Launching CritiTAR: Navigating the grey zones of critical care.
My inaugural deep-dive: "The IVC Delusion" — moving from measuring a vessel to understanding a system.
Read & Subscribe: https://t.co/KZGyYO13aL
Think. Analyze. Reflect.
#FOAMed#POCUS#IntensiveCare#MedEd
@NivaBupaSupport@Niva_Bupa@BupaNiva@NivaBupaSupport
Can someone respond at the earliest? The delay is from your side if at all in responding and in addition with due date still away increasing premium doesn't make sense
@NivaBupaSupport I have a premium payment notice with invoice sent via email early this month, due July 4th. Without further notice and lot of time still left for due date why did the premium increase? I got a call once and they said they would revert. Still waiting.
The neuro-ICU reflex: Post-thrombectomy systolic hits 180, start the antihypertensives. 🛑
But are our rigid BP algorithms actually starving the penumbra?
New data is reframing the entire approach. 🧵👇
🔗 https://t.co/xDJFQ0E9Kk
#NeuroICU#MedTwitter
Enter the HOPE trial. We need to move from a universal BP ceiling to a precision, reperfusion-stratified range (using vasopressors to protect the floor!).
The question is no longer how low BP should go. It’s identifying which brain needs which pressure. #foamcc#NeuroICU#Stroke
We looked at the trials (ENCHANTED2/MT, OPTIMAL-BP). Intensive lowering has consistently failed.
Worse, aggressive lowering creates physiological instability that worsens functional outcomes without actually preventing the haemorrhages it was meant to avoid.
@BupaNiva@NivaBupaSupport why is my premium amount changing even before the due date? Just a week prior you release a payment invoice and now the app reflects another payment premium claiming inflation?
@stephanamayer Great work on HOPE! With strict SBP (100-140) benefiting TICI 2c/3, it contrasts the harm seen in Hashmi & ENCHANTED2. Since HOPE excluded >50% stenosis, must we now stratify post-EVT targets by BOTH reperfusion status AND vessel pathology (ICAD vs Embolic)? #NeuroTwitter
The HOPE Trial
Does personalized BP control after EVR (<160 for TICI 2B and <140 for TICI-2C/3) improve outcome compared to standard of care (SBP <180)?
Yes -- a 13% absolute increase in favorable outcome (mRS 0-2) and a 9% absolute decrease in hemorrhagic transformation.
Is this a new standard of care? Let us know what you think!
Personalized Blood Pressure Targeting After Endovascular Therapy for Acute Ischemic Stroke https://t.co/4GpqbfJ4hQ
@stephanamayer just went through your post on the HOPE trial. What's your take on going by reperfusion score and individualizing especially with large core strokes.
ATLAS strengthened case for EVT in large-core LVO. After TICI 2b/3 reperfusion in ASPECTS 3–5 patients, what SBP target are you using? We accept SBP 140–180 mmHg post-EVT, but does that remain appropriate in the setting of extensive infarction and greater reperfusion injury risk?
Ee Sala Nu Cup Namdu! ❤️🔥🏆
Welcome to the RCB Era, ladies and gentlemen! 😎
You waited, you believed and you stayed… this one’s for you again, 12th Man Army! 🥹❤️
#PlayBold#ನಮ್ಮRCB#IPL2026
At the End of the Bed is a short piece about the space between the machines and the patient. An honest look at the gray zone they enter when we have done everything, but they still slip through.
https://t.co/zTBe2XVsm6
#CriticalCare#ICUstories