NO ASSOCIATION BETWEEN PREPROCEDURAL FASTING AND WITNESSED PULMONARY ASPIRATION
A SYSTEMATIC REVIEW AND META-ANALYSIS
I want to bring to everyone's attention the publication of an article we have been working on for some time.
Ever been annoyed by having cases cancelled because a patient ate recently? I had this happen a couple of years ago. This motivated me to look at the preoperative fasting literature.
I was surprised to learn how little actual evidence there is to support fasting policies.
In our recent publication we point out that 1) aspiration rates are no different now than they were before fasting was imposed before administering anesthesia 2) The studies used in fasting research use surrogate outcomes that have never been shown to be relevant to human aspiration events.
See the article published in Surgery (@SurgJournal) here:
https://t.co/KzdmhSQ2UM
There is a pressing need to rethink preoperative fasting policies. New studies are needed that employ proper endpoints to provide guidance for how long patients really need to fast. My guess is, not very long.
[1] #Hemodynamics Tweetorial #2
Heart failure pt in ICU is -3.5L after 2d of aggressive diuresis. On day 3, urine output is ⬇️and BUN/Cr is ⬆️
You personally wedge #PAC at bedside and obtain a mean wedge 17 mmHg (a normal mean wedge is 6-10 mmHg). Admission wedge was 24
The front page of tomorrow's @dailytarheel –
I shed many tears while typing up these heart-wrenching text messages sent and received by UNC students yesterday. Our campus was on lockdown for more than three hours.
Beyond proud of this cover and the team behind it.
NNT to prevent 1 death from any cause
Aspirin for secondary prevention: 333
Spironolactone for HFrEF: 9
If discharging a CAD patient without aspirin sounds crazy, then what does that say about discharging a HFrEF patient without an MRA?
UK is seeking applicants for its advanced cardiovascular imaging fellowship for academic year 2023-2024.
More information on this link and the 🧵https://t.co/vsN4wTM7cZ
Please email [email protected] to apply.
#ADVOR trial: acetazolamide added to intravenous loop diuretics decreases congestion within 3 days in patients with acute decompensated #heartfailure.
#ESCCongress
Consistent data from propensity matched studies. More complications with Impella, no mortality benefit.
See Dhruva et al. JAMA 2020 and Amin et al. Circulation 2020 and Schrage et al. Circulation 2019. We urgently need RCTs! #DanGer#ECLS-SHOCK
Thank you to everyone that’s joined @cardionerds rounds so far! We are not done yet…
🗓 Join us June 17th at 12:00 PM EST to round with the hemodynamics master @BurkhoffMd as he breaks down the physiology of 🫀Shock with P-V loops
Register here now: https://t.co/RHyW6a9axy
VExUS is not a measurement of RAP!! It is a measurement of pressure transmission from RA to peripheral organ veins.
This transmission is a function of RAP yes, but also of venous distensibility!
Correlation of VExUS with RAP is moderate at most 👇 1/2