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1/🧵🎥 How do “Dominoes of life” fall in critical illness⁉️
A pt arrives awake & talking but vomiting. In just 8 hrs he nearly dies of sepsis 🤯
Lung & kidney failure, heart attack, coma.
How can this happen & can we save him?
This🧵can help us understand the “arc of illness”
A pt arrives awake & talking but vomiting. In just 8 hrs he nearly dies of sepsis 🤯
Lung & kidney failure, heart attack, coma.
How can this happen & can we save him?
This🧵can help us understand the “arc of illness”
2/ His disease is Ascending Cholangitis
A gall stone lands in his common bile duct
📍Pain & vomiting
📍He’s admitted to the ICU
📍GI performs an ERCP to place a stent, bypass the stone, drain pus & control the source of sepsis
📍Add fluids & antibiotics
📍But he gets worse
Why?
A gall stone lands in his common bile duct
📍Pain & vomiting
📍He’s admitted to the ICU
📍GI performs an ERCP to place a stent, bypass the stone, drain pus & control the source of sepsis
📍Add fluids & antibiotics
📍But he gets worse
Why?
3/ We bypassed the septic source (stone) & drain the pus, but dominoes were already falling.
Bacteria had gotten into his blood.
Too much inflammation & capillary blood clotting occurred, just like in COVID.
What happens when “cellular” dominoes start to fall uncontrollably?
Bacteria had gotten into his blood.
Too much inflammation & capillary blood clotting occurred, just like in COVID.
What happens when “cellular” dominoes start to fall uncontrollably?
