ScvO2 is extremely imprecise & noisy (if you do the math and look at the data).
The reason that ScvO2 has been around forever and few people use it is that it’s unreliable.
We tried to stomp it out a decade ago.
Math & data here: https://t.co/iCdhf6z79t #2/2
"Drink more water!" It's the easiest health advice around. Tired? Headache? Trying to be like Tom Brady? Just drink more water. But as a nephrologist, I get asked all the time: How much is the right amount? And the truth is... we don't really know. 🧵
Relaxed potassium supplementation (threshold 3.6 mEq/L) post-CABG surgery is noninferior to tight control (4.5 mEq/L) in preventing atrial fibrillation after cardiac surgery, potentially reducing costs & patient risks. https://t.co/rPSfoaORbl
#ESCCongress
It takes an epidemiologist to link fluoride intake in pregnant women to neurobehavioral problems in kids... but it takes a nephrologist to explain why urinary fluoride is not a good proxy for intake.
Thread on the new @JAMANetworkOpen study...
With tremendous joy, I share that our patient who received a gene-edited pig kidney transplant was discharged home today after removal of his dialysis access. We hope that this is a first step that will bring hope to many patients waiting for a kidney transplant #xenotransplant
“Lactic acidosis” is incorrect because conversion of glucose to lactate is not acidifying and the increased proton production responsible for metabolic acidosis in hyperlactatemia results from ATP hydrolysis without ability to consume protons in oxidative phosphorylation
@NephRodby Potentially total sodium excretion could be more important than total urine volume. Interesting and novel concept. UNa is cheap and easy to get. I’m looking forward to further studies!
@Rampradeep470@divya_kondapi@drmohansai BUN 69 to Cr 3.3 Congestion was a thought but he is not in cardiogenic shock. Well perfused, on room air, lactate just 3
50M w TEE cardioversion (EF 30-35%) placed on Multaq c/o malaise after 2 days. No encephalopathy. Found to have AST 12K ALT 7K INR >8.5. Cr 3.5 Normal LFTs 3 months prior. No alcohol, No Tylenol, no OTC/supplements, hepatitis panel neg, liver Doppler. Other causes??@theliverdoc
@AaronGoodman33 @Dr_Oubre Had this exact exchange today! Being told to downgrade people from the ICU like we don’t think about that for every patient, everyday, multiple times a day
I’m usually decent at this acid/base stuff but I can’t get this one: Elderly male pt with HIV, ESRD in the ICU with IE. pH 7.54, PCO2 36, calculated bicarb 31, however, measures is 21. Where is the alkalemia coming from? #askrenal