Maybe unpopular but I think that’s my fav episode

Absolutely. For as long as it takes I love Day 1 of service. It is the day to scrape the MAR, scrape the note and make things tidy.

Hence the need for our mutual practice of zentensivism

Too true

Even starting vaso, only about half of patients have a BP response, and I never see it stopped when there is no response

Haha as long as you’re willing to stop what you started, it can work

I think that’s the key, inadequate characterization at the outset is what starts the problem

And the second problem is the lack of a follow up assessment after you start something!

a man in a blue shirt and green tie is standing in front of a counter . ALT: a man in a blue shirt and green tie is standing in front of a counter .

Don’t even get me started on the cases where SV or clinical perfusion parameters aren’t even being assessed

Aka “set it and forget it”

The success rate of “idk try an inotrope” has to be sub 5%*

*even for intermediate physiologic outcomes

🛠️ ICU clinicians ❤️ monitoring tools… but ever worry you’re interpreting them wrong?

Just out in #journal_CHESTCritCare, M Siuba et al present a HIDI on interpreting invasive hemodynamics in clinical context:

www.chestcc.org/article/S294...

➕ learn about esoph manometry!

@accpchest.bsky.social

Our review on esophageal manometry for invasive hemodynamic monitoring is live at @accpchest.bsky.social Critical Care

Omg old school twitter nostalgia

Incidence of Adverse Events in Peripheral Intravenous Vasopressor Use This systematic review and meta-analysis examines incidence of adverse events and central venous catheter avoidance after peripheral intravenous administration of vasopressors in adults with hypotensi...

new systematic review & meta-analysis on peripheral pressors:

"the incidence of adverse events after short-term vasopressor administration through PIV catheters was low… with appropriate monitoring, PIV administration might reduce the need for CVC placement."

in @jamanetworkopen.com

Thanks for the opportunity Seth!

Peripheral Vasopressors for Shock Interest in the use of peripheral intravenous (PIV) catheters to administer vasoactive medications to patients in shock has grown in recent years. Potential benefits include faster shock reversal as w...

commentary by @zentensivist.bsky.social in @jamanetworkopen.com on the safety of peripheral pressors:

"PIV administration of vasopressors likely can be accomplished safely, with perhaps less discomfort and harm, compared with conventional CVC-based approaches in some critically ill patients."

Cartoon by Tommy Siegel

Thanks Matt!! Appreciate the feedback and great to hear from you

Hey @zentensivist.bsky.social , that was a great discussion of the RV you had on Critical Care Time. Thanks!

Thrilled to join @nickmark.bsky.social and @askinforair.bsky.social to talk about managing the RV in the ICU

YT link here youtu.be/Supq1q7J28w?...

Also on your fav podcast platforms

Thrilled to join @nickmark.bsky.social and @askinforair.bsky.social to talk about managing the RV in the ICