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Table of Contents

March 7, 2024 by Josh Farkas

SYSTEMS

  • Cardiology
  • Endocrinology
  • Gastroenterology
  • Hematology & Oncology
  • Infectious diseases
  • Nephrology
  • Neurology
  • Obstetrics
  • Pulmonology
  • Rheumatology
  • Toxicology & Temperature

intro

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  • Overview: Guide to supportive care in critical illness
  • Medication reconciliation in the ICU
  • About this book
    • How to create your own IBCC smartphone app 📲

cardiology

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General

  • Approaches to problems
    • Cardiac arrest
    • 🔜 Chest pain
    • Hypertensive emergency
    • Preoperative risk stratification & optimization
    • 🔜 Syncope
  • Therapeutics & invasive hemodynamics
    • ECMO
    • IABP (intra-aortic balloon pump)
    • Impella
    • RHC (right heart catheterization)
    • Vasopressors

Arrhythmia

  • Bradycardia
    • BRASH syndrome
  • Atrial fibrillation & flutter
  • Ventricular arrhythmias
    • Monomorphic VT storm
    • Torsade de pointes
    • Ventricular arrhythmias s/p MI

Coronary disease

  • MI (type I)
  • Post-MI complications
  • Troponin elevation in non-cardiac critical illness

Myocardial & pericardial disease

  • Myocarditis
  • Pericardial tamponade
  • Pericarditis
  • Takotsubo syndrome

Shock & heart failure

  • Specific forms of heart failure & shock:
    • LV failure
    • RV failure
    • SCAPE (Sympathetic Crashing Acute Pulmonary Edema)
  • Interventions & devices
    • ECMO
    • IABP (intra-aortic balloon pump)
    • Impella
    • RHC (right heart catheterization)
  • Shock (undifferentiated)

Valvular & aortic disease

  • Aortic dissection
  • Endocarditis
  • LV outflow tract obstruction (LVOTO)
  • 🔜 Valvular heart disease

endocrinology

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Adrenal crisis

Glucose & insulin

  • Diabetic ketoacidosis (DKA)
  • Hyperglycemic Hyperosmolar State (HHS)
  • Glycemic control in the ICU
  • Hypoglycemia

Thyroid

  • ⬆️ Thyroid Storm
  • ⬇️ Decompensated Hypothyroidism

gastroenterology

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Abdominal compartment syndrome

Biliary

  • Acalculous cholecystitis
  • Community-acquired biliary sepsis (ascending cholangitis & calculus cholecystitis)

GI hemorrhage

Intestine

  • Nausea & antiemetics
  • C. difficile
  • Motility disorders
    • Gastroparesis
    • Ileus
    • Colonic pseudoobstruction (Oglivie's syndrome)

Liver

  • Acute Liver Failure (ALF)
  • Acute on Chronic Liver Failure (ACLF)
  • Alcoholic hepatitis
  • Coagulopathy in liver failure
  • Hepatic encephalopathy:
    • In chronic liver failure
    • In acute liver failure
  • Hepatorenal syndrome (HRS-AKI)
  • Spontaneous bacterial peritonitis (SBP)

Nutrition

  • Critical care nutrition
  • Gastroparesis
  • Refeeding syndrome

Pancreatitis


heme/onc

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Anemia & transfusion

  • Anemia & hemoglobin transfusion targets
  • Massive Transfusion Protocol (MTP)
  • Sickle cell anemia – acute chest syndrome

Anticoagulation, therapeutic

  • Anticoagulant reversal
  • Parenteral anticoagulants (heparin, fondaparinux, argatroban, bivalirudin)

Coagulopathy

  • Coagulation studies (conventional & TEG)
  • Coagulopathy in liver failure
  • Disseminated intravascular coagulation (DIC)
    • Purpura fulminans

Malignancy

  • Acute promyelocytic leukemia (APL)
  • CAR-T cell recipient
  • Immune-related adverse events from checkpoint inhibitors
  • Tumor lysis syndrome

