — Tetanus and botulism — two neurotoxin-mediated diseases from Clostridium species requiring ICU management. TETANUS: Clostridium tetani exotoxin (tetanospasmin) travels retrograde t (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### obstetric - [Acute Postpartum Haemorrhage — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/obstetric/postpartum-haemorrhage-comprehensive-icu) — Acute postpartum haemorrhage (PPH) — ACOG defines maternal haemorrhage as cumulative blood loss of 1000 mL or more, or blood loss with signs or symptoms of hypovolaemia, within 24 (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### oncology - [Acute Severe Tumour Lysis Syndrome — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/oncology/acute-tumour-lysis-syndrome-comprehensive-icu) — Acute severe tumour lysis syndrome (TLS) = a metabolic oncological emergency from rapid lysis of malignant cells releasing intracellular contents into the extracellular space: HYPE (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Immune Checkpoint Inhibitor Toxicity in the ICU](https://medvellum.com/s/icu/topics/oncology/immune-checkpoint-inhibitor-toxicity-icu) — Immune checkpoint inhibitor (ICI) toxicity — immune-related adverse events (irAEs) from CTLA-4 (ipilimumab), PD-1 (nivolumab, pembrolizumab), and PD-L1 (atezolizumab, durvalumab) i (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### pharmacology - [ICU Antibiotic Pharmacology — Comprehensive (PK/PD in Critical Illness)](https://medvellum.com/s/icu/topics/pharmacology/antibiotic-pharmacology-comprehensive-icu) — ICU antibiotic pharmacology — the evidence-based framework for optimising antimicrobial dosing in critically ill patients where altered pharmacokinetics (PK) make standard doses un (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [ICU Antihypertensive Drugs — Comprehensive](https://medvellum.com/s/icu/topics/pharmacology/antihypertensive-drugs-comprehensive-icu) — IV antihypertensives for the ICU — the nine agents every intensivist must master: LABETALOL (combined alpha+beta blocker — versatile first-line for most hypertensive emergencies; 2 (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICU Corticosteroids — Comprehensive Pharmacology (Glucocorticoids in Critical Illness)](https://medvellum.com/s/icu/topics/pharmacology/corticosteroids-comprehensive-icu) — ICU corticosteroid pharmacology -- the evidence-based use of glucocorticoids across the full spectrum of critical illness. The four agents every intensivist must master: HYDROCORTI (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [ICU Diuretics Pharmacology — Comprehensive (Loop, Thiazide, K-Sparing, Acetazolamide)](https://medvellum.com/s/icu/topics/pharmacology/diuretics-pharmacology-comprehensive-icu) — ICU diuretics — comprehensive pharmacology organised by SITE OF ACTION in the nephron. The four classes map onto four sequential segments: PROXIMAL TUBULE → acetazolamide (carbonic (exams=CICM,FFICM,EDIC; updated=2026-08-18) - [ICU Sedation and Analgesia Pharmacology — Comprehensive (PADIS Bundle)](https://medvellum.com/s/icu/topics/pharmacology/icu-sedation-analgesia-pharmacology-comprehensive) — ICU sedation and analgesia pharmacology — the evidence-based approach to managing pain, sedation, and delirium in mechanically ventilated ICU patients following the PADIS (Pain, Ag (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### rehabilitation - [ICU-Acquired Weakness (CIP/CIM)](https://medvellum.com/s/icu/topics/rehabilitation/icu-acquired-weakness-comprehensive-cip-cim) — ICU-acquired weakness (ICUAW) is the acquired muscle and nerve dysfunction that develops during critical illness, affecting 25 to 50 percent of ICU patients ventilated over 7 days. (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### renal - [Continuous Renal Replacement Therapy (CRRT) — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/renal/crrt-comprehensive-circuit-citrate-icu) — CRRT (continuous renal replacement therapy) — the renal support modality for haemodynamically unstable ICU patients. Three modalities: CVVH (continuous venovenous haemofiltration — (exams=CICM,FFICM,EDIC; updated=2026-08-17) ### renal-metabolic - [Acute Severe Rhabdomyolysis — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/renal-metabolic/rhabdomyolysis-comprehensive-icu) — Rhabdomyolysis — skeletal muscle breakdown releasing intracellular contents (myoglobin, creatine kinase, potassium, phosphate, urate) into the circulation → AKI (myoglobin nephroto (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Pulmonary-Renal Syndrome in the ICU](https://medvellum.com/s/icu/topics/renal-metabolic/pulmonary-renal-syndrome-icu) — Pulmonary-renal syndrome (PRS) — the combination of diffuse alveolar haemorrhage (DAH) and rapidly progressive glomerulonephritis (RPGN) — caused by small-vessel vasculitis: ANCA-a (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Rheumatological Emergencies in the ICU](https://medvellum.com/s/icu/topics/renal-metabolic/rheumatological-emergencies-icu) — Rheumatological emergencies in the ICU — life-threatening presentations of systemic autoimmune diseases requiring critical care: (1) scleroderma renal crisis (SRC — sudden malignan (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Systematic Arterial Blood Gas Interpretation — Comprehensive](https://medvellum.com/s/icu/topics/renal-metabolic/blood-gas-interpretation-comprehensive-icu) — Systematic arterial blood gas (ABG) interpretation — the 10-step approach to analysing every ABG in ICU. Step 1: pH (acidosis <7.35, alkalosis >7.45). Step 2: PaCO2 (respiratory (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### respiratory - [Acute Respiratory Distress Syndrome (ARDS) — Berlin Definition, Lung-Protective Ventilation, Proning, ECMO, and Phenotyping](https://medvellum.com/s/icu/topics/respiratory/ards-berlin-comprehensive-icu) — Acute respiratory distress syndrome (ARDS) — a syndrome of acute, diffuse, inflammatory lung injury causing increased pulmonary vascular permeability, loss of aerated lung, and sev (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Hypoxaemia Mechanisms — Comprehensive (5 Causes, A-a Gradient, Shunt vs V/Q Mismatch)](https://medvellum.com/s/icu/topics/respiratory/hypoxaemia-mechanisms-comprehensive-icu) — There are exactly FIVE mechanisms of hypoxaemia: (1) ventilation-perfusion (V/Q) MISMATCH — the commonest cause, which RESPONDS to oxygen; (2) SHUNT — blood bypasses ventilated alv (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Oxygen Therapy and Oxygen Delivery — Comprehensive ICU Physiology](https://medvellum.com/s/icu/topics/respiratory/oxygen-therapy-delivery-comprehensive-icu) — Oxygen therapy and delivery — the physiological principles governing oxygen movement from the atmosphere to the cell, and the ICU interventions to optimise it. The oxygen cascade: (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Ventilator Waveforms — Comprehensive (Scalars, Loops, Asynchrony)](https://medvellum.com/s/icu/topics/respiratory/ventilator-waveforms-comprehensive-icu) — Ventilator waveforms — the graphical display of pressure, flow, and volume over time during mechanical ventilation. Three SCALAR waveforms (pressure-time, flow-time, volume-time) a (exams=CICM,FFICM,EDIC; updated=2026-08-20) - [Ventilator-Induced Lung Injury (VILI) — Mechanisms and Prevention](https://medvellum.com/s/icu/topics/respiratory/ventilator-induced-lung-injury-vili-mechanisms-icu) — Ventilator-induced lung injury (VILI) — the lung damage caused by mechanical ventilation itself, distinct from the underlying disease process. Four mechanisms: (1) Volutrauma (alve (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### resuscitation - [Acute Severe Anaphylaxis — Comprehensive Peri-Arrest Management](https://medvellum.com/s/icu/topics/resuscitation/acute-severe-anaphylaxis-comprehensive-icu) — Acute severe anaphylaxis — a rapidly progressive, life-threatening systemic hypersensitivity reaction causing mast cell and basophil degranulation → release of histamine, tryptase, (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Extracorporeal Cardiopulmonary Resuscitation (ECPR)](https://medvellum.com/s/icu/topics/resuscitation/extracorporeal-cpr-ecpr-icu) — Extracorporeal cardiopulmonary resuscitation (ECPR) — the rapid deployment of venoarterial extracorporeal membrane oxygenation (VA-ECMO) during ongoing CPR in patients with refract (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Post-Cardiac Arrest Syndrome (PCAS) — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/resuscitation/post-cardiac-arrest-syndrome-pcas-icu) — Post-cardiac arrest syndrome (PCAS) — the multi-system