Tom Chad

Doctor. Anaesthetic SpR. New PhD student. Science magpie.

[Giacomo De Luca @jackdeliuc]

👉🏻 This a thread about Hypocalcemia in critical care.

🧐 Why hypocalcemia is important in critical care and when do we need to take care of it?

[Aging Science News @AgingBiology]

Multimorbidity is associated with myocardial DNA damage, nucleolar stress, dysregulated energy metabolism, and senescence in cardiovascular disease
https://t.co/LXLsyFiwQW

[Intensive Care Medicine @yourICM]

🫀🫁Right ventricular injury in adults receiving #ECMO for respiratory support, rationale & expert position statements: PRORVnet study
Open access #FOAMcc #FOAMecmo on @yourICM
🔓 https://t.co/WJh3OCi8nk

[Tom Chad @thechadologist]

🫀👨‍🔬

[Tom Chad @thechadologist]

@DocDoLi 😂

[M Velia Antonini @FOAMecmo]

RV dysfunction despite #ECMO?? @efan75 on the neglected ventricle at #APELSO2023
🫀 RV dysfunction/failure common in #ARDS
🫁 optimize ventilatory strategy: LPV, higher PEEP, deep sedation/NMBA
🫁 prone positioning may have beneficial effects on both lung & RV
🩸 ECCO2R or VV #ECLS? other configurations (VA? VPA?) If failing on #extracorporeal support consider adding other adjuncts (synergy?)
⏳ What about optimal timing of interventions & treatment algorithm?
���️ Focus on RV protection to be included in holistic approach to ventilatory/support strategy: prevention is the key! prevent RV dysfunction as treating it when occurring might be too late...
Consider reading, open acces on @asaiojournal
🔓 https://t.co/mbuqnYmRJU
@APELSOorg @ELSOOrg @EuroELSO @CCRG_Research

[Tom Chad @thechadologist]

@Anaes_Journal Exceedingly rare in the cited study; 1/1779 in non-diabetic patients. Mirrors the other large outcome studies. Although the recent BJA article supports some degree of metabolic change peri procedurally (although no sig interaction in cardiac)

[Unicyclemedic @unicycle_medic]

The maximum anaesthetist capacity and the minimum alveolar concentration of sevoflurane are both 2

[The Nobel Prize @NobelPrize]

BREAKING NEWS
The 2023 #NobelPrize in Physiology or Medicine has been awarded to Katalin Karikó and Drew Weissman for their discoveries concerning nucleoside base modifications that enabled the development of effective mRNA vaccines against COVID-19.

[Tom Chad @thechadologist]

#mitochondria 🔋

reading list

https://t.co/xocvVvDVIS https://t.co/Sbi7thybf4

[Tom Chad @thechadologist]

Nice finish to my ACF with some extra #postnoms #MRes ✅

[Tom Chad @thechadologist]

@Aidan_Baron Might have to select pts carefully in these settings I reckon. Mg antagonises Ca -> reduced vascular tone and catecholamine release. Also has some inhibitory effect on plts I think.

[Tom Chad @thechadologist]

@willtube4food @Jopo_dr I think we wrote this one up

https://t.co/a5d1K0e1YY

[M Velia Antonini @FOAMecmo]

Acute RV injury in cardiothoracic surgery & #ICU, 1
🫀 cardiac surgery: CPB/myocardial protection, RV afterload, RV ischemia
🫀🫁 heart & lung #transplant
🫁 chronic thromboembolic PAH
🫀#LVAD
🫁 thoracic surgery: one-lung MV/lung resection
@JCVAonline
🔗 https://t.co/vQwko9VGrx

[Roshana 🦴 @RoshanaMN]

Don’t worry guys we’ve done yours too

@SteveBarclay @RishiSunak

[Tom Chad @thechadologist]

@srturaga @VirtueOfNothing There *probably is *some kind of effect of propofol on bioenergetics of myocardium which *might be relevant in cardiac surgery but I don’t think that explains the above results

https://t.co/6W5U8UAukd

[Tom Chad @thechadologist]

@VirtueOfNothing Really nice summary. I went straight to the cardiac forest plot as well, and the 2016 paper, but missed points 6 and 7!

[British Journal of Anaesthesia @BJAJournals]

Minimum false-positive risk of primary outcomes and impact of reducing nominal P-value threshold from 0.05 to 0.005 in anaesthesiology randomised clinical trials. New cross-sectional study by Chuang et al #anaesthesia #statistics

https://t.co/dRFt3WuRG9

[Abdulla A. Damluji, MD, PhD @DrDamluji]

Right Ventricular Failure: @NEJM

In-depth review on the right heart: @Brian_Houston12 @RyanTedfordMD

Will try to hit the highlights, but cannot substitute for the details in the full text!

👇👇

[Lewis Goodall @lewis_goodall]

NEW: confirmed- junior doctors in England vote to strike by a *98%* yes vote. Turnout of 77.5%.