medicine away week 3 some more notes TRICC summary

3 types of aspergillus infection

1. aspergilloma (ball) - seen in COPD, TB, sarcoid, needs a cavity to grow in, treating with abx not really effective because ball ~avascular low circulation, just keep it in

2. allergic bronchopulmonary aspergillosis (ABPA) - immune reaction high titers of IgE, reaction to aspergillosis

3. disseminated aspergillosis

patient is tachycardic and the nurse calls you...

get ekg- if sinus tachycardia the major causes are...

1. fever

2. pain

3. dehydration

4. pulmonary embolism

typical a-flutter has inverted p waves in the inferior leads

TRICC trial - transfusion trial in critical care (liberal vs restrictive transfusion)

canadian study -

admitted direct to ICU euvolemic and hgb >9

wings

1. keep hgb 10-12

2. transfuse <7

endpoints 30 day mortality, hospital mortality

6451 patients screened - ~860 enrolled

RESULTS

no sig difference in overall mortality at 30 days

decreased mortality in less critically ill patients APACHE <20

no sig difference in older patients or patients w/cardiac disease

in hospital mortality sig lower in restrictive group overall

"a restrictive strategy is at least effect, possibly superior to critically ill patients except myocardial infarction /unstable angina"