Claudia Castillo Zambrano

🇪🇨 MD @uees_ec | Internal Medicine PGY-2 @imdartmouth | coffee enthusiast ☕️ | interested in PCCM | my opinions are my own

[Jason Ryan @jasonryanmd]

I like teaching high-achieving students, but my favorite students are the overwhelmed, anxious, average to below-average learners who doubt themselves. Medicine doesn’t need doctors steeped in self-doubt. My favorite compliment you is: "You helped me believe I could do it."

[Ross Prager @ross_prager]

https://t.co/1RiF6qGFQG

[IMCrit @IM_Crit_]

Life in the #ICU is not always fun...

#MedTwitter

[NephroPOCUS @NephroP]

. @FH_Verbrugge says, pulse pressure is cheap man’s 🦢
Great talk on #heartfailure - #HR2025 Hospitalist side

[IMCrit @IM_Crit_]

The Dunning-Kruger effect:

#foamcc #foamed #meded #MedTwitter

[Critical Care Medicine @CritCareMed]

🔍 New Study: Initial fluid resuscitation with lactated Ringer’s solution, compared with 0.9% saline, might be linked to improved outcomes in patients with sepsis-induced hypotension.

➡️ Read the research from CCM: https://t.co/W0Zl9xPiGv

#sepsis #SCCM #CritCareMed @SCCM

[Christine Lynn Chen, MD @PristineThinPen]

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I still vividly remember what it was like to be an intern — the fear and uncertainty of stepping into the role of “doctor” for the first time. So I drew this comic series to reflect on things I’d tell a younger version of myself (patient story generalized for confidentiality)

[Claudia Castillo Zambrano @ClaudiaCastZ]

Intern Report during Academic Half Day with this rockstar @imalliesheridan #improud @imdartmouth

[Michael Justus @mhjrad]

submitting a case report

[IMCrit @IM_Crit_]

ICU Hemodynamic Secrets – The role of ScvO2:

There is not such a thing as a “normal” cardiac output (CO). A CO of 3.5 l/min may be adequate for a 90 years’ old, 100 pounds sedated patient but inadequate for a 40 years’ old, 250 pounds patient with septic ARDS. Ideally,

[Claudia Castillo Zambrano @ClaudiaCastZ]

@NephCCM El punto no es perfección, es transparencia y honestidad. Mientras sea vox populi que eso faltó durante muchos años, no confiaré en aquellos que esta demostrado utilizaron el dinero de impuestos para su enriquecimiento ilícito sin hacerse responsables.

[Michael Justus @mhjrad]

warming up before internal medicine rounds

[JAMA @JAMA_current]

This JAMA Clinical Guidelines Synopsis summarizes the 2024 Society of Critical Care Medicine guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia.

https://t.co/MrFIHsGxXR

[Adam Rodman @AdamRodmanMD]

There is a lot of buzz about our new paper in Nature Medicine on the effects of LLMs (GPT-4) on physician management reasoning! I had TONS of fun working on this -- but what it MEANS requires some unpacking.

A 🧵⬇️
https://t.co/yLZJw1U5IE

[Allison Fitzgerald, MD, PhD @allisonoconn]

The amount of delusion I have putting on sunscreen everyday as a resident. This skin does not see the light of day.

[Critical Care Reviews @CritCareReviews]

A Rational Approach to the Treatment of Acute Pulmonary Embolism

CCR Journal Watch
https://t.co/Sp06oA6IDG

Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at https://t.co/nitMzacLrj

[Matt Frederickson, MD @mattyfred_]

There should be a medical tv show but it’s about a resident on call at night, and it’s esthetically themed like a film noir

[Allison Fitzgerald, MD, PhD @allisonoconn]

I had a med student once ask “will rounds always take so long?” after we finished at 11am. I truly hope they’re now thriving in the surgical subspecialty of their choice.

[Patrick Wieruszewski @pwierusz]

Intravenous vasopressor infusions are amongst the most common pharmaceuticals we use in critical care medicine - 1 in every 4 patients admitted to ICU receive them.

Are “oral pressors” here to replace them?

🧵Read below for our take on available evidence and the ongoing pursuit that is to reduce the burden of IV vasopressors 👇🏼
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