Ged

[Mühendislik Harikası @muhendisIiktr]

Japonya’nın hızlı treni, çözülmesi imkânsız gibi görünen bir sorun yaşıyordu… ta ki küçücük bir kuş çözümü gösterene kadar.

[Critical Care & Emergency Medicine PSN @sscpCCEmpsn]

📢 We’re continuing our review of updates from the SSC 2026.

Today’s post will focus on Hemodynamic Management and highlight the key recommendations.

Check out the attached summary for a quick overview.

#Sepsis #CriticalCare #PharmICU #ClinicalPharmacy #ICU #SSC2026

[4kDesignHub.. @Classicwalls001]

🏆🇧🇷 Brasil's Legendary Stars have Gathered together to watch the 2026 FIFA WORLD CUP! 👑✨

Kaka, Ronaldo, Ronaldinho, cafu, Bebeto, Robert Carlos And Rivaldo. ALL IN ONE PLACE 🔥✨

[казамі Δ ⏾ ⋆⁺₊✧ @kaze_storm]

drastic times call for drastic measures 🤙

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

🫁 ARDS is not one disease...It is a syndrome with multiple phenotypes that may respond differently to the same ventilator strategy.

Recent PubMed indexed guidelines and reviews emphasize that ARDS should be analyzed by severity, cause, timing, mechanics, recruitability, radiology, inflammation, hemodynamics, and response to treatment (Grasselli et al., 2023; Qadir et al., 2024).

A practical bedside phenotype includes:

Clinical cause: sepsis, pneumonia, aspiration, pancreatitis, trauma, transfusion, COVID, postoperative lung injury.

Severity: PaO₂/FiO₂, SpO₂/FiO₂, need for HFNC, NIV, invasive ventilation, prone position, or ECMO.

Respiratory mechanics: driving pressure, plateau pressure, compliance, mechanical power, dead space, ventilatory ratio.

Radiology: focal versus diffuse ARDS. Focal ARDS may be less recruitable and more prone to overdistension. Diffuse ARDS may tolerate higher PEEP better if recruitability is present.

Recruitability: response to PEEP, recruitment-to-inflation ratio, compliance change, oxygenation, CO₂ clearance, EIT when available, and hemodynamic tolerance.

Biology: hyperinflammatory versus hypoinflammatory phenotypes. Hyperinflammatory ARDS is associated with higher inflammatory biomarkers, shock, acidosis, worse outcomes, and may respond differently to PEEP, fluids, corticosteroids, and future targeted therapies (Das et al., 2025; Petrick et al., 2025).

Treatment must follow phenotype, not habit.

All ARDS: lung-protective ventilation, low tidal volume, plateau pressure limitation, driving pressure awareness, conservative fluids when shock is controlled, and prevention of VILI.

Moderate-severe ARDS: early prone positioning.

Recruitable diffuse ARDS: consider higher PEEP carefully.

Poorly recruitable focal ARDS: avoid aggressive recruitment and excessive PEEP.

Severe refractory hypoxemia: evaluate early for VV ECMO.

Inflammatory early ARDS: corticosteroids may be considered according to recent guidelines, but timing, cause, infection risk, and phenotype matter.

References 📚

Das, S. K., et al. (2025). Critical Care. PMID: 40734796

Grasselli, G.. Intensive Care Medicine, 49, 727–759. https://t.co/67nFMfpurf

Petrick, P. L., et al. (2025). Journal of Clinical Medicine, 14(20), 7204.

Qadir, N. American Journal of Respiratory and Critical Care Medicine, 209(1), 24–36. https://t.co/Cf5W5R79KU

[M Velia Antonini @FOAMecmo]

Venopulmonary #ECLS, ELSO Registry analysis:
🫀🫁 indications: heart failure/CS 54.4%; acute respiratory failure/#ARDS 26.6%; PC shock 6.7; ACS/ischemic heart disease 5.3%; valvular disease/complications of intracardiac devices 4.2%; PE 2.9%
🚧 common adverse events included need for #CRRT or AKI, infections, arrhythmias, bleedings
Hospital outcomes, complications, survival differed according to the diagnosis leading to VP #ECMO use. Younger age, male sex, lower BMI, and no CRRT use prior to cannulation confer a lower risk of death.
@TheJHLT
🖇️ https://t.co/wh7sjT4s6G

[Critical Care Reviews @CritCareReviews]

Evolution of the Monro-Kellie Doctrine from Static Intracranial Pressure to Dynamic Intracranial Physiology: A Critical Review of the Monro-Kellie 1.0 Through 4.0 Framework and Its Implications for Contemporary Neurocritical Care

CCR Journal Watch
https://t.co/Sp06oA6IDG

[21 @twentyone21___]

GOOD MORNING!

[Pokémon @Pokemon]

Here’s your first look at official art for Pokémon Tales: The Misadventures of Sirfetch’d & Pichu! 🛡️⚡

Prepare for an epic stop-motion journey through the wilds of Galar where gallant quests and noble deeds await our heroes. Coming 2027!

[𝐆𝐰𝐢𝐥𝐥𝐬 @GwillsBlancos]

🚨UPDATE: The FIFA World Cup has just updated their official logo✍🏾

[Embajador del Japón en México @embjpmx]

Estoy en el Estadio Monterrey🇲🇽 listo para apoyar a la Selección Japonesa🎌
El ambiente aquí es increíble!!! Vamos Japón!! 🇯🇵
@jfa_samuraiblue @MonterreyFWC26 #SamuraiBlue

[Bleed blue snoopy @BleedSnoopy]

Let's go japan samurai Blue🇯🇵

[El Guarromántico @Guarromantico_]

Llamadas que no respondo:

– Números privados.
– Números desconocidos.
– Trabajo.
– Gente que no es familia.
– Gente que sí es familia.
– Cualquier llamada que entra.

[VIEW @viewsoff]

300 year old oak trees, Oak Alley Plantation, Louisiana

[Pocket Monsters X @PocketMonsz3ur]

Seeking the Life Pokémon in the heart of the forest. ✨🦌
#pokemon #xerneas

[DaVinci @BiancoDavinci]

This Japanese restaurant logo is simultaneously a Japanese crane and a hand holding chopsticks.

[Pocket Monsters X @PocketMonsz3ur]

The Sky High Pokémon descending from the ozone layer. 🐉✨

[Martinalgui @MartinoliCuri]

JAJAJAJAJAJAJAJA 100% REAL