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ICU Management of Acute Severe Pancreatitis
The management of acute severe pancreatitis (ASP) in the ICU involves a multifaceted approach to stabilize the patient and prevent complications. Initial management focuses on aggressive fluid resuscitation with lactated Ringer's solution, hemodynamic monitoring, and the use of vasopressors if necessary. Respiratory support may include oxygen therapy or mechanical ventilation for cases of acute respiratory distress syndrome (ARDS). Pain control is primarily achieved with opioids, supplemented by non-opioid analgesics. Early enteral nutrition is preferred to maintain gut integrity, while parenteral nutrition is reserved for intolerant patients. Close monitoring for complications such as infected pancreatic necrosis and acute kidney injury is essential, with appropriate interventions as needed. A multidisciplinary team approach ensures comprehensive care and improves patient outcomes.
About the Speaker
![Dr. Rishabh Kumar Mittal Profile Image](https://assimilate.one/wp-content/uploads/2023/09/DR-RISHABH-KUMAR-MITTAL​.png)
Dr. Rishabh Kumar Mittal
Associate Director & Head Department of Critical Care Medicine Sarvodaya Healthcare, Faridabad
Dr Rishabh Kumar Mittal is a well known intensive care physician having more than 12 years ofexperience in the field of Critical Care Medicine. After completing his post graduation from prestigious S.M.S Medical College and attached group hospitals , Jaipur; he ventured in the field of Critical Care Medicine and completed F.N.B in Critical Care Medicine from Fortis Escorts Heart Institute, New Delhi. He is an astute clinician and academician and is a teacher & guide for DrNB,F.N.B, IDCCM, IFCCM and IDCCN courses in Critical Care Medicine. He has published many articles in indexed journals and has written many chapter in various critical care medicine books. He has delivered many talks in Critical Care and Anaesthesiology National and International conferences. His key areas of interest are Nutrition in Critically ill, Ventilation in ARDS patients , ECMO, Gastro Critical care, Post organ transplant care and antibiotic stewardship in Critical Care. Before joining Max Hospital , Dr Rishabh has served as academic coordinator and In-charge of Gastro Medical & Liver Transplant Intensive care units at Fortis Escorts Hospital, New Delhi.
Upcoming Case Discussions
Anaphylaxis In Emergency Department
A dangerous systemic hypersensitivity reaction with a typically quick onset that can be fatal is anaphylaxis. Rapid onset of breathing, circulation,and/or airway issues are its defining characteristics. The most crucial treatment is intramuscular adrenaline, although many patients do not receive it even in medical facilities, despite recommendations to the contrary. The significance of positioning during the management of anaphylaxis and the necessity of avoiding activities that could postpone the timely and proper delivery of adrenaline. Antihistamines should only be used as a last resort when ABC characteristics have been successfully treated in order to lessen skin involvement.
Clinician’s Approach to Hypertensive Nephropathy
Many processes influence the management of chronic kidney disease (CKD) and lead to the development of hypertension in the disease. Increased sympathetic tone in patients with chronic kidney disease (CKD) is a result of afferent signals produced by functionally failing kidneys. The great majority of CKD patients suffer from hypertension, which can both cause and result from the disease. In people with CKD, controlling hypertension is crucial since it lowers the risk of CVD and slows the disease's course. There is no agreement on the ideal blood pressure (BP) targets provided by current guidelines. Consequently, when deciding how to care specific patients.
Circulatory Shock In Trauma
The inability of the circulatory system to supply tissue oxygenation and organ perfusion necessary to meet cellular metabolic demands is known as shock. Although non-haemorrhagic shock, such as cardiogenic or neurogenic shock, can occur after trauma, hemorrhage is more frequently linked to trauma-related shock. Evidence gathered over the past ten years has shown that trauma patients suffer from acute traumatic coagulopathy (ATC), which is brought on by the actual process of injury. Damage control resuscitation (DCR), the current method for managing acute shock, was developed with this as a key component. Haemostatic resuscitation, which uses blood products as the main resuscitative fluid, permissive hypotension, and damage control surgery are the three main resuscitative techniques included in DCR.
Fertilization & Early Development
Fertilization occurs when a sperm cell merges with an egg cell, creating a zygote, which is the first stage of a new life. This process takes place in the fallopian tube. The zygote then undergoes rapid cell division, known as cleavage, forming a multi-cellular structure called a blastocyst. As the blastocyst moves toward the uterus, it continues to divide and develop. Approximately 5-7 days after fertilization, the blastocyst implants itself into the uterine lining, initiating pregnancy. Early development involves the formation of the foundational structures and systems that will shape the embryo.
Metabolic Syndrome and Heart Health
Metabolic syndrome is a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes. These conditions include high blood pressure, elevated blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels. When these risk factors occur together, they amplify the risk of developing cardiovascular issues. Metabolic syndrome is closely linked to insulin resistance, where the body struggles to use insulin effectively. Lifestyle changes, such as adopting a healthy diet, regular exercise, and weight management, are crucial in managing the syndrome. Early intervention is essential to prevent the progression to heart disease and other complications.