CICM Fellowship interactive diagrams

Frank-Starling curve + Nephron + diuretic sites + Renin-angiotensin-aldosterone system — Manage low cardiac output states using pharmacological support (dobutamine, milrinone, levosimendan) and mechanical circulatory support; describe criteria for escalation to cardiac transplantation or LVAD bridge

Frank-Starling curve — Describe the pharmacology and clinical indications for vasopressors (noradrenaline, vasopressin, metaraminol, phenylephrine) and inotropes (adrenaline, dobutamine, milrinone); and outline the approach to refractory vasod…

Lung + chest wall compliance (Campbell diagram) + Mechanical ventilation modes — Apply the Berlin definition of ARDS; describe lung-protective ventilation (low tidal volume 6 ml/kg PBW, plateau pressure <30 cmH2O, PEEP titration using PEEP-FiO2 tables) and the evidence from ARDSNet; and outline rescu…

Mechanical ventilation modes — Describe the mechanisms of ventilator-induced lung injury (barotrauma, volutrauma, atelectrauma, biotrauma); apply strategies to minimise VILI in clinical practice; and outline the pathophysiology of dynamic hyperinflati…

Mechanical ventilation modes — Select and apply modes of mechanical ventilation (VC-AC, PC-AC, PRVC, SIMV, PSV); adjust ventilator settings based on respiratory mechanics; and recognise and manage patient-ventilator dyssynchrony (double triggering, re…

Mechanical ventilation modes — Apply a systematic approach to weaning from mechanical ventilation including daily spontaneous breathing trials (T-piece vs PSV), extubation readiness assessment (RSBI, cough strength, secretion management) and post-extu…

Mechanical ventilation modes — Describe the evidence base for non-invasive ventilation (CPAP, BiPAP) in acute hypercapnic respiratory failure (COPD), cardiogenic pulmonary oedema and immunocompromised patients; and outline criteria for NIV failure and…

Coagulation cascade — Describe the circuit configuration of venovenous (VV-ECMO) and venoarterial (VA-ECMO) ECMO; manage the anticoagulation strategy (heparin, ACT, anti-Xa targets); and outline the approach to ECMO weaning and decannulation

Oxygen cascade — atmosphere to mitochondrion — Apply the physical principles of ECMO: oxygenator gas exchange (sweep gas governs CO2 clearance; blood flow and FdO2 govern O2 delivery), recirculation in VV-ECMO (definition, measurement, mitigation), pre- vs post-membr…

Mechanical ventilation modes — Manage severe asthma in the ICU including inhalational bronchodilators, IV salbutamol, IV magnesium, ketamine and the principles of ventilation in status asthmaticus (permissive hypercapnia, high PEEP limitation)

Mechanical ventilation modes — Manage COPD exacerbation in the ICU including controlled oxygen therapy (target SpO2 88–92%), nebulised bronchodilators, systemic corticosteroids, NIV (BiPAP) and the management of dynamic hyperinflation on mechanical ve…

Nephron + diuretic sites + Acute kidney injury staging — Apply the KDIGO AKI staging criteria in the ICU; differentiate pre-renal, intrinsic renal (ATN, GN, interstitial nephritis) and post-renal causes; and outline the principles of AKI management including fluid optimisation…

Coagulation cascade + Acute kidney injury staging — Compare the modalities of CRRT (CVVH, CVVHD, CVVHDF) with intermittent haemodialysis; prescribe CRRT (dose, fluid balance, anticoagulation — systemic heparin vs regional citrate); and describe the criteria for RRT cessat…

Nephron + diuretic sites + Renin-angiotensin-aldosterone system — Apply a systematic approach to hyponatraemia and hypernatraemia in the ICU; diagnose and manage SIADH (fluid restriction, vasopressin antagonists); and describe the management of central and nephrogenic diabetes insipidu…

Nephron + diuretic sites + Renin-angiotensin-aldosterone system — Manage life-threatening hyperkalaemia in the ICU (calcium gluconate, insulin-dextrose, salbutamol, sodium bicarbonate, RRT) and hypokalaemia (replacement rate, ECG monitoring); and apply the approach to refractory hypoka…

Davenport acid-base diagram + Anion gap and delta ratio — Apply the Henderson-Hasselbalch equation to complex acid-base disorders; use the Stewart approach (SID, SIG, ATot) where appropriate; and diagnose and manage metabolic acidosis (anion gap, delta ratio, normal AG) and alk…

Acute kidney injury staging — Apply strategies to prevent contrast-associated AKI (volume expansion, N-acetylcysteine, iso-osmolar contrast); describe the management of aminoglycoside and vancomycin nephrotoxicity; and outline cisplatin and amphoteri…

