Rant #4: What does that test result actually mean?
There is general acceptance that we are overzealous with routine blood testing in ICU with plenty of studies describing this.
Aligned to this, the dynamic nature of critical illness can render some tests uninterpretable - why do we still do them?
There is general acceptance that we are overzealous with routine blood testing in ICU with plenty of studies describing this.
Aligned to this, the dynamic nature of critical illness can render some tests uninterpretable - why do we still do them?
Reposted from
Ben Morton
Over the years I've developed a number of "rants" (aka teaching) that seem to resonate with trainees on #ICUsky ward round.
This pedogogical style might make educationalists wince but keeps me and (crucially) trainees, interested
Interested in any counter rants, refined rants or rant affirmation
This pedogogical style might make educationalists wince but keeps me and (crucially) trainees, interested
Interested in any counter rants, refined rants or rant affirmation
Comments
This image from a great paper called "the sepsis seesaw" (https://pubmed.ncbi.nlm.nih.gov/19424209/) is really helpful to conceptualise this, demonstrating the hyper- followed by hypo-inflammatory response seen in sepsis
There was a whole series on this (very good for exams) in the Lancet Diabetes and Endocrinology...
https://www.thelancet.com/series/endocrine-and-metabolic-considerations-in-critically-ill-patients
https://bsky.app/profile/benmorton.bsky.social/post/3lbbxpm6ap22x
We talk about validity and reliability
(my consultant colleagues take great pleasure in labouring the results of these, gleefully monitoring for any tortured reactions from my non-existent poker face)
A couple of examples: TFTs and Factor Xa
https://www.nice.org.uk/guidance/ng145/chapter/recommendations