ORtoICU

Tutorials in Anesthesiology & Intensive Care

Fundamentals of Anesthesiology and Critical Care Series

Posted on September 14, 2025 by Pat Neligan

Here are the first 9 Tutorials in the Series – the majority are useful for Anesthesiologists and Intensive Care practitioners. Every tutorial contains something that you may not have previously known: I guarantee, who ever you are, that you’ll learn something.

Tutorial 1: Saturated Vapor Pressure

Tutorial 2: The Gas Laws

Tutorial 3: Mixtures of Gases

Tutorial 4: The Alveolar Gas Equation

Tutorial 5: Henry’s Law

Tutorial 6: Carbon Dioxide Solubility

Tutorial 7: Oxygen Solubility

Tutorial 8: Oxygen Content of Blood

Tutorial 9: Oxyhemoglobin Dissociation

New Series – Fundamental of Anesthesiology – Gases and Vapors

Posted on July 24, 2025 by Pat Neligan

This is a new series on the Fundamentals of Anesthesiology – the first course is on Gases and Vapors. It should serve as a good introduction to the topic for early stage residents in Anesthesiology – but is also applicable in critical care and emergency medicine and nursing. For experienced practitioners it will be a straightforward refresher course – but I guarantee you’ll learn something.

First up I discuss the forgotten gas – water vapor – and why it is really important in our practice. The main concept that you must learn is the Saturated Vapor Pressure.

Clinical Forum – Western Anaesthesia Symposium 2025

Posted on June 16, 2025 by Pat Neligan

Here is a presentation that I gave at WAS in April – looking at the best papers that had been published in Critical Care up to that point in 2024-25.

A SHORT COURSE ON LOCAL ANESTHETICS

Posted on May 28, 2025 by Pat Neligan

I published 3 tutorials on Local Anesthetics this Month. These are part of a new series of Anesthesiology Tutorials.

Tutorial 1 looks at the basic pharmacology of local anesthetics

Tutorial 2 looks at the various different drugs that we use, the volume and concentration. I discuss the maximum safe doses at the end of the tutorial.

Tutorial 3 looks at the history of, the diagnosis of and the treatment of Local Anesthetic Systemic Toxicity (LAST)

Metabolic Acidosis in 2025 – More Important than Ever!

Posted on May 28, 2025 by Pat Neligan

This is a longer version of the lecture that I delivered at the 2025 College of Anaesthesiologists of Ireland Annual Scientific Meeting.

Anaphylactic Shock

Posted on April 3, 2025 by Pat Neligan

This tutorial, from the Introduction to Critical Care Series, looks at perioperative anaphylaxis. It covers topics that are relevant to practitioners in the OR, ICU, ED and wards.

Nutrition 3 – Timing and Route of Nutrition in ICU

Posted on March 19, 2025 by Pat Neligan

This HI-Impact tutorial looks at the common questions relating to commencement and route of nutrition in critical care. Is TPN good, bad or indifferent. Is enteral feed better than parenteral? When should we start feeding? Is it useful to add parenteral feed to enteral if the patients’ caloric goals have not been met? When should patients achieve their isocaloric goals. I guarantee you’ll learn something.

Acute Coronary Syndromes and Cardiogenic Shock

Posted on March 13, 2025 by Pat Neligan

This is a trio or tutorials on Acute Myocardial Ischemia, Acute Coronary Syndromes and Cardiogenic Shock.

Critical Illness Nutrition 2 – Calories, Protein, Enteral Route, Gastric Residuals

Posted on March 13, 2025 by Pat Neligan

This is the second tutorial in the nutrition series. Previously I looked at metabolism in critical illness. In this tutorial I start to answer many of the questions that arise on rounds principally: how many calories does the patient need? How much protein? What are the routes of food administration? Is there a benefit to post pyloric feeding tubes? Should I feed the stomach continuously or by bolus? Should I check gastric residual volumes? I provide you with the answers to these questions using the best available evidence.

Critical Illness Cachexia (metabolism in acute and chronic critical illness)

Posted on February 5, 2025 by Pat Neligan

Patients who spend significant time in critical care may lose a staggering amount of weight, particularly lean body mass. In early critical illness glucose is used as the principle energy source in the stress response; glycogen is rapidly exhausted and glycogenic amino acids are mobilized from muscular protein to generate glucose via gluconeogenesis, to maintain plasma glucose levels to feed, principally red blood cells. This has a major impact on muscle mass and in particular muscular strength, that may take years, perhaps a decade to restore. The most effective mechanism of preventing the development of critical illness cachexia is to curtail the duration of the stress response, by rapid source control, deresuscitation and early mobilization. In general, patients should be receiving full nutrition and be mobilized by day 8 following injury.