Thrombocytopenia

  • Thrombocytopenia
  • Catastrophic Antiphospholipid Syndrome (CAPS)
  • Hemophagocytic lymphohistiocytosis (HLH)
  • Thrombotic microangiopathies (including TTP and HUS)

infectious diseases

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General approach

  • Allergy to beta-lactam antibiotics
  • Antimicrobial:
    • Antibiotics
    • Antifungal agents
  • Approach to fever in the ICU
  • Septic shock

Specific infections

  • Biliary sepsis (ascending cholangitis & calculus cholecystitis)
  • Candidiasis
  • C. difficile
  • Endocarditis
  • Epiglottitis
  • Influenza
  • Line infection
  • Meningitis & encephalitis
  • Necrotizing fasciitis
  • Pneumonia
    • Aspergillosis, invasive
    • Candidia pneumonia
    • Community-Acquired Pneumonia (CAP)
    • Influenza
    • Pneumocystis jiroveci pneumonia (PJP)
    • Ventilator-associated pneumonia (VAP)
  • Spontaneous bacterial peritonitis
  • Tickborne illnesses
  • Toxic Shock Syndrome
  • Urologic
    • Community-acquired urosepsis
    • Catheter-associated UTI (CAUTI)

nephrology

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Acid-base disorders

  • Diagnosis: approach to pH analysis
  • Metabolic acidosis
    • AGMA (Anion-Gap Metabolic Acidosis)
    • NAGMA (Non-Anion-Gap Metabolic Acidosis)
  • Metabolic alkalosis
  • Respiratory acidosis (hypercapnia)
  • Respiratory alkalosis (hypocapnia)

Acute kidney injury

  • AKI & oliguria
  • Hepatorenal syndrome
  • Rhabdomyolysis
  • Tumor lysis syndrome
  • Contrast nephropathy myth

Electrolytes.

  • Sodium
    • Hypernatremia
    • Hyponatremia
  • Potassium
    • Hypokalemia
    • Hyperkalemia
    • BRASH syndrome
  • Calcium
    • Hypocalcemia
    • Hypercalcemia
  • Magnesium
    • Hypomagnesemia
    • Hypermagnesemia
  • Phosphorous
    • Hypophosphatemia
    • Hyperphosphatemia

Fluids & diuretics

  • Fluid selection & pH-guided resuscitation
  • Deresuscitation: Dominating the diuresis

neurology

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General

  • Approaches to problems:
    • Delirium
    • Stupor & Coma
    • ICP elevation
    • Brain death
    • Neuro emergencies in pregnancy
  • Diagnostics
    • EEG
    • Neuro exam & lesion localization
    • Neuroimaging
    • Neuro-ultrasonography
  • Therapeutics
    • Analgesia and sedation
    • Antiemetics

Anoxic brain injury

  • Management of the post-cardiac arrest patient
  • Neuroprognostication after anoxic brain injury

Effects on other organ systems

  • Central (neurogenic) fever
  • Takotsubo (stress) cardiomyopathy
  • Neurogenic pulmonary edema

Infectious diseases

  • Approach to CNS infection
  • Sites of infection
    • Meningitis/encephalitis
    • Brain abscess
    • Spinal Epidural Abscess (SEA)
  • Specific pathogens
    • Viruses
    • Neurological complications of COVID
    • Fungi
    • Unusual bacteria & mycobacteria
    • Parasites & prions

Inflammatory

  • Autoimmune encephalitis
  • Acute demyelinating disorders

Movement disorders

  • Movement disorders
  • Baclofen withdrawal & toxicity
  • Catatonia
  • Serotonin Syndrome
  • Malignant hyperthermia
  • Neuroleptic Malignant Syndrome

Neuromuscular weakness

  • Neuromuscular disorders & generalized weakness
  • Guillain-Barre Syndrome (GBS)
  • Myasthenic crisis
  • Rhabdomyolysis

Neurosurgery

  • External Ventricular Drain (EVD)
  • Post-craniectomy management & complications

Oncological

  • Neuro-oncology emergencies
  • ICANS (CAR-T cell toxicity)
  • Leptomeningeal carcinomatosis

Seizures

  • Convulsive status epilepticus
  • EEG & Ictal-Interictal Continuum (IIC)
  • Nonconvulsive status epilepticus (NCSE)

Spinal Cord

  • Spinal cord disorders
  • Spinal Epidural Abscess (SEA)
  • Traumatic Spinal Cord Injury (SCI)

Toxic / metabolic

  • Alcohol withdrawal
  • Wernicke encephalopathy
  • (More on toxicology 👇 below)

Traumatic

  • Traumatic Brain Injury (TBI)
  • Paroxysmal sympathetic hyperactivity (PSH)
  • Spinal Cord Injury (SCI)

Vascular

  • Occlusion
    • Acute Ischemic Stroke (AIS)
    • Cerebral Venous Thrombosis (CVT)
    • Cervical artery dissection (carotid & vertebral)
  • Hemorrhage
    • Intracranial hemorrhage
    • Subarachnoid hemorrhage (SAH)
  • Vascular tone abnormality
    • PRES (Posterior Reversible Encephalopathy Syndrome)
    • RCVS (Reversible Cerebral Vasoconstriction Syndrome)

Appendix

  • Index of the IBNCC
  • About the IBNCC

obstetrics

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  • Cardiopulmonary disease in pregnancy
  • Neurological emergencies in pregnancy
  • Preeclampsia & HELLP syndrome
  • Thrombotic microangiopathy in pregnancy

pulmonology

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General 🫁

  • Approaches to common problems
    • Approach to pulmonary infection
    • ARDS
    • CO2 abnormality: Hypercapnia and Hypocapnia
    • Eosinophilic lung disease
    • Hemoptysis and DAH (diffuse alveolar hemorrhage)
    • SCAPE (Sympathetic Crashing Acute Pulmonary Edema)
  • Diagnostics
    • ABG, VBG, and pulse oximetry
    • Capnography and end-tidal CO2
    • Diagnosis of acid-base disorders
    • Pulmonary function tests (PFTs)
    • Other diagnostics & exam signs
  • Radiology
    • Approach to thoracic imaging
    • Atelectasis
    • Cavitary lesions
    • Consolidation
    • Cystic lung disease
    • Distribution of abnormalities
    • GGO (ground glass opacification)
    • Lymphadenopathy
    • Nodular patterns
    • Reticular patterns
  • Therapeutics
    • ECMO
    • Extubation
    • Immunosuppression
    • Inhaled pulmonary vasodilators
    • Lung transplantation
    • Noninvasive respiratory support (CPAP, BiPAP, HFNC)
    • Smoking cessation

Airway disorders 🫁

  • Asthma
    • Asthma: Ambulatory & ward
    • Asthma in ICU
  • Bronchiectasis
  • Bronchiolitis
  • COPD
    • COPD: Ambulatory & ward
    • COPD in ICU
  • Cystic Fibrosis exacerbation
  • Upper airway disease
    • Vocal cord dysfunction
    • Aspiration

Exposures

  • Aspiration
  • Drug-induced lung disease
  • EVALI (E-cigarette or vaping associated lung injury)
  • Fat emboli syndrome
  • Pneumoconiosis

Infectious 🫁

  • Clinical infectious syndromes
    • Approach to pulmonary infection
    • CAP (community acquired pneumonia)
    • HAP (hospital acquired pneumonia)
    • VAP (ventilator associated pneumonia)
    • Lung abscess
  • Bacteria
    • Typical pneumonias
    • Atypical pneumonias
    • Nocardia
    • Actinomycosis
  • Mycobacteria
    • Tuberculosis
    • Non-tuberculous mycobacteria
  • Fungi
    • Pneumocystis
    • Cryptococcus
    • Endemic mycoses
      • Blastomycosis
      • Histoplasmosis
      • Coccidioidomycosis
    • Mold
      • Aspergillosis
      • Mucormycosis
    • Candida
  • Viral
    • Influenza
    • Other viruses

