WBM Emergency & Critical Care

The stress index is a ventilator waveform concept used to assess lung stress, overdistension, and tidal recruitment during mechanical ventilation. In this episode, we review what the stress index is, how it is interpreted on ventilator waveforms, how it relates to lung-protective ventilation, and how clinicians use it to think about PEEP, tidal volume, compliance, and ventilator-induced lung injury.

Topics covered include: • What t...

Norepinephrine is one of the most important vasopressors in emergency medicine and critical care. In this masterclass episode, we review the foundations of norepinephrine, including mechanism of action, receptor effects, hemodynamics, dosing, adverse effects, and monitoring, then take a deeper dive into clinical scenarios and bedside applications where norepinephrine is commonly used.

Topics covered include: • What norepinephrine i...

Dobutamine and milrinone are two important inotropes used in heart failure, cardiogenic shock, low cardiac output states, and critical care. In this masterclass episode, we compare dobutamine and milrinone with a focus on mechanisms of action, receptor effects, hemodynamics, dosing considerations, adverse effects, monitoring, and practical bedside use.

Topics covered include: • What inotropes are • Cardiac output, contractility, an...

Norepinephrine is one of the most important vasopressors in emergency medicine and critical care. In this episode, we review norepinephrine with a focus on core principles, clinical applications, dosing, hemodynamic effects, receptor physiology, adverse effects, and unique bedside scenarios where norepinephrine is commonly considered.

Topics covered include: • What norepinephrine is • Norepinephrine mechanism of action • Alpha-1, b...

Dobutamine and milrinone are two commonly used inotropes with important differences in mechanism, hemodynamics, dosing, adverse effects, and clinical use. In this episode, we review the key differences between dobutamine and milrinone and how to think through inotrope selection at the bedside.

Topics covered include: • Dobutamine mechanism of action • Milrinone mechanism of action • Beta-1 agonism versus PDE-3 inhibition • Hemodyna...

The oxygen-hemoglobin dissociation curve is a foundational concept for understanding oxygen binding, oxygen unloading, hemoglobin saturation, P50, left and right shifts, oxygen content, oxygen delivery, and clinical oxygenation. In this masterclass episode, we bring together the core physiology and advanced applications of the oxygen-hemoglobin dissociation curve, including the Bohr effect, 2,3-BPG, anemia, sepsis, shock, and tissu...

Norepinephrine, vasopressin, and epinephrine are three of the most commonly used vasopressors in emergency medicine and critical care. In this episode, we review how these ICU vasopressors work, their receptor effects, hemodynamic profiles, common indications, dosing considerations, adverse effects, and practical bedside differences.

Topics covered include: • What vasopressors are • Vasopressors and shock physiology • Norepinephrin...

The 12-lead ECG is a foundational tool for evaluating cardiac rhythm, conduction, ischemia, chamber enlargement, and structural heart disease. In this episode, we review a structured approach to ECG interpretation, including cardiac axis, PR/QRS/QT intervals, bundle branch blocks, left ventricular hypertrophy, and practical pattern recognition.

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Topics covered include...

Tumor lysis syndrome is an oncologic emergency caused by rapid tumor cell breakdown and release of intracellular contents into the bloodstream. In this episode, we review the pathophysiology, risk factors, laboratory abnormalities, diagnostic criteria, prevention, and treatment of tumor lysis syndrome.

Topics covered include: • What tumor lysis syndrome is • Why tumor lysis syndrome occurs • High-risk cancers and clinical risk fact...

The oxygen-hemoglobin dissociation curve is a foundational concept for understanding oxygen binding, oxygen unloading, hypoxemia, and tissue oxygen delivery. In this episode, we review what the oxygen-hemoglobin dissociation curve represents, how hemoglobin saturation relates to PaO2, what P50 means, and how left and right shifts change hemoglobin’s affinity for oxygen.

Topics covered include: • What the oxygen-hemoglobin dis...

The oxygen-hemoglobin dissociation curve is a foundational concept for understanding oxygen binding, oxygen unloading, hypoxemia, and tissue oxygen delivery. In this episode, we review what the oxygen-hemoglobin dissociation curve represents, how hemoglobin saturation relates to PaO2, what P50 means, and how left and right shifts change hemoglobin’s affinity for oxygen.

Topics covered include: • What the oxygen-hemoglobin dis...

Volume control and pressure control are two of the most important mechanical ventilation modes used in critical care. In this episode, we review the physiologic principles behind both modes, explain how ventilator settings influence pressure, flow, and tidal volume, interpret ventilator scalars and waveforms, and compare the advantages, limitations, and bedside applications of each mode.

Topics covered include: • Foundations of con...

Dead space ventilation is a foundational concept in pulmonary physiology and mechanical ventilation. In this episode, we review anatomic dead space, alveolar dead space, physiologic dead space, and how dead space relates to ventilation-perfusion mismatch, shunt physiology, CO2 clearance, respiratory failure, and bedside clinical interpretation.

Topics covered include: • What dead space ventilation means • Anatomic dead space • Alve...

Volume control and pressure control are two foundational modes of mechanical ventilation. In this episode, we compare volume control ventilation with pressure control ventilation, focusing on core principles, ventilator settings, pressure and flow patterns, tidal volume delivery, and practical bedside differences.

Topics covered include: • What volume control ventilation is • What pressure control ventilation is • Mandatory breaths...

Decompensated cirrhosis is defined by the development of major complications of advanced liver disease and portal hypertension. In this episode, we review the core complications of decompensated cirrhosis, including esophageal variceal bleeding, spontaneous bacterial peritonitis, hepatorenal syndrome, and hepatic encephalopathy.

Topics covered include: • What decompensated cirrhosis means • Portal hypertension and advanced liver di...

Pulmonary physiology is essential for understanding hypoxemia, respiratory failure, oxygenation, V/Q mismatch, and shunt physiology. In this episode, we review ventilation-perfusion relationships, V/Q mismatch, pulmonary shunting, and the key differences between these mechanisms of impaired oxygenation.

Topics covered include: • Ventilation and perfusion basics • Normal V/Q relationships in the lung • What V/Q mismatch means • Low ...

Hepatopulmonary syndrome and portopulmonary hypertension are two important pulmonary vascular complications of liver disease and portal hypertension. In this episode, we compare hepatopulmonary syndrome with portopulmonary hypertension, focusing on pathophysiology, clinical presentation, diagnostic evaluation, hemodynamics, treatment, and liver transplant considerations.

Topics covered include: • What hepatopulmonary syndrome is • ...

Spontaneous bacterial peritonitis, or SBP, is a serious infection of ascitic fluid that occurs in patients with cirrhosis and portal hypertension. In this episode, we review the pathophysiology, clinical presentation, diagnostic evaluation, treatment, albumin use, and prophylaxis of spontaneous bacterial peritonitis.

Topics covered include: • What spontaneous bacterial peritonitis is • Why SBP occurs in cirrhosis and ascites • Bact...

Hepatorenal syndrome is a serious kidney complication of advanced liver disease and portal hypertension. In this episode, we review the pathophysiology, diagnostic criteria, clinical evaluation, differential diagnosis, and treatment of hepatorenal syndrome.

Topics covered include: • What hepatorenal syndrome is • The relationship between cirrhosis, portal hypertension, and kidney dysfunction • Splanchnic vasodilation and reduced ef...