⚤ Sex & gender differences in #ICU, influence on:
🏥 admission
🧫 #sepsis & septic shock
🫀 cardiac arrest
🫁 #ARDS
🫀 cardiogenic shock
🫘 #AKI
😵‍💫 delirium
🩺 medical treatment
🏥 general outcomes
Evidence is still scarce, and data remain conflicting. Be aware & work toward addressing them in clinical practice/research to improve management in a personalized, patient-centered manner.
Open access #FOAMcc on @ICM 🔓 https://bit.ly/483cePH

@onisillos another reminder of the heterogeneity within one disease label such as "ARDS" and also that the common aspect of all inflammatory diseases is the human immune system, so it's not surprising to find overlap between host responses seen in ARDS and sepsis. Hopefully all heading towards host-directed #personalisedmedicine !
#IDMastodon #infectiousdiseases #immunology #ARDS #Sepsis

New research article in The Lancet Respiratory Medicine

Identifying molecular phenotypes in #sepsis: an analysis of two prospective observational cohorts and secondary analysis of two randomised controlled trials

https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(23)00237-0/fulltext

#ARDS #IDMastodon #MedMastodon

A Northwestern Medicine study has uncovered a promising therapeutic target for #ARDS in elderly patients, per @sciencetm: http://spr.ly/6013Pm2ZF

📢 August issue of @ICM is out! Manuscripts on
🟫 liver failure
🩸trauma
🧫 infections, #sepsis & antibiotics
🫁 ventilator associated tracheobronchitis & pneumonia
🫁 #ARDS & MV
🧠 neurological diseases
💪🏼 #ICUrehab
🖋️ #ICMfromtheInside
& more!
🔗 bit.ly/ICMAug2023

🆕 What’s new in neonatal & pediatric #ECMO?? Insights from #EuroELSO2023! The last 2 years (2022 + beginning of 2023) have been particularly fruitful for #ECLS research in children: from pediatric #ARDS to cardiac support and #ECPR, from circuit technology to anticoagulation, but also end-of-life. This manuscript summarizes main achievements.
🖇️ https://rebrand.ly/qoef7t5

Enjoying a cappuccino at the Capuchin Friary at #Ards

🖌 Do NOT forget to register now for #ELSO2023, 34th ELSO annual conference!! We look forward to seeing everyone in Seattle, to share updates on #ECMO, respiratory failure, #ARDS, circulatory failure, #ECPR, #MCS, artificial intelligence in #ECLS, research funding, debates and much more...
🗺️ Seattle, WA
All the info at
📎 https://bit.ly/ELSO2023

📢 Do NOT miss #ELSO2023, 34th ELSO annual conference!
🚑 state of the art in #ECPR
🔮 life after ECMO
🔥 what’s hot in device development
🫁 state of science in #ARDS
🆕 🫁 🫀 transitioning from ECMO in advanced cardiopulmonary disease - ELSO/ ISHLT Joint Session

Visit
📎 https://bit.ly/ELSO2023
🗓️ adult & neo-peds ECMO #simulation course (Step 2 Certification) - Sep 27
🗓️ pre-conference - #ECMO management & physiology, Sep 28
🗓️ conference - Sep 29-Oct 1
🗺️ Seattle, WA

Ventilation settings in children on #ECMO for P-#ARDS? Variable among centers! However, higher odds of mortality if during #ECLS:
🫁 high PEEP levels & driving pressure above 15 cmH2O: tight control to limit DP during run seems to be associated with better survival rate
🫁 native lung FiO2 above 60% on D14 of ECMO: seems to be essential to early decrease FiO2 once EBF allows an efficient oxygenation
Free to read #FOAMcc
🖇️ https://rdcu.be/dhPo2

Acute RV injury in surgical & critical care settings
🫁 acute respiratory distress syndrome #ARDS
🧫 #sepsis & septic shock
🟤 liver disease & #transplantation
🫀 management of RV Injury & Failure
#ThePeoplesVentricle🫀 2 just out on Journal of Cardiothoracic & Vascular Anesthesia
🔗 bit.ly/RVinjury2

