João Rua 🇺🇦

MD, Internist, Critical Care, UPCIRA @chuc_hospital; Emergency Medicine, Infection control and antibiotic stewardship enthusiast; @fcporto fan(atic); 🇵🇹

[Gonçalo Levy Cordeiro @glevycordeiro]

Um enormíssimo texto. Vale a pena ler e, acima de tudo, vale a pena agir no sentido do que é dito no texto. Estamos sentados sobre um barril de pólvora e não vale a pena assobiar para o lado.

[João Rua 🇺🇦 @joaomfRua]

@BradSpellberg I appreciate your concerns with methodology and possible harm. Personally, I favour guidelines providing expert opinion for uncertain relevant points if properly disclosed, but I understood you point and maybe I don’t grasp the true impact of such in a system like yours. Thank U

[João Rua 🇺🇦 @joaomfRua]

@ABsteward @BradSpellberg @MartenHawkins @zacroBID @PulmCrit PHANTASi had only 4% patients in shock, ~100, and global mortality of 8% vs estimated of 40%. Probably lots of non severe patients included and time to hospital ~20 min. not the ideal data for the subject in hand, don’t you agree? Also couldn’t find specific shock group result

[João Rua 🇺🇦 @joaomfRua]

@BradSpellberg @MartenHawkins @ABsteward @zacroBID @PulmCrit I would agree on sepsis, not septic shock. What is the evidence that made irrelevant the time to abx in a septic shock patient? Enlighten me please, Dr Spellberg. I am a big fan of your work and cite you plenty, but couldn’t disagree more on this,neither by data nor experience.

[João Rua 🇺🇦 @joaomfRua]

@BradSpellberg @MartenHawkins @ABsteward @zacroBID @PulmCrit I believe that there is more than enough evidence to support that time to antibiotics (and source control) matters in patient already in shock. Do you wish proof that a shocked patient in an ambulance = shocked patient in an hospital? We are just fighting ghosts now.

[João Rua 🇺🇦 @joaomfRua]

@BradSpellberg @MartenHawkins @ABsteward @zacroBID @PulmCrit The “experts” part shows the line of fair criticism is long gone. Much to criticize but strength of recs/evidence is well stated. Good Abx pre-hosp is hard but if achieved makes a diference. or can you do evidence backed statement that time to abx is irrelevant in septic shock?

[João Rua 🇺🇦 @joaomfRua]

@ABsteward @AliSMV7 In most european countries, a doctor. Abx can be protocolized according to regional microbiologic data and adjusted later if special considerations arrise. Cultures are >50% negative, does it justify delaying abx in a very small very sick group of patients? Deescalate without it

[João Rua 🇺🇦 @joaomfRua]

@MartenHawkins @ABsteward @zacroBID @BradSpellberg @PulmCrit All this whining from grown up docs about suggestion of pre-hospital antibiotics in patients with highly probable septic shock and predictable long time transport to hospital is just ambarrasing. Did I miss the memo saying time became irrelevant and stopping abx was impossible?

[João Rua 🇺🇦 @joaomfRua]

@DrJMarine @BradSpellberg As a typical cardiologist, you have your head so up your ass that you can’t understand other people reality even when you try. Your comments are appaling and clearly from someone who has no idea about how things were in those dreadful days. You are just embarrassing yourself.

[Ashley Miller @icmteaching]

Critical closing pressure - how it should guide personalised care

If CCP is a threshold (not a pressure), the clinical aim is simple:
👉 keep arterioles open
👉 preserve flow continuity from pump → tissue

Not chase MAP or SVR in isolation.
https://t.co/BqDSedyClz

[EHF EURO @EHFEURO]

António Areia, what kind of magic is that? 😱😍

#ehfeuro2026 #puregreatness #handball @AndebolPortugal

[João Rua 🇺🇦 @joaomfRua]

@ross_prager As still in shock after thrombolysis, did you repeat angioCT? Checked for refractory thrombus needing thrombectomy?
Seen a few of these and all had those and improved fast after PT.
What do you think about before NE as vasopressor due to less pulmonary vasoconstriction?

[European Commission @EU_Commission]

Movember starts today!

This month is all about raising awareness of men’s health, especially prostate cancer, testicular cancer, mental health, and suicide prevention. ❤️‍🩹

Early detection saves lives! In the EU, we’re taking action through ⬇️

[João Rua 🇺🇦 @joaomfRua]

@lfc_lance Etoo!!

[João Rua 🇺🇦 @joaomfRua]

https://t.co/GHoECj4Kqn

[João Rua 🇺🇦 @joaomfRua]

Grandíssimo capitão e expoente máximo do jogador à Porto!
DEP enorme Bicho, nunca serás esquecido!

[FC Porto @FCPorto]

“O meu coração é azul e será sempre azul”

#E2ERNO

[Warren Kinsella @kinsellawarren]

A Justin Trudeau quote that will long be remembered:

“𝙏𝙝𝙚 𝙐𝙣𝙞𝙩𝙚𝙙 𝙎𝙩𝙖𝙩𝙚𝙨 𝙡𝙖𝙪𝙣𝙘𝙝𝙚𝙙 𝙖 𝙩𝙧𝙖𝙙𝙚 𝙬𝙖𝙧 𝙖𝙜𝙖𝙞𝙣𝙨𝙩 𝘾𝙖𝙣𝙖𝙙𝙖, 𝙞𝙩𝙨 𝙘𝙡𝙤𝙨𝙚𝙨𝙩 𝙥𝙖𝙧𝙩𝙣𝙚𝙧 𝙖𝙣𝙙 𝙖𝙡𝙡𝙮, 𝙩𝙝𝙚𝙞𝙧 𝙘𝙡𝙤𝙨𝙚𝙨𝙩 𝙛𝙧𝙞𝙚𝙣𝙙. 𝘼𝙩 𝙩𝙝𝙚 𝙨𝙖𝙢𝙚 𝙩𝙞𝙢𝙚 𝙩𝙝𝙚𝙮’𝙧𝙚 𝙩𝙖𝙡𝙠𝙞𝙣𝙜 𝙖𝙗𝙤𝙪𝙩 𝙬𝙤𝙧𝙠𝙞𝙣𝙜 𝙥𝙤𝙨𝙞𝙩𝙞𝙫𝙚𝙡𝙮 𝙬𝙞𝙩𝙝 𝙍𝙪𝙨𝙨𝙞𝙖, 𝙖𝙥𝙥𝙚𝙖𝙨𝙞𝙣𝙜 𝙑𝙡𝙖𝙙𝙞𝙢𝙞𝙧 𝙋𝙪𝙩𝙞𝙣: 𝙖 𝙡𝙮𝙞𝙣𝙜, 𝙢𝙪𝙧𝙙𝙚𝙧𝙤𝙪𝙨 𝙙𝙞𝙘𝙩𝙖𝙩𝙤𝙧. 𝙈𝙖𝙠𝙚 𝙩𝙝𝙖𝙩 𝙢𝙖𝙠𝙚 𝙨𝙚𝙣𝙨𝙚."

[João Rua 🇺🇦 @joaomfRua]

@elonmusk Have you ever heard about checks and balances between powers in a democracy, Mr. @elonmusk?

[Volodymyr Zelenskyy / Володимир Зеленський @ZelenskyyUa]

Three years of resistance. Three years of gratitude. Three years of absolute heroism of Ukrainians. I am proud of Ukraine! I thank everyone who defends and supports it. Everyone who works for Ukraine. And may the memory of all those who gave their lives for our state and people be eternal. 🇺🇦🇺🇦🇺🇦

#SupportUkraine