Boris De Gracia

Papá de Lucario (su pokemon favorito), internista a veces, intensivista la mayoría del tiempo, ecmo un poco, aunque mi parte preferida es ser Papá..

[IMCrit @IM_Crit_]

One of my ICU rules:

Venous access saves lives. Arterial line gives data

I have never seen a patient die because an arterial catheter wasn't placed promptly. I have seen plenty of patients getting hurt (or die) because reliable venous access came too late (or never)

Place the venous catheter first. Sweat about the arterial line later

And yes. I place a lot of arterial lines and I was not pleased with how many people interpreted the EVERDAC trial
(NEJM 2025; 393: 1875-88 -
DOI: 10.1056/NEJMoa2502136)

[Boris De Gracia @borisdo0415]

IAo severa por prolapso valvular.
TEP confirmado.
HTAP probable/severa.
VD severamente dilatado y disfuncionante.
IT severa.
Shock cardiopulmonar.

Respuesta hemodinámica pre/post LAVA-ECMO.
Pre LAVA: PAP 63/32, media 45.
Post LAVA: PAP 37/23, media 28.

[Boris De Gracia @borisdo0415]

Do you remember when you joined X? I do! #MyXAnniversary

[ELSO @ELSOOrg]

🎥 Learning from tough cases:
⚖️ #ECLS, ethics, end-of-life in a resource limited scenario
⚙️Troubleshoot misbehaving circuit
🫀VA #ECMO in severe AR
🫀Temporary #MCS
⚖️ Pediatric patient with capacity: who should make the decisions?
Register for virtual #ELSO2025!!

[ELSO @ELSOOrg]

#ELSO2025 🧵3/4
🎓How to build effective simulations? ELSO resources + key roles
⚖️ Tough cases: ethics/end-of-life in resource limited scenario; troubleshooting circuit on VP ECMO; LAVA #ECLS in severe AR, temporary #MCS; pediatric pt with capacity: who should make decisions?

[IMCrit @IM_Crit_]

Kudos to the authors:

#foamed #foamcc #meded #medtwitter

[ECMO Heart Team Mx @DrECMO]

😜😜😜

No cierto, si estoy defendiendo al Swan, si llegaste hasta aquí dale like y comparte por chismocito

[M Velia Antonini @FOAMecmo]

Experience with #ECMO support in Latin America - Experiencia con ECMO en América Latina:
🗺️ 13 #ECLS units included
⚙️ 133 consoles
🔍 1629 runs 2016-2020: 1018 adults (mostly refractory hypoxemia), 468 pediatric (mostly PC shock), 143 neonates
🔎 310 specialists involved in care, 70.3% received ECMO training
🛏️ nurse-to-patient ratio 1:1 in most centers (76.9%)
🩺 mean overall survival to decannulation 55.7%
🔗 https://t.co/eZx2SBDogH

[Ashley Miller @icmteaching]

There are 4 types of microcirculation abnormalities. 3 of them can be iatrogenic from injudicious fluid administration. Haemodilution, high CVP and oedema all reduce tissue perfusion. Maintaining coherence between circulatory interfaces is key. Follow those tagged for more.

[CCSSdeCostaRica @CCSSdeCostaRica]

Colores y paisajes alegran la estancia de los pacientes de la Unidad de Cuidados Intensivos Quirúrgicos del hospital Calderón Guardia.

Acá más detalles: https://t.co/s8cKIRcAPy

[Boris De Gracia @borisdo0415]

🫶🏻🫶🏻🫶🏻

[Boris De Gracia @borisdo0415]

https://t.co/NxklsStk4C

[RESPIRATORY CARE @respcare]

Wheeler and Bullock provide a Year in Review on ECMO the literature surrounding the management of mechanical ventilation, prone positioning, anticoagulation, bleeding complications, and neurologic outcomes for subjects undergoing ECMO published in 2022.
https://t.co/U8Rh9rm7JO

[Ingrataaaa🎵🎵 @ingrid8511]

Hace tiempo que no hago hilitos de articulos pero este articulo merece una repasada. @OrlandoRPN tu tweet me puso a leer.

[Critical Care Reviews @CritCareReviews]

Today's paper of the day is by Mareike Gierhardt on the impairment of hypoxic pulmonary vasoconstriction in acute respiratory distress syndrome
https://t.co/JKgcYjlUQ5

Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2023

[INTENSIVE - The Alfred ICU @intensiveblog]

Intro to ECMO for New ICU Staff - INTENSIVE

Fantastic short animated videos for ECMO newbies by Ken Hoffman. The 4 videos cover ecmo components and nomenclature, V-V ECMO, V-A ECMO, and ECPR https://t.co/lOrX5TKw8w

[CCSSdeCostaRica @CCSSdeCostaRica]

#AtrévaseADonar El proceso de donación y trasplante en nuestro país se da dentro de un marco de transparencia, respaldado por la Ley 9222. En cada operativo de donación pueden llegar a participar hasta 100 personas, lo que le da aún mayor transparencia al proceso.#CCSSdeCostaRica