injury following return of spontaneous circulation (ROSC), comprising four interconnected components (Nolan 2008 ILCOR/AHA sc (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Sepsis and Septic Shock — Comprehensive Integrated (SSC 2021, Hour-1 Bundle, Vasopressors, Source Control)](https://medvellum.com/s/icu/topics/resuscitation/sepsis-septic-shock-comprehensive-integrated-icu) — Sepsis and septic shock — the leading cause of death in the ICU and the highest-yield topic in critical care exams. SEPSIS-3 DEFINITIONS (Singer 2016): sepsis = life-threatening or (exams=CICM,FFICM,EDIC; updated=2026-07-26) ### toxicology - [Acute Carbon Monoxide Poisoning — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/toxicology/carbon-monoxide-poisoning-comprehensive-icu) — Acute carbon monoxide (CO) poisoning — odourless, colourless gas of incomplete combustion (faulty heaters, house fires, exhausts, generators). CO binds haemoglobin with ~240x the a (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Digoxin Toxicity — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/toxicology/digoxin-toxicity-comprehensive-icu) — Digoxin toxicity — Na/K-ATPase inhibition: gastrointestinal signs, bradycardia and heart block predominate; death is from ventricular fibrillation or tachycardia; hyperkalaemia in (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute Lithium Toxicity — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/toxicology/lithium-toxicity-comprehensive-icu) — Acute and chronic lithium toxicity — a narrow therapeutic-index drug excreted almost exclusively by the kidney as the free ion (maintenance targets 0.6-0.8 mmol/L, some authorities (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Methanol and Ethylene Glycol Poisoning — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/toxicology/toxic-alcohols-comprehensive-icu) — Toxic alcohol poisoning = methanol and ethylene glycol (the 'toxic alcohols') — both are metabolised by ALCOHOL DEHYDROGENASE (ADH) to highly toxic organic acids → SEVERE HIGH ANIO (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Organophosphate and Nerve Agent Poisoning](https://medvellum.com/s/icu/topics/toxicology/organophosphate-nerve-agent-poisoning-icu) — Organophosphate (OP) and nerve agent poisoning — inhibition of acetylcholinesterase (AChE) → acetylcholine accumulation → overstimulation of muscarinic receptors (SLUDGE: salivatio (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Paracetamol (Acetaminophen) Overdose — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/toxicology/paracetamol-overdose-comprehensive-icu) — Acute paracetamol (acetaminophen) overdose — the commonest cause of acute liver failure in the developed world. Most of an absorbed dose is safely conjugated by glucuronidation and (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Acute Salicylate Poisoning — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/toxicology/salicylate-poisoning-comprehensive-icu) — Acute salicylate (aspirin) poisoning — uncoupling of oxidative phosphorylation, inhibition of Krebs-cycle dehydrogenases and increased ketoacid production give the signature MIXED (exams=CICM,FFICM,EDIC; updated=2026-08-17) - [Acute Snake Envenomation — Comprehensive (ANZ Context)](https://medvellum.com/s/icu/topics/toxicology/snake-envenomation-comprehensive-icu) — Acute snake envenomation in Australia and New Zealand — the world's most venomous snakes belong to the family Elapidae (front-fanged: brown snake [Pseudonaja — 1 cause of snakebite (exams=CICM,FFICM,EDIC; updated=2026-07-26) - [Acute Tricyclic Antidepressant (TCA) Poisoning — Comprehensive ICU Management](https://medvellum.com/s/icu/topics/toxicology/tca-poisoning-comprehensive-icu) — Acute tricyclic antidepressant (TCA) poisoning — the classic 'membrane stabilising' overdose. The lethal mechanism is a QUINIDINE-LIKE block of fast cardiac sodium channels: phase (exams=CICM,FFICM,EDIC; updated=2026-08-19) - [Drug-Induced Hyperthermia Syndromes — Comprehensive Differential and Management](https://medvellum.com/s/icu/topics/toxicology/drug-induced-hyperthermia-syndromes-icu) — Drug-induced hyperthermia syndromes — five life-threatening conditions that present with hyperthermia + autonomic instability + altered mental status + (often) muscle rigidity, eac (exams=CICM,FFICM,EDIC; updated=2026-08-19)