Also read part 1
🫀🫁 cardiac & thoracic surgery
🫀🫁 heart & lung #Tx
🫁 chronic thromboembolic PAH
🫀 #LVAD implantation
🔗 bit.ly/RVinjury1

VV #ECMO: primary modality in selected children with #ARDS & cardiovascular instability? #ECLS initiation associated with immediate & sustained reduction in vasoactive-inotropic score over first 24 hours. VIS decrease associated with lower mean airway pressure + improved respiratory/metabolic acidosis & improved systemic oxygenation. #PedsICU
🖇️ https://bit.ly/3Dp6K3D

📢 The July issue of Intensive Care Medicine is out!
🫁 ESICM guidelines on #ARDS
☔️ IV fluids in #sepsis
💉 antibiotics in #ICU: precision dosing, aereosols,TDM
🩸CVP monitoring
🫁 NIV in acute hypoxemic respiratory failure
🏥 #ICUrehab
🫁 impact of tracheostomy
🫁 #AI, #machinelearning & #datascience
& more! Most #FOAMcc
🖇️ https://bit.ly/ICMJul2023

@Charlotte_Summers @kennethbaillie i will be looking for it ! Thank you for sharing !

There’s an interesting question still to resolve, IMHO, what’s the place of inhaled pulmonary vasodilators in #ARDS ?

I know there’s a low LOE but I think there’s a need for further investigation.

New ESICM #ARDS guideline is out!
Congrats @Charlotte_Summers for your amazing work in the taskforce ! 👏

https://med-mastodon.com/@ICM/110553889627399372

Free #OpenAccess

https://link.springer.com/article/10.1007/s00134-023-07050-7

ESICM guidelines on acute respiratory distress syndrome, from definition & phenotyping to respiratory support strategies:
🫁 #ARDS definition
🫁 phenotyping
🫁 high‑flow nasal oxygen #HFNO
🫁 CPAP/NIV
🫁 low tidal volume ventilation
🫁 PEEP & recruitment maneuvers
🫁 prone positioning
🫁 neuromuscular blocking agents
🫁 extracorporeal life support #ECMO #ECLS #ECCO2r
Open access #FOAMcc on @yourICM
🖇️ https://bit.ly/43J1OCe

Some insights on the association of PEEP, CVP, or inflammation with worsening of renal function in (covid) ARDS.

Single center from bad times. Proud of the team for persevering. I think it tells us some interesting things.

https://www.accjournal.org/journal/view.php?doi=10.4266/acc.2022.01494

#CriticalCare #ARDS #Physiology #Congestion #PEEP #CVP

RV dysfunction in patients with #ARDS receiving
VV #ECMO:
🫀 RV physiology, ventriculo-ventricular interaction, right ventricle-pulmonary interactions
🫀 RV dysfunction on #ECLS for ARDS
🫀 effect of ECMO on RV function
🫀 diagnosis of RV
dysfunction: #POCUS & PAC
🫀 care of patients
Open access #FOAMcc #FOAMecmo
🔓 https://rebrand.ly/rg3c0m6

🫁 Ventilatory ratio & mortality in patients with #ARDS requiring prolonged MV? Patient-level data from 6 RCTs conducted by ARDS Network (ARMA, ALVEOLI, FACTT, ALTA, EDEN SAILS. Following the trajectory of ventilatory ratio up to day 21, analyses demonstrate persisting association.
Free to read #FOAMcc on @ICM
🖇️ https://rdcu.be/ddu42

Propofol-associated hypertriglyceridemia in adults with #ARDS on #ECMO: according to the results of this retrospective, cohort study
➡️ occurred in ⅓ of pts receiving continuous infusion on VV #ECLS
➡️ propofol-associated HTG
did not occur immediately, resolved quickly, pancreatitis rare
➡️ higher illness severity before cannulation & run duration associated with increased risk of developing propofol-associated HTG; rate/duration of infusion not identified as risk
🖇️ https://bit.ly/3qhmvqb