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Cardiology case 01

“If you’re not up to it, find something else to do with your life.”

No more than a couple of days go by without someone around me using the phrase "gut feeling", not just in a healthcare context but in all aspects of life. Sensing something, without the information you would normally use to draw conclusions, is a part of human nature.

We've been having debates about what fluids to use in trauma and sepsis for about as long as - well - about as long as we've had fluids. We've had quite a bit of dogma going round, and a fair amount of recent dogmalysis - for example with Dan Horner heralding the end of potatoes on the ICU at St. Emlyn's.

"There are three constants in life: change, choice and principles"

This paper from Canada sought and then analysed 66 papers looking at pituitary function after head injury. Inclusion criteria for papers included cohort, RCT, observational studies that enrolled more than 5 patients critical care patients that assessed at least one element of pituitary function (axis).