There is a lot we don't know, and hopefully we will learn through this pandemic, but there are some things we do know:
1. 100% FiO2 is not good
2. doubling your resting volume is bad
3. high trans pulmonary pressure is bad
4. spontaneous breathing leading to #2 and #3 is bad
🚨 Exciting new episode of @CritCareTime about AIRWAY CONTROVERSIES out now!
We go DEEP into several controversies in airway management:
1️⃣Preox: NIPPV vs HFNC
2️⃣Paralytic: Rocuronium vs Sux
3️⃣Induction: Etomidate vs Ketamine
4️⃣Scope: VL vs DL
And much more!
1/
For anyone interested in airway management in the critically ill patient, particularly the ICU patient, consider giving this book a read. It's been out for about a month now, and I hope you find it helpful.
https://t.co/pf2WBJiYP0
@JohnCSakles Also, kind of an odd metaphor if you think about the origin of the term. Gaius Julius crossed the rubicon and defeated his rival to become Julius Caesar, one of the most famous leaders of all written history.
I’m all for VL Caesar!
Outcomes in Patients with Acute Hypoxemic Respiratory Failure Secondary to COVID-19 Treated with Noninvasive Respiratory Support versus Invasive Mechanical Ventilation https://t.co/sHwCOzyJYk #medRxiv
I mean, if we are going to throw all the saline out because of a high probability that 0-1% difference in mortality or MAKE30 is clinically meaningful, then going with VL every time should be a no-brainer.
1/ We just published our full @Cochrane_ACE systematic review and meta-analysis of videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation.
The full review is here, but first - some of our key takeaways 👇
https://t.co/HxzXhF83ZB
Oct 24-30 is Respiratory Care Week. So congratulations to Dr. Jarrod M Mosier of the University of Arizona Tucson -- Recognized as an Expertscape World Expert in Intratracheal Intubation.
https://t.co/X8V1HudMqV
4. A person with the right Social media platform can do an extraordinary amount of damage.
5. If you’re trying to build your social media brand, be careful who you hitch your wagon to.
6. Fame is a hell of a drug.
There are a few lessons in this entire debacle:
1. What makes you great may also be your undoing.
2. Believing in something hard enough doesn’t make it true.
3. Gaslighting will eventually burn you.
The Marik MATH protocol study was just retracted because of major stats errors: they thought mortality was 6%; it was actually 28%
Its reasonable to wonder about another underproduced Marik study: the 2017 @accpchest study at the same hospital showing that vitamin C cures sepsis