Abdullah AlSomali

[Abdullah AlSomali @AlSomali]

Great thread on Albumin

[Ashley Miller @icmteaching]

🧵 Albumin in Critical Care: 70 Years, 700 Papers… Zero Benefit

1/
Albumin is the most studied fluid in critical care.
Decades of trials. Endless meta-analyses.
And yet – not a single clinically meaningful benefit.

Here’s why the entire theory collapses once you understand Extended Starling. 👇

[Historic Vids @historyinmemes]

25 years ago today, the Sopranos gave us Pine Barrens, the greatest episode in TV history

[Sam Evans @SamEvansArt444]

25 years ago today Pine Barrens first aired.

[CineVow @cinevow]

Denzel Washington and Russell Crowe on the set of American Gangster, 2006

[Abdullah AlSomali @AlSomali]

@22Demarai @0xml2 كومبو جميل!

[Abdullah AlSomali @AlSomali]

@Qtr7077 Classic & sophisticated

[Abdullah AlSomali @AlSomali]

@SalmanFahad_j cuir de chine و rose de jamal اجمل عطرين في هذا البراند.

[Abdullah AlSomali @AlSomali]

@nickmmark @mac_eden Indeed no improvement in outcome both LINC & PARAMEDIC trials. LUCAS is a great logistical tool and a good cognitive offload in order to focus on reversible causes, POCUS, A.line and team dynamics.

[Abdullah AlSomali @AlSomali]

@hamood578 Apnic oxygenation

[Haney Mallemat @CriticalCareNow]

Intubation used to be a lot scarier 😱
Relying on a straight line of sight meant difficult anatomy often left you flying blind. Modern VL turns scary surprises into manageable procedures. Don't risk it—relying on your eyes alone is an unnecessary risk in 2026. #AirwayManagement

[Abdullah AlSomali @AlSomali]

@CriticalCareNow Couldn’t agree more that normal geometry VL should be standard of care it would optimize first pass success enormously.

[Josh Farkas MD 💊 @PulmCrit]

Fresh blog: Six reasons to stop relying on the NPi (neurological pupil index)

👁️ NPi is based on a secret, proprietary formula used by one company

👁️ The neuroICU field was somehow convinced that we're too stupid to understand pupillometry tracings, so we need the NPi...(#1/2)

[Josh Farkas MD 💊 @PulmCrit]

Antibiotics probably aren’t beneficial for patients with cirrhosis & GI bleeding

It will take time to change practice on this, but this is probably ripe for some antimicrobial stewardship

The idea that a few doses of ceftriaxone improve *mortality* in GI bleed was always sus…

[Skyler Lentz @SkylerLentz]

What’s optimal PEEP for your patients with an increased BMI?

Our study showed a simple equation you can use:

PEEP = BMI/3

There’s variability, but BMI/3 approximates the mean optimal PEEP (by esophageal manometry) from BMI 25 to > 40

#foamcc

https://t.co/qwHioxtP6H

[IMCrit @IM_Crit_]

Albumin (A) replacement therapy in septic shock

In a multicenter RCT, 440 pts w septic shock were treated w A aiming to keep serum A >3.0 g/dL or w standard fluid therapy. 90-day mortality did not differ between the A group (43.3%) & controls (45.9%)

https://t.co/aVOvAW9n13

[Joel M. Topf, MD FACP @kidney_boy]

Poor guy died because the doctor had been fooled into the myth of contrast nephropathy. When death is on the
Iine, fuck the kidneys.

[Paul Wischmeyer MD @Paul_Wischmeyer]

Do you feed ICU patients on vasopressors? Evidence says it can be safe—and lifesaving when patients are adequately resuscitated.
🆕 New paper online today in @SurgicalClinics

Key points 👇
• Vasopressors ≠ automatic contraindication to enteral nutrition
• Dose, stability, and trends matter more than presence alone
• Early trophic EN is reasonable once resuscitated
• Close monitoring for intolerance is essential
• PN remains critical when EN isn’t safe or feasible

Not “feed everyone early” ❌
Feed the right patient, at the right time, the right way ✅

How do you approach feeding patients on pressors in your ICU?
Protocol-driven or individualized?

Read the full paper: https://t.co/GEQi7cqSlt

#ICUNutrition #FOAMcc #ICURehab
@ICUnutrition @YukiKotani5

[Pulmonary-POCUS @HoosierPocus]

Check out trial bites
Each week, trialnites will post digestible, bite-sized information on a pivotal trial on an ICU topic, such as ARDS, sepsis, pressors, and more! Each topic will contain five weeks of trial summaries before transitioning into the next one. @NephroP @PulmPEEPs

https://t.co/yZDenjDy9o