Published May 2, 2003
Hi all. A new article: "Two Interesting Situations" is up on the MICU faq website at http://www.icufaqs.org - a person with pulmonary hypertension gets an inhaled nitric oxide trial, and a person with an RV MI gets large-volume fluid resuscitation, and both have really interesting changes in cardiac output, SVR, PVR, etc. Interesting stuff, if a bit on the geeky side. Let us know what you think.
We had an inservice on nitric oxide, and basically the dr said that, while it did dilate vessels, the affects were so short-term that it usage was impractical. He never mentioned weaning from nitric oxide therapy to calcium channel blockers. If you could explain that procedure, that would be really helpful. Also, did the doctors ever do anything about the right-to-left sided shunt? I would imagine that you'd have to fix the pumonary htn before fixing the shunt or else you'd just blow the seal again....
I work for the county, and we get a lot of homeless patients. It's a bit sad and depressing to work with them because their illness is a result of chronic mal-behavior. In the end, it usually comes down to comfort care.
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