Most resuscitationists are very comfortable with aggressively adding therapies to stabilize patients.
The zentensivist approach is to aggressively deresuscitate as well.
I recently joined Brandon Oto and Bryan Boling on their excellent podcast, Critical Care Scenarios. Their podcast is notable for excellent descriptions of clinical pearls that are framed in case-based scenarios.
We discussed my approach to deresuscitation, including a few key issues:
- Diuresis, including a combination approach
- Diuresis or ultrafiltration while on vasopressors
- Liberalizing vent settings to maximize patient comfort while maintaining safety
- Moving aggressively towards extubation (#AlwaysBeExtubating)
- Getting plastic out of the patient
The podcast can be found on your favorite streaming platforms, and also at this link on their site.