Pedro Mansur

Médico #FOAM

[Vitor Borin P. de Souza @vitorborin_]

Please stop using composite endpoints within composite endpoints.

Stop including outcomes of little importance/reliability in the composite.

Or at least, do not spin your conclusions by implying that all components were reduced when the overall result was driven by just one.

[Peter Johns M.D. @PeterJohns84]

@prahladnb HINTS exam is not a stroke screen. It's to determine if patients with persistent dizziness/vertigo and nystagmus at rest have vestibular neuritis or a stroke. Using HINTS on patients without nystagmus at rest will give many falsely concerning results.

[Stephen W. Smith @smithECGBlog]

Just published Ed and European Hart Journal Acute cardiovascular Care

@PMcardioApp @josenalencar @ECGcases

https://t.co/UR8ip3df1J

[Ross Prager @ross_prager]

Patient with cirrhosis and now escalating doses of vasopressors. Cause? Next step?

[IMCrit @IM_Crit_]

ICU Practice Fact:

“When people don't want to do something, they cite a study that shows it doesn't work”...

#foamed #foamcc

[Igor Eckert @igoreckert]

Quando o protagonismo dá ruim, o textão que viraliza é aquele que diz o contrário deste aqui. No mundo do futebol o que não faltam são análises e comentários "certeiros" após o desfecho.

[Philippe Rola @ThinkingCC]

Let’s keep it simple. There’s only really three classes of patients that need fluids. Patients who are hypovolemic and patients with tamponade or tension pneumothorax while you are preparing your needle.

[Rory Spiegel @TheEMNerd]

5/ The retrospective design limits how certain we can be of this signal of harm. But consider INTERACT-2 and ATACH-2 found no meaningful benefit and this cohort showed what happens when these targets are actually implemented in the real-world and the potential harms associated.

[Ashley Miller @icmteaching]

Large volume fluids then vasopressors then beta agonists for shock. In 2026. This is so low IQ.

[Pedro Mansur @batmansur_]

@ecgandrhythmRoe Old and LVEF 25% = VT, until proved otherwise

[reuben strayer @emupdates]

The myth that will not die
(hint: prevalence = 0)

1. Treat dangerous hypoglycemia immediately. Do not wait for thiamine or anything else.
2. Have a low threshold to treat patients at risk for Wernicke's with IV thiamine.

https://t.co/ov1LYjU370

[Ashley Miller @icmteaching]

1/21
Acid–base interpretation often feels like a maze.
But there’s a simple way to make sense of it at the bedside.
It starts with pH, strong ions, and base excess.

[Ashley Miller @icmteaching]

1/
Shock isn’t “give fluids, then pressors, then inotropes.”
That recipe misses the physiology.
Here’s how to manage shock properly: 🧵
#MedX #haemodynamics

[Pedro Mansur @batmansur_]

@JonahRubinMD @HarvardPulm @MGH_PCCM @MGHHeartHealth @MGHanesthesia @MGHHCICU Hello Jonah.
I always tell my colleagues to watch this sequence of lectures because they are the best that I’ve seen but i cannot find them anymore on YouTube!

How can I watch them again?

Thanks for your expertise and dedication.

[Turning the Tide @Turningthe_Tide]

🧵1/
Hypovolaemia is the most overdiagnosed concept in medicine.
We say it reflexively — especially in sepsis.
But here’s the uncomfortable truth:
We can’t measure blood volume.
We infer it.
Often wrongly.
Let’s unpack why that matters. 👇
#MedTwitter #FOAMed

[小谷祐樹 Yuki Kotani｜集中治療医 @YukiKotani5]

💉“Is drawing blood cultures from an A-line really a no-go?”

Our new meta-analysis tackles this common ICU question!
🔍 Compared contamination rates between A-lines and venipuncture or V-lines:
🔸 A-line vs. venipuncture: no difference
🔸 A-line vs. V-line: A-line may actually have lower contamination

✅ With A-lines, you can draw painlessly, quickly, and in sufficient volume.
Still, many of us were taught: “Don’t draw from A-lines — it increases contamination.”
But that guidance was mostly based on central venous line data.

👨‍⚕️Our study suggests it may be time to reconsider: blood cultures from A-lines might be a valid option.
https://t.co/CXQUcwGmdf

[Natalie May @_NMay]

#DGINA2025 There are no intentions more honourable than these.

[John B. Holbein @JohnHolbein1]

timeless

[Ross Prager @ross_prager]

Its trauma season again in our #ICU.

Here are 5 things to remember for the critically ill trauma patient.

🧵

(0/5)

[ANDROMEDA-SHOCK @AndromedaShock]

A new addition to the ANDROMEDA-SHOCK family: PEGASUS! Providing an epidemiological perspective to the RR between pulse pressure and stroke volume! Fundamental study after A2! Cross-talk now between Physiology and Epidemiology!! NCT 06737614