Case set 03: educational synthesis

Educational work by a pre-medical student — not medical advice. Not a clinical protocol, prescription, or patient handout, and not for patient care. See DISCLAIMER.

Revised 27 October 2026. This summary follows the corrected case bank. It supplies no separate medication, device or escalation instructions.

Scenario 1: CABG with vasoplegia, hypothermia and bleeding. A preserved EF does not exclude important low-output physiology, and hypothermia should not be assumed to cause vasodilation.
Scenario 2: VA-ECMO with rising lactate. A transmembrane gradient alone is not an oxygenator-change rule; interpretation belongs to the ECMO team.
Scenario 3: LVAD with RV dysfunction. Device alarms and displayed flow do not establish a unique diagnosis or universal speed adjustment.
Scenario 4: ARDS after supination. A mode switch alone does not cap injurious lung stress. No universal pH or driving-pressure trigger for ECMO is prescribed.
Scenario 5: Aortic repair with new pain and oliguria. This is a prompt for urgent expert evaluation, not a sequence of fluids followed by imaging only if a numerical target fails.
Scenario 6: Early lung-graft dysfunction. No graft diagnosis, PEEP range or ECMO threshold follows from this short vignette alone.
Scenario 7: Abdominal sepsis with refractory shock. Laboratory values and positive balance do not alone establish a dialysis indication or an ultrafiltration rate.
Scenario 8: SAH with cardiac dysfunction. A preselected MAP or sodium range is not a validated plan for every SAH patient.

Reflection

For each scenario, separate observed fictional facts from hypotheses; identify missing data; explain one alternative mechanism; and cite a source with its population and limits. Do not treat a successful exercise as clinical competency or institutional approval.