All right, welcome back to the Internet Book of Critical Care podcast. I'm here with Adam Thomas,

and we're going to talk about Scape or sympathetic crashing acute pulmonary edema.

Josh, it's been a minute. How are you doing? I'm hanging in there, man. How are you?

Living the dream. Just took me to get a little rona infection

to boost my immunity to slow me down, eh? Yikes. So now I get some time to work on this again. So I

apologize to everybody. Josh, in his finest, has always been quite productive. I don't know how he does it.

He's a beast. But Josh, we picked a fun, fun topic today because it's one of those things that's really,

really dramatic, but we can turn it around really quick, can't we?

Yeah.

Usually.

Yeah.

Scape is widely beloved, I think, by resuscitationists for that very reason.

So today we'll talk about Scape versus Sub-acute Pomeradema.

We'll talk about the triggers.

Our principles, namely non-invasive support, afterload reduction,

treating symptoms, improving forward flow, and then how to get the total volume down if that's

the problem. So Josh, coming into this, I guess let's talk about the causes of this and the pathophysiology,

because if you blow a valve, we're not really going to make

that better with this management. But that's not the patient we're trying to talk about is that we're

trying to talk about too much vasoconstriction. They're sympathetically driven. And we can intervene in

this spiral of death. Exactly. So the vicious spiral of escape basically involves folks get some

pulmonary dema going on and that causes

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