Critical Care Scenarios Lightning rounds 51: Hemodynamic interfaces with Philippe Rola
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Apr 2, 2025 AI Snips
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1990s Physiology Memories
- Philippe recalled ICU attendings in the 1990s who used pressure-based physiology before bedside ultrasound.
- He contrasted that era's hands-on physiology with later protocol-driven EBM approaches.
Four Hemodynamic Interfaces
- Circulation is best understood as four key interfaces rather than isolated compartments.
- Focusing on interfaces highlights where coupling fails and reveals the weakest link to treat.
MAP Can Be Misleading
- Improving MAP alone can worsen tissue perfusion if coupling is ignored.
- Vasopressors can raise arterial pressure yet uncouple arteriolar-to-capillary flow and reduce capillary perfusion.