Rosaria Sofia

Italy 🇮🇹 Medical doctor 👩🏽‍⚕️

[Rosaria Sofia @sofia_rosaria]

Did you know CAG results after OHCA? 🚑🫀
Do not waste another second and run to read our article just published!
#CAG #OHCA @ResusJournal

https://t.co/koZzsDIfzW

[Rosaria Sofia @sofia_rosaria]

We managed a complex case of radial artery spasm (RAS).

Based on this experience, we propose a step-wise approach to RAS @ccijournal.

📄Read the full article: https://t.co/gVJcz00KoS.

#Radialarteryspasm #coronarycatheterization #deepsedation

[Journal of Brown Hospital Medicine @BrownJHM]

Hemoglobinopathies @PedsCases #MedEd

[CardiovascularCorner @TrackYourHeart]

How do we measure the severity of Mitral Regurgitation (MR)? Enter the PISA method.

1/
PISA = Proximal Isovelocity Surface Area
It's a hemispheric zone of blood flow seen on color Doppler as it rushes toward a leaky mitral valve. The faster the flow, the more curved (and larger) this shell becomes.

2/
By adjusting the Doppler baseline toward the MR jet, we get a clearer PISA "dome." Measure the radius (r) of this dome—from the valve to the first color change (aliasing point).

3/
Use this formula to calculate the size of the leaky opening:
EROA = (2πr² × Valiasing) / Vmax(MR jet)
EROA = Effective Regurgitant Orifice Area
A larger EROA = more severe MR.

4/
To calculate how much blood is leaking:
Regurgitant Volume = EROA × VTI(MR)
(VTI = total flow over time from the MR jet)

5/
Why it matters:
- Helps assess MR severity
- Guides treatment decisions
- Combines well with other echo findings
#Echo #Cardiology #PISA #MitralRegurgitation #CardioTwitter

[M Velia Antonini @FOAMecmo]

Awake #ECMO in adults with respiratory failure, SR
📈 feasible & low failure risk in selected patients
🫁 mostly investigated in BT lung #transplantation (acceptable success), experimental in #ARDS
🫁 worsening respiratory failure, #delirium/agitation, bleeding most common reasons for failure; mortality almost 60% in patients who failed
📉 complications rate poorly reported
📖 https://t.co/JwZovOzNMd

With editorial on physiology-based indications to improve outcome of awake #ECLS
📖 https://t.co/wSXzlD42sA

#ICUrehab @CritCareMed

[San Raffaele Anesthesia and Intensive Care @SRAnesthesiaICU]

1/3

We assessed feasibility and safety of awake #ECMO without invasive ventilation in patients with severe respiratory failure

467 awake ECMO patients from 57 manuscripts are described in this article

🔗 Just published in @CritCareMed: https://t.co/hhUTTZcUk8

#FOAMcc

[Benjamin Abella, MD MPhil @BenjaminAbella]

@sofia_rosaria @ResusJournal @tscquizzato @giovannilandoni great job, Rosaria and team! When and if to intervene on coronary lesions in the setting of OHCA remains an important topic - glad to see this study.

[Tommaso Scquizzato, MD @tscquizzato]

WHAT ARE THE FINDINGS OF CAG AFTER OHCA?🫀

We performed a SRMA of 128 studies (>62k pts) to describe angiographic features in resuscitated and refractory OHCAs

We found that
🔸 significant CAD is present in 75%
🔸 CAD is more severe in refractory OHCA
🔸 CAD is common also in pts with non-shockable rhythms and without ST↑

📄 Just published @ResusJournal https://t.co/A8YT90A5XB
🧵 Learn more in the thread 👇

#ResusTwitter #CardioTwitter #FOAMcc

[Tommaso Scquizzato, MD @tscquizzato]

Great teamwork produces great results at @SRAnesthesiaICU

Thanks to all the team who help to study cardiac arrest and CPR: @sofia_rosaria @arianna_gazzato @alessanro_pruna @ABonaccorsoMD @MargheritaRoc10 and others

We’re young but we’ve already achieved great results together

[Giovanni Landoni, MD @giovannilandoni]

our Gianvito Martino @SanRaffaeleMI @MyUniSR published in @NatureMedicine a phase I study on #MultipleSclerosis safely intrathecally injecting neural precursor cells

Interestingly, high dose neural cells was associated with lower rate of brain atrophy

https://t.co/kiPzACayrE

[Journal of Cardiothoracic and Vascular Anesthesia @JCVAonline]

Left ventricular longitudinal #strain could differentiate the prognosis after CABG in patients with preserved LVEF and provide significant incremental prognostic value to LVEF. https://t.co/0Wpnq8Tjlp

[Giovanni Landoni, MD @giovannilandoni]

Pulmonary Thrombosis
(not Pulmonary Embolism)
(not Pulmonary Thromboembolism)

#pulmonarythrombosis
#microclots

[Giovanni Landoni, MD @giovannilandoni]

More patients in the high dosing #PROTAMINE group received plasma (11 % vs 0 %; p=0.02) and platelet concentrate (21 % vs 6 %; p=0.04) compared to the low dosing #PROTAMINE group.
Abundant protamine dosing increased postoperative blood loss
https://t.co/EK8ixVbl2n

[Giovanni Landoni, MD @giovannilandoni]

@MattDelNin @Dan_Landry @DrToddLee @BradSpellberg I think a correct approach should be "full anticoagulation in #covid19 outside the ICU, if the physician does not perceive increased bleeding risk"

this is the phylosophy behind it https://t.co/ITRXo0QELX

and this is the EBM
https://t.co/FNowdLm0fg

@DrToddLee

[Giovanni Landoni, MD @giovannilandoni]

Evidence is accumulating that full anticoagulation in #covid19 #icu patients is not beneficial for survival https://t.co/iIAA48MMc5

Please remember that evidence is accumulating that full anticoagulation in #covid19 patients outside the ICU is beneficial for survival

[Giovanni Landoni, MD @giovannilandoni]

Validation of awake calibration of TOF monitoring

⚖️Awake calibration on one arm before anesthesia induction vs. anesthetized calibration on the other arm

🤝Close agreement in the duration to normalization between awake and anesthetized calibration

🔗https://t.co/DL7r29kg5D

[San Raffaele Anesthesia and Intensive Care @SRAnesthesiaICU]

Our students, residents, anesthesiologists, intensivists, cardiologists, researchers, nurses, and every healthcare provider strongly support #WorldRestartAHeart @ERC_resus @Ilcor_org and #SettimanaViva @ircouncil
1️⃣ Check
2️⃣ Call
3️⃣ Compress
… and use an AED ⚡️

#ResusTwitter

[Luca Baldetti @lucabaldetti]

From #mechanical #afterload reduction to #prognostic oral drug in acute #HF: initiation of #ARNI therapy during #IABP support to enhance #MCS weaning is feasible and promising! 💊🫀@MarioGramegnaMD @guglielmogallo1 @CorstiaanU @davebaran

[San Raffaele Anesthesia and Intensive Care @SRAnesthesiaICU]

Our article is out.

Will we find a way to protect the kidneys and prevent #AKI with continuous infusion of amino acids?

We’ve already randomized 2000/3500 patients in 16 centers.

🔗 https://t.co/USmDq9ZMoh #PROTectionTrial #FOAMcc
https://t.co/QlO0Ydeef7

[Giovanni Landoni, MD @giovannilandoni]

Children had an higher #IQ (IQ=128) 2 weeks after general anesthesia when compared to before surgery (IQ=124) ⁉️

https://t.co/uO13nbpyTn