I'm at a point of great confusion at this time. My father is 74 and a heart/kidney/liver patient. I do his hemodialysis at home 5x per week. He began dialysis the last week of 2014. He had a first ever outbreak of shingles on his upper right leg which is belived to have infected his blood. As I key this, my dad is in the ICU. H did not have dialysis for a full week. He was intubated for about 48 hours so he's fluid overloaded and his mentation is off. He was diagnosed as being in septic shock and MRSA. He's received zosyn and vancomycin. Also has very low dose pressors going - vasopressin & levo. He is receiving crrt pulling 200ml/hr. All of his fluid swelling is gone. He's making small improvements by the day. He understands what is said tk him, he responds with correct answers, he's just a bit loopy. zi feel like there's something I can do to help but I don't know what. Palliative care called me today to discuss plan of care going forward. No one thinks he's yet reached hospice level but clearly, anything is possible. Does anyone have any thoughts or ideas?
great post thank you. Does that mean we should not start Rifaximin for all cases of HE that is grade 2 or higher
Yes correct that means, its difficult to identify HE grade 1, and Rifaximin to be given as second line to recurrent HE.
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I'm at a point of great confusion at this time. My father is 74 and a heart/kidney/liver patient. I do his hemodialysis at home 5x per week. He began dialysis the last week of 2014. He had a first ever outbreak of shingles on his upper right leg which is belived to have infected his blood. As I key this, my dad is in the ICU. H did not have dialysis for a full week. He was intubated for about 48 hours so he's fluid overloaded and his mentation is off. He was diagnosed as being in septic shock and MRSA. He's received zosyn and vancomycin. Also has very low dose pressors going - vasopressin & levo. He is receiving crrt pulling 200ml/hr. All of his fluid swelling is gone. He's making small improvements by the day. He understands what is said tk him, he responds with correct answers, he's just a bit loopy. zi feel like there's something I can do to help but I don't know what. Palliative care called me today to discuss plan of care going forward. No one thinks he's yet reached hospice level but clearly, anything is possible. Does anyone have any thoughts or ideas?