Clinical Challenges in Surgical Critical Care: Arrhythmias

Behind The Knife: The Surgery Podcast

Science, Health & Fitness, Medicine, Education

4.8 • 1.4K Ratings

🗓️ 29 November 2021

⏱️ 29 minutes

🔗️ Recording | iTunes | RSS

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Summary

Cardiac arrhythmias such as atrial fibrillation are common in any ICU. But, adequately addressing additional perioperative considerations is key in the surgical ICU. In this Critical Care episode of Behind the Knife, Drs. Bankhead, Dumas, & Park will address how to approach a critically ill patient who presents with an arrythmia. Hemodynamically stable vs. unstable patients are discussed, as well as the current ACLS guidelines for management of a patient in cardiac arrest.

Referenced Articles and Guidelines:

1. Van Gelder I, Groenveld H, Crijns H, et al. Lenient versus Strict Rate Control in Patients with Atrial Fibrillation. NEJM 2010.

2. Walkey A, Hogarth K, Lip G. Optimizing Atrial Fibrillation Management: From ICU and Beyond. CHEST 2015.

3. AFFIRM Investigators. A Comparison of Rate Control and Rhythm Control in Patients with Atrial Fibrillation. NEJM 2002.

4. ACLS Training Center: Tachycardia with a Pulse Algorithm. https://www.acls.net/acls-tachycardia-algorithm

5. ACLS Training Center: Cardiac Arrest Algorithm. https://www.acls.net/acls-secondary-survey

6. ACLS Training Center: Acute Coronary Syndromes Algorithm. https://www.acls.net/acute-coronary-syndromes-algorithm

Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.

Transcript

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0:00.0	This episode is brought to you by Hayu, whether you need a break from your stacked schedule,
0:06.3	a distraction from the housework, or some company during night feeds with the newborn.
0:11.2	Hayu is home to your perfect combination of shows, catch all episodes past, present
0:16.4	and upcoming, for favourites like the Real Housewives, Vanderpump Rules, Southern Charm
0:21.4	and more.
0:22.4	To start watching, head to hayu.com
0:30.0	Behind the Night, the Surgery Podcast, relevant and engaging content designed to help you dominate
0:40.4	the day.
0:41.4	Hello, everyone, and welcome to another Critical Care episode of Behind the Night.
0:54.1	I'm Brittany Bankhead with Texas Tech University in Lubbock, Texas, and I also have with me
0:58.0	today, Brian D. Maugh, and Caroline Park from Utah, Southwestern and Parkland in Dallas,
1:03.4	Texas.
1:04.4	We're all trauma and acute care surgeons and surgical intensivists.
1:07.7	Thank you, Dr. Bankhead for the introduction.
1:10.6	Let's first review the format of this podcast, which will be scenario-based, so we will all
1:14.0	first start with a scenario in ICU patient with an arrhythmia, and it's going to be our
1:17.8	job to work this up and review the literature behind our decisions.
1:21.0	So take it away, Dr. Bankhead.
1:22.5	All right, so let's start with the patient and the ICU, obviously.
1:27.0	She's a 55-year-old female, no prior comorbidities, status post-signoid collect me for a henchief
1:33.0	for diverticulitis.
1:34.2	And the ICU now, she's post-up day three, and had been on low dose phase oppressors, but
	...

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