Thrombocytopenia is a common laboratory finding in critically ill patients admitted to the intensive care unit. Potential etiologies of thrombocytopenia are myriad, ranging from acute disease processes and concomitant conditions to exposures and drugs. The mechanism of decreased platelet counts can also be varied: laboratory measurement may be spurious, platelet production may be decreased, or platelet destruction or sequestration may be increased. In addition to evaluation for the cause of thrombocytopenia, the clinician must also guard against spontaneous bleeding due to thrombocytopenia, prophylax against bleeding resulting from an invasive procedure performed in the setting of thrombocytopenia, and treat active bleeding related to thrombocytopenia.

Respirable toxicants are a spectrum of irritant and nonirritant gases, vapors, fumes, and airborne particles that can be entrained into the body through the respiratory tract, resulting in exposures that cause pulmonary injury and/or systemic disease. Sources of respirable toxicants include structural fires, industrial accidents, domestic mishaps, and intentional releases of injurious agents on the battleground (warfare) or in civilian settings (acts of terrorism). Acute toxic inhalational exposures may result in respiratory failure, multisystem organ dysfunction, and death. Management of victims includes assessment and protection of the airway, monitoring and treatment of systemic toxicity, and delivery of exposure-specific and nonspecific therapies that improve outcomes. Treatments may include antidotes, hyperbaric oxygen, and other nonspecific life-supporting interventions.

The prevalence of subcentimeter pulmonary nodules is on the rise due to widespread use of multidetector row computed tomography. These lesions have created a new set of challenges for patients and their physicians. Such nodules are poorly characterized by imaging tests and are difficult to biopsy. Fortunately, the available data suggest that the vast majority of such nodules are benign in etiology. However, this increases the challenge to provide a cost-effective evaluation that minimizes unnecessary radiation exposure and complications from invasive biopsies while promptly identifying malignancy when it is present. In this review, we summarize the current available literature regarding subcentimeter nodules, as well as the current recommendations regarding their investigation.