Ahmed T Abdellah

Cardio/CC friendly nephrologist. In love with POCUS, cardiorenal & critical care medicine. Tweets reflect my own personal opinion

[Ahmed T Abdellah @MynephCC]

#_POCUS
Few tips for learning POCUS for beginners like myself
1- it is very steep learning curve & long journey.
2- pick up one source & keep watching it over & over again. Youtube has lot of them
3- POCUS has 3 parts: image acquisition, interpretation & clinical integration

[Ahmed T Abdellah @MynephCC]

@rudyunni I don't have a definitive answer, and I really appreciate everyone's opinions.

[Ahmed T Abdellah @MynephCC]

What is your explanation for this HVD
pt : EF 65% severe torrential TR

[Ahmed T Abdellah @MynephCC]

Good to see some hospitals taking TED ( Timed Early Diuretic) Pathway to guide and titrate up initial diuretic dose based on Spot Urine Sodium. It is an Epic Order Set. They use Bumex here.

[Ahmed T Abdellah @MynephCC]

@SVRaoMD @KadoshBernard @SCAI @CMichaelGibson @SripalBangalore @ThinkingCC

[Ahmed T Abdellah @MynephCC]

@NephroP I think that above 2000 cc, the swinging-heart effect degrades the accuracy of the measurement, which is why you see the correlation loosen 🤔

[Ahmed T Abdellah @MynephCC]

@BaniowdaMuath Congrats. I have no doubt you will ace it

[Ahmed T Abdellah @MynephCC]

@NephroP @MDBeni @icmteaching @IM_Crit_ @ross_prager @khaycock2

[Ahmed T Abdellah @MynephCC]

@IM_Crit_ I think knowing baseline cardiac function would be so helpful (or should be a requirement)before using Dobutamine especially in heterogenic septic population and particularly when continuous, advanced hemodynamic monitoring is unavailable..

[Ahmed T Abdellah @MynephCC]

@ThinkingCC @khaycock2 Relatively narrow PP (32), and variable pleth. it sounds more of interface 2 issue. Still need to know CVP and RV status

[Ahmed T Abdellah @MynephCC]

@argulian Here is how I see it

[Ahmed T Abdellah @MynephCC]

@IM_Crit_ "hospital policy" & "Patient safety"

[Ahmed T Abdellah @MynephCC]

@icmteaching @NephroP @IM_Crit_ @ross_prager @ThinkingCC midodrine is the neph favorite vasopressor

[Ahmed T Abdellah @MynephCC]

What is your take on this device:
I have recently POCUSed pt with hypotension(78/45). Already had 2 L NS. On my POCUS exam: hyperdynamic LV with LVOT VTI 22 , ROVT VTI 18 , no WMA, IVC collapsible, Lung A-Lines. RN came with this device & said he is not fluid responsive

[Ahmed T Abdellah @MynephCC]

@NephroP @IM_Crit_ @ross_prager @ThinkingCC @icmteaching

[Ahmed T Abdellah @MynephCC]

When are you going to start Vasopressors ?
I said, I am not. Based on history it is hypovolemia+ BP med use. no evidence of sepsis. I ordered a dose of midodrine & closed the chapter. it fixed the problem.
Do you trust this Cheetah on your pt in making decisions ?

[Dr G Rajesh (Gopalan Nair Rajesh). @DrRajeshG1]

For fellows. Colour M mode through hepatic vein. Finding?

[Ahmed T Abdellah @MynephCC]

@icmteaching @IM_Crit_ @iamritu @NephroP @intensivaev @MDBeni

[Ahmed T Abdellah @MynephCC]

MAPSE, also known as "poor man strain", correlates well
with LVLS

[Ahmed T Abdellah @MynephCC]

@LeslieMegom Thank you so much for sharing these useful tips.
just wanted to share this fig from https://t.co/tQGf7AXsnn
TAPSE/PASAP ratio ( cutoff 0.31) correlated with RVOT VIT and PAAT even more correlated with RVOT VTI.