Mark Lucey

Irishman abroad /Intensivist at RPAH/Clinician first and foremost/Love golf/Opinions obvs my own

[Curiosity @CuriosityonX]

NASA told the world that, on July 19, 2013 a spacecraft would be photographing Earth from Saturn.

They published the exact time. They asked everyone on the planet to go outside and smile at the sky.

Thousands of people did.

This is the photo it took.

If you were alive in July 2013, you're somewhere in this picture.

From 898 million miles away, the universe waved back.

[Curiosity @CuriosityonX]

This is the image that defines a generation.

This raw shot from the Artemis II crew shows reality of deep space travel.

The smudges on the glass make it feel real. We are finally back.

[Matt Mullin @matthewwmullin]

NASA HAS RELEASED OVER 12,000 IMAGES OF THE ARTEMIS II MISSION.

Unbelievable perspectives captured by the Crew! The aurora on the eclipse is incredible.

[The Astronomy Guy @astrooalert]

While zooming in on the Moon during daytime, the International Space Station was captured passing directly across its surface a rare and perfectly timed moment.

[Dr. Chacón-Lozsán F .'. @franciscojlk]

💧 DKA resuscitation: Normal Saline vs Ringer’s Lactate, does it really matter?

For decades, 0.9% NaCl has been the default fluid in diabetic ketoacidosis.

But… is it still the best choice?

🧪 New randomized ICU data (2025-2026)

👉 88 patients with severe DKA
👉 Ringer’s Lactate (RL) vs Normal Saline (NS)
👉 Same insulin protocol

📊 Primary outcome: DKA resolution at 48h

➡️ No difference
• RL: 56.5%
• NS: 50%
(p = 0.66)

⚖️ So… clinically equivalent? Not exactly.

The physiology tells a different story 👇

🧠 What RL does better

Compared to NS:

✔️ Higher bicarbonate early
✔️ Better potassium levels
✔️ Lower chloride at 48h

➡️ Translation:

• Less hyperchloremic metabolic acidosis
• Lower risk of hypokalemia
• More physiologic acid-base recovery

⚠️ What NS still does

❗ Same DKA resolution speed
❗ Same ICU stay
❗ Same mortality

➡️ So endpoints look “equal”…
…but physiology is not.

🚨 Why this matters in real ICU practice

Hyperchloremia is not benign:

• Worsens metabolic acidosis
• Increases respiratory workload
• Promotes renal vasoconstriction
• Delays recovery

And hypokalemia?

• Arrhythmias
• Insulin resistance
• Delayed metabolic correction

🧬 Clinical interpretation

This is not about:

❌ “Which fluid resolves DKA faster?”

This is about:

➡️ Which fluid creates a better internal environment for recovery

🔥 Take-home message

👉 NS is acceptable
👉 RL is physiologically smarter

➡️ Especially in:

• Severe acidosis
• High chloride states
• Patients at risk of hypokalemia

📚 Trifi A. et al. (2025)
Medicina Intensiva
https://t.co/ulM20yqLRa

[Bryan Behar @bryanbehar]

The face of someone who’s devoted their life to service, science and space exploration needing to listen to some draft-dodging, out-of-shape bozo brag that he easily could’ve been an astronaut.

[Mark Lucey @lucey_mark]

@Hoang_HQ E Street

[Mark Lucey @lucey_mark]

@hkairlines How do I make sure I am actually booked into your flight out of Sydney on Monday? AI Bella is hopeless.

[Mark Lucey @lucey_mark]

@takomogolf Folks I’ve just received an email apparently from you guys about a possible non-conforming IGNIS driver. Is this a scam or genuinely from you?

[NASA @NASA]

Hello, Moon. It’s great to be back.

Here’s a taste of what the Artemis II astronauts photographed during their flight around the Moon. Check out more photos from the mission: https://t.co/rzM1P0QbOl

[Mark Lucey @lucey_mark]

@DanCollins2011 Richard Roper??

[Seán Mac an tSíthigh @Buailtin]

A dramatic rescue outside Dingle harbour. 14 crew airlifted to safety from a stricken trawler. Impressive operation by Irish coastguard in extremely difficult conditions. Trawler is French with Portuguese and Indonesian crew.

[Piers Morgan @piersmorgan]

‼️ THE BONDI HERO ‼️
Ahmed El Ahmad, a 43yr-old father-of-two fruit shop owner.
After so bravely jumping on the first terrorist, he was then shot twice by the second terrorist, and is now being treated in hospital but expected to be OK. Thank you Ahmed. 👏👏

[Mark Lucey @lucey_mark]

@DanielGarb Been inevitable for years…..

[Mark Lucey @lucey_mark]

So brave

[Drew Pavlou 🇦🇺🇺🇸🇺🇦🇹🇼 @DrewPavlou]

AUSTRALIAN HERO TOOK GUN OFF SHOOTER

TERROR ATTACK SYDNEY AT LEAST TEN DEAD

AUSTRALIAN HERO TOOK DOWN GUNMAN

[Mark Lucey @lucey_mark]

@sciencegirl They drowned 🤷‍♂️🤷‍♂️

[Bill Madden @maddenifico]

Wake the fuck up, America! 🎯🎯🎯🎯🎯👇

[Mark Lucey @lucey_mark]

@Geniustechw Well…..Baise moi!! What a joke.

[Francynancy @FranMooMoo]

Lucy Zelic didn't hold back when Stephen Conroy arrogantly defended family reunion entitlements for politicians👏

[Jane Caro @JaneCaro]

America’s loss will be Europe’s, Africa’s and Australasia’s gain. https://t.co/dRR6wrdKF6