ABA Critical Care case studies
ABA Critical Care · Put your knowledge to work in context.
The Critical Care Medicine Exam is one of the subspecialty examinations offered by the American Board of Anesthesiology (ABA). The ABA lists it among its subspecialty exams, alongside adult cardiac anesthesiology, health care administration, leadership and management, hospice and palliative medicine, neurocritical care, pain medicine, pediatric anesthesiology, and sleep medicine, and it describes subspecialty certification as a way for diplomates to go further into multidisciplinary fields after initial certification. The ABA Critical Care case studies are 5 cases and about 4,006 words.
1Severe ARDS in a patient with class III obesity: tidal volume, driving pressure, and when to prone
62-year-old man, BMI 44 kg/m², day 3 of ARDS from influenza pneumonia. Sedated, RASS −4, on volume-control ventilation: tidal volume 480 mL, rate 24, PEEP 14 cm H₂O, FiO₂ 0.70.
831 words, about 4 min2Mixed cardiogenic and septic shock after NSTEMI: choosing an inotrope and judging fluid responsiveness
71-year-old woman, day 4 after an NSTEMI with LVEF 28%. She is now febrile to 38.9 °C, with MAP 62 mmHg on norepinephrine 0.30 µg/kg/min, heart rate 112 in sinus rhythm, CVP 17 mmHg, cardiac index 2.0 L/min/m², SVR 780 dyn·s·cm⁻⁵, ScvO₂ 58%, lactate 5.2 mmol/L and urine output 15 mL/h.
784 words, about 4 min3Hyperchloremic acidosis and AKI after massive saline resuscitation: what to buffer and when to dialyse
58-year-old man, day 3 after emergency laparotomy for perforated sigmoid diverticulitis. Creatinine 3.4 mg/dL (baseline 1.0), urine output 20 mL/h, norepinephrine 0.05 µg/kg/min.
744 words, about 4 min4Day 4 of septic shock: antibiotic de-escalation and de-resuscitation in a patient who is now fluid-overloaded
66-year-old woman, day 4 of septic shock from ascending cholangitis treated with ERCP and a biliary stent. Norepinephrine was stopped 12 hours ago; MAP 72 mmHg, lactate 1.4 mmol/L (from 6.0), creatinine 2.1 mg/dL (baseline 1.2).
754 words, about 4 min5Catastrophic intracerebral haemorrhage: a written directive, a divided family, and a request for tracheostomy and PEG
79-year-old woman, day 3 after a 40 mL right basal ganglia haemorrhage. She is intubated with GCS 5 (E1 V1 M3), no eye opening, no verbal output, and no motor response other than extension to pain; brainstem reflexes are present.
893 words, about 4 min