🫁 Fantastic new @TheLancet Series on #ARDS, announced today at #ERS2022
Two must-read reviews:
1️⃣ Causes, pathophysiology, and phenotypes
https://t.co/h7NygZ1WmP
2️⃣ Diagnosis, outcomes, long-term sequelae, and management
https://t.co/PVTMFJ1rZe
#FOAMed#FOAMcc
Following case has been altered but is based on real events:
I was called to the patient’s bedside for episode of SVT and hypotension. Our patient was admitted recently with acute renal failure and cardiogenic shock.
Sharing a couple of slides from our Mechanical Ventilation course for 1st year #CriticalCare fellows across DC & Maryland.
Eric Kriner & @docwoods725 from @whcpccm w/ excellent insights into harm & how to fix reverse triggering on ventilator
#MedEd
The HOT-ICU Trial: Lower vs Higher O2 Targets for Acute Hypoxemic Respiratory Failure via @JShethMD
-RCT of 2900pts
-Median O2 sat 93% vs 96%
-No diff in 90d Mortality
-Results not surprising
-Continue to target SpO2 of 92 to 96%
https://t.co/UioECUnUzW
#FOAMed#FOAMcc
At the request of several people, here is a thread on acute liver failure and decompensated cirrhosis in the ICU. Disclaimer: This is a broad overview of some key issues, but I am not a hepatologist. 1/
1/ As a learner, why do some rotations have you looking forward to work but then others leave you counting down the days until it’s over?
And, as a team leader, how can you create an environment that results in the former?
This week: Rapport & Inclusion - the #MedEd foundation
The VEINART Trial: VBG vs ABG
In non-hypoxemic pts...
-VBG is less painful compared to ABG
-VBG is easier for the healthcare team compared to ABG
-VBG provides useful information similar to ABG for physicians in regard to treatment decisions
https://t.co/TSewxeNJ2h
#FOAMed
1/3-Back by request for new ICU residents!
💥 12 KEY TRIALS I teach on #ICU Rounds each week they must know!
Do you agree?
Any you would add?
1. ARDSNET @NEJM -PMID 10793162
2. LEUVEN Glucose 1 @NEJM-PMID 11794168
3. SAFE Trial @NEJM PMID: 15163774
#FOAMcc#medtwitter#MedEd
EM residents need to know that we have no RCTs showing efficacy of thrombolytics for stroke now that ECASS-3 and NINDS have been reanalyzed. #EBM#FOAMed https://t.co/cVyV1MklMB
Perfusion pressure is not exactly MAP: look at both sides of circulation: venous (dark side) of circulation need some attention! how much congestion is affecting organs??
VExUS Venous Excess #ultrasound@ThinkingCC#COVID19POCUS#POCUS#echofirst#FOAMus https://t.co/7EeSbNleTg
BREAKING: HALT-IT Trial (TXA in GI bleed) published https://t.co/rICXiD07J0
Death from bleeding @ 5d: No stat sig diff
Death from any cause @ 28d: No stat sig diff
No diff in any secondary outcomes
VTE higher in TXA group 0.8% vs 0.4%
TXA should NOT be given for GI bleeding
Hot off the Press: Addressing the Elephant in the Room: Microaggressions in Medicine https://t.co/nEAPvuSrmt @AdairaLandryMD@MelMolinaMD@anitachary @BurnettBowie