Cerebral autoregulation (CBF vs MAP / PaCO₂ / PaO₂) + Monro-Kellie intracranial volume + ICP curve — Apply the BTF guidelines for severe traumatic brain injury; manage ICP using a tiered approach (HOB 30°, osmotherapy, CSF drainage, CRANIECTOMY); describe CPP targets; and outline multimodal monitoring (ICP, PbtO2, TCD, …

Cerebral autoregulation (CBF vs MAP / PaCO₂ / PaO₂) + Monro-Kellie intracranial volume + ICP curve — Manage spontaneous intracerebral haemorrhage in the ICU including reversal of coagulopathy, blood pressure targets (INTERACT2 data), surgical decompression criteria and ICP management

Spirometry — V-t + flow-volume loop — Manage Guillain-Barré syndrome in the ICU including respiratory monitoring (FVC, NIF thresholds for intubation), IVIG vs plasmapheresis; and describe critical illness polyneuropathy and myopathy recognition and managemen…

Coagulation cascade — Diagnose DIC using ISTH scoring (platelets, PT, fibrinogen, D-dimer, soluble fibrin monomers); describe the management of bleeding DIC (FFP, cryoprecipitate, platelets) and thrombotic DIC; and distinguish from other caus…

Coagulation cascade — Apply the 4T score for HIT type 2; confirm with PF4-heparin antibody ELISA and serotonin release assay; describe cessation of heparin and initiation of alternative anticoagulation (argatroban, danaparoid, fondaparinux); …

Coagulation cascade — Describe the anticoagulation strategy in the ICU including unfractionated heparin (infusion, APTT monitoring), LMWH dosing in CKD, DOACs and reversal agents (idarucizumab, andexanet alfa, PCC); and outline anticoagulatio…

Iron homeostasis — Apply BCSH guidelines for blood product transfusion in critically ill patients; describe the restrictive transfusion strategy (TRICC trial, Hb threshold 70 g/L); and manage acute haemolytic transfusion reactions, TRALI a…

Glucose homeostasis — Manage DKA in the ICU (ADS (Australian Diabetes Society) / eTG adult DKA protocol: fixed rate IV insulin 0.1 units/kg/hr, NS resuscitation, potassium replacement); describe the management of HHS (slower correction, antic…

Glucose homeostasis — Apply the NICE-SUGAR trial glucose targets (6–10 mmol/L) in ICU; describe continuous insulin infusion protocols; and manage hypoglycaemia as a healthcare complication

Hypothalamic-pituitary-adrenal axis — Diagnose critical illness-related corticosteroid insufficiency (CIRCI) using random cortisol and the cosyntropin test; describe the hydrocortisone dosing regimen in vasopressor-dependent septic shock (APROCCHSS/ADRENAL t…

Cerebral autoregulation (CBF vs MAP / PaCO₂ / PaO₂) + Monro-Kellie intracranial volume + ICP curve — Manage severe TBI in ICU applying BTF guidelines: ICP < 22 mmHg, CPP 60–70 mmHg, tier 1 (HOB, sedation, normocapnia) to tier 3 (barbiturate coma, decompressive craniectomy) interventions; and interpret multimodal neuromo…

Acute kidney injury staging — Describe the pathophysiology, diagnosis and management of rhabdomyolysis (forced diuresis, urinary alkalinisation, haemodialysis for refractory hyperkalaemia); and outline crush syndrome management in mass casualty incid…

Glucose homeostasis — Manage calcium channel blocker and beta-blocker toxicity in the ICU using high-dose insulin euglycaemic therapy (1–10 U/kg/hr), lipid rescue emulsion (intralipid), vasopressors, glucagon and VA-ECMO as rescue

Lung volumes & capacities + Mechanical ventilation modes — Describe the physiological adaptations of pregnancy relevant to ICU care (increased CO, reduced FRC, altered drug pharmacokinetics, hypercoagulable state) and their implications for mechanical ventilation and drug dosing

Train-of-four monitoring — Describe the indications for neuromuscular blockade in the ICU (ventilator dyssynchrony, severe ARDS — ACURASYS data, tetanus, ICP management); outline train-of-four monitoring; and describe the management of ICU-acquire…

Train-of-four monitoring — Describe neuromuscular blockade monitoring and complications — train-of-four with a peripheral nerve stimulator (target T1–T2 of 4), choice of agent (cisatracurium vs rocuronium, reversal with sugammadex), depth of paral…

Acute kidney injury staging — Apply dose adjustment principles for renally cleared drugs in AKI and during CRRT; describe drugs requiring hepatic dose reduction; and apply the principles of drug dosing during ECMO (increased Vd for lipophilic drugs, …

Acute kidney injury staging — Manage electrical and lightning injury in the ICU including mandatory cardiac monitoring, management of rhabdomyolysis and AKI, fasciotomy for compartment syndrome; and describe the delayed presentations