Interstitial lung diseases 🫁

  • Acute exacerbation of ILD
  • Amyloidosis
  • CT-ILD (connective tissue-related ILD)
  • DAD (diffuse alveolar damage)
  • DIP (desquamative interstitial pneumonitis)
  • Eosinophilic lung disease
  • GLILD (granulomatous & lymphocytic ILD)
  • HP (hypersensitivity pneumonitis)
  • IgG4-related lung disease
  • IPF (idiopathic pulmonary fibrosis)
  • LIP (lymphocytic interstitial pneumonia)
  • Lipoid pneumonia
  • NSIP (nonspecific interstitial pneumonia)
  • OP (organizing pneumonia)
  • PAP (pulmonary alveolar proteinosis)
  • PAM (pulmonary alveolar microlithiasis)
  • PLCH (pulmonary Langerhans cell histiocytosis)
  • PPFE (pleuroparenchymal fibroelastosis)
  • RBILD (respiratory bronchiolitis ILD)
  • Sarcoidosis

Malignant 🫁

  • Lung cancer
  • Lymphoproliferative disorders
  • Pulmonary complications from malignancy

Neuromuscular weakness 🫁

  • Neuromuscular disorders
  • Guillain-Barre Syndrome (GBS)
  • Myasthenic crisis

Pleural 🫁

  • Pleural effusion
  • Air:
    • Pneumothorax & bronchopleural fistula
    • Pneumomediastinum

Vascular 🫁

  • Pulmonary embolism
    • Diagnosis of PE & tx of low-risk PE
    • Submassive/massive PE
  • Pulmonary hypertension
    • Pulmonary hypertension
    • RV failure
  • Pulmonary vasculitis & Diffuse alveolar hemorrhage
  • Pulmonary AVMs & other vascular abnormalities
  • Sickle cell acute chest syndrome
  • Superior vena cava syndrome (SVCs)

Other 🫁

  • Pulmonary manifestations of systemic diseases
  • Cardiopulmonary disease in pregnancy
  • Sleep-disordered breathing
  • Calcification & metastatic bone formation

rheumatology

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Allergy

  • Allergy to beta-lactam antibiotics
  • Anaphylaxis
  • Angioedema

Inflammatory

  • Catastrophic Antiphospholipid Syndrome (CAPS)
  • Hemophagocytic lymphohistiocytosis (HLH)
  • Pulmonary vasculitis

tox & temp

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Basic toxicology

  • Approach to the poisoned patient
  • Dysthermias:
    • Hyperthermia
    • Hypothermia

Common intoxications & withdrawals

  • Acetaminophen
  • Alcohol et al.
    • Alcohols, toxic (ethylene glycol & methanol)
    • Alcohol withdrawal
    • Wernicke encephalopathy
  • Anticholinergics
  • Baclofen withdrawal & toxicity
  • Beta-blockers
  • Bupropion
  • Calcium channel blockers
  • Carbon monoxide
  • Digoxin
  • Lithium
  • Local Anesthetic Systemic Toxicity (LAST)
  • Malignant hyperthermia
  • Metformin-associated lactic acidosis (MALA)
  • Methemoglobinemia
  • Neuroleptic Malignant Syndrome (NMS)
  • Opioid
    • Opioid intoxication
    • Opioid withdrawal & buprenorphine
  • Salicylate
  • Serotonin Syndrome
  • Sodium channel blockers
  • Sympathomimetics
  • Tricyclic antidepressants
  • Valproic Acid

Cite this post as:

Josh Farkas. Table of Contents. EMCrit Blog. Published on March 7, 2024. Accessed on December 11th 2025. Available at [https://cmefix.emcrit.org/ibcc/toc/ ].

Financial Disclosures:

The course director, Dr. Scott D. Weingart MD FCCM, reports no relevant financial relationships with ineligible companies. This episode’s speaker(s) report no relevant financial relationships with ineligible companies unless listed above.

CME Review

Original Release: March 7, 2024
Date of Most Recent Review: Jul 1, 2024
Termination Date: Jul 1, 2027

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The Internet Book of Critical Care is an online textbook written by Josh Farkas (@PulmCrit), an associate professor of Pulmonary and Critical Care Medicine at the University of Vermont.


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