Wednesday, April 4, 2007

Wednesday April 4, 2007
Daptomycin (Cubicin) and renal failure

As Daptomycin has now been approved for right-sided MSSA and MRSA endocarditis since our previous pearl *, and as we are seeing it more in ICUs, it would be of worth to re-visit that, Cubicin needs to be adjusted in renal failure. With CrCl less than 30, it should be given every 48 hours. It is recommended to be given on hemodialysis day following hemodialysis. Daptomycin doesn't get cleared in CVVHD and need to adjusted as renal failure dose.


Related previous pearls:

Daptomycin induced rhabdomyolysis

3 new antibiotics *

* Since this previous pearl, Cubicin is approved for right-sided MSSA and MRSA endocarditis.

Tuesday, April 3, 2007

Tuesday April 3, 2007
Endotrol

Q: What is that ring on ETT (endotracheal tube) ?

A; Endotrol (trade name) is a modification of regular ETT with a ring attached at the proximal end. While intubating, pulling the ring makes distal tip goes anterior and help ETT in directing towards vocal cord. It is said to be helpful in hardly visualize vocal cords, in difficult intubations and in blind nasal intubations.

Related previous pearls:

The GlideScope, Airtraq, Light Wand and How many attempts to intubate?



Sunday, April 1, 2007

Sunday April 1, 2007
Pseudo-hypokalemia


Pseudo-hypokalemia is usually seen with very high WBC count, when the drawn sample is allowed to sit at room temperature for longer period of time. It happens due to uptake of plasma potassium by high leukocytes in the sample.

If Pseudo-hypokalemia is suspected, real potassium level can be measured by sending specimen quickly to the lab, and requesting to measure potassium level in separated plasma or serum.