#Albumin Should Be Remembered When Patients With #SepticShock Are Resuscitated
“Although no significant difference in 28-day mortality rate or 90-day mortality rate was observed between the use of albumin and #crystalloids, #colloids appeared to be more effective than crystalloids in stabilizing hemodynamic end points.”
I couldn't agree more. Sometimes you have to find what to do at the moment. It is safe and may help.

https://journal.chestnet.org/article/S0012-3692(23)00654-2/fulltext

#FOAMcc #CHEST #CriticalCare #Sepsis #Hemodynamics

Who still uses #DEX in #ICU?

“Use of #dexmedetomidine in critical-ill patients: is it time to look to the actual #evidence?”

https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04618-z

#CriticalCare #CritCare #FOAMcc #Sedation #Pharmacology

But what strikes me most is that it is becoming more and more easy to track flow changes in patient.

In their work, they present a little wearable Doppler ultrasound.

There is now no reason to justify that every mL of fluid given to improve the patient hemodynamics’ isn’t monitored accurately and that clinicians still rely on poor or inappropriate surrogates (including HR, MAP, PP, PPV, urine output, etc.)

#JIntensiveCare #Physiology #Hemodynamics #FOAMcc #Monitoring #CriticalCare

Nice work by Jon-Emile Kenny et. al emphasizing that a significant amount of fluid challenge in ED are ineffective to improve flow, therefore can’t have any positive effect at all.

https://jintensivecare.biomedcentral.com/articles/10.1186/s40560-023-00655-6

#JIntensiveCare #FOAMcc #CriticalCare #Physiology #Hemodynamics

A patient with stable coronary artery disease and type 2 diabetes describes their threshold for angina being closely correlated with their blood glucose levels. What likely explains this phenomenon? #physiology #cardiology #cardioed #foamcc #foamed

In the unlikely event of managing #arrhythmia in #pregnancy, this excellent article could be handy !
https://pubmed.ncbi.nlm.nih.gov/35057977/

Baseline,
-Beta blockers are 1st line (favor labetalol/metoprolol)
-Na channel blockers to be considered (favor lidocaine/flecainide)
-avoid amiodarone, can be considered in life threatening arrhythmia
-electrical cardioversion is safe

#CriticalCare #FOAMcc #MedMastodon #MastoRx

#ccr23 is on today

And it’s being live streamed for FREE. Excellent #foamed #foamcc

https://criticalcarereviews.com/

Who’s watching? @kennethbaillie

Very interesting that “Critical Care and Resuscitation” is now an #OpenAccess journal!

#MedMastodon #FOAMcc #FOAMed

https://www.sciencedirect.com/journal/critical-care-and-resuscitation

I’m not really on self promotion but I’m really proud to be part of the amazing #EZResus team !!

To deep #Space & beyond !

https://globalnews.ca/video/9713944/canadian-er-doctor-designs-revolutionary-app-that-dramatically-i

#FOAMcc #FOAMed

#POCUS is the real stethoscope !

What is used since Laënnec should be named “stethophone” instead of “stethoscope”

Wonderful insight from an 1913 article👇
https://jamanetwork.com/journals/jama/article-abstract/216920

#FOAMcc #FOAMed

Very interesting case report of pulse methylprednisolone in treatment of steroid-refractory #Immune #CheckPointInhibitor #pneumonitis

We also treated a patient with a grade IV pneumonitis with high dose steroid. My observation is a very rapid improvement, within 48h.

Further research is needed but it could be promising for life-threatening immune checkpoint inhibitor reaction

https://pubmed.ncbi.nlm.nih.gov/36119082/

#MedMastodon #FOAMcc #FOAMed

“We of course concur that mortality, duration of ventilation, and LOS are important outcomes when determining timing of tracheostomy. Respectfully, we feel that perhaps the patient’s perspectives have been lost in this growing mountain of early versus late tracheostomy studies.”

https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04443-4

#CriticalCare #CritCare #FOAMcc #Tracheostomy

Fluid removal tolerance during the de-escalation phase: is preload unresponsiveness the best guiding candidate?

https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04444-3

#CritCare #FOAMcc #Physiology #Fluid #CriticalCare

All the high tech are worthless if you haven’t the skilled staff

“ICU’s most powerful tool will always be skilled staff”
https://www.bmj.com/content/381/bmj.p804

#FOAMcc #FOAMed #ICU #MedMastodon

Great discussions of Andrew Davies with Chris Nickson on this episode of #MasteringIntensiveCare podcast !

Talking education, personal well-being, psychological safety & more

Definitely worth listening!

https://litfl.com/mastering-intensive-care-078-with-chris-nickson/

#MedMastodon #FOAMcc #FOAMed

High-dose prophylactic #anticoagulation is (was?) affective to reduce the occurence of #thrombosis without impacting outcomes in #Covid hypoxemic failure

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2802821

#JAMAInternalMedicine #FOAMcc #CriticalCare

No #isicem hashtag to follow…

#CriticalCare #FOAMcc

@load_dependent very nice illustration of the powerful synergy of life-support AND monitoring

none of them alone can improve patients

#CriticalCare #Hemodynamics #Physiology #FOAMcc

The littles things come a long way in #ICU #delirium

If we reach for a silver bullet treatment of delirium, non pharmacological approach should be the way & on top of it, maybe some pharmacotherapy 🤔

“Less pharmacotherapy is more in delirium”
https://link.springer.com/content/pdf/10.1007/s00134-022-06707-z.pdf
#WDAD2023 #FOAMcc

Interesting study by colleges of #CHUSteJustine on room temperature stability of neuromuscular blockers

- Rocuronium 👉 18 months
- Succinylcholine 👉 6 months

Can be helpful for crash cart planning

#FOAMed #FOAMcc #TooteRx #MastodonRx

In French
https://pharmactuel.com/index.php/pharmactuel/article/download/553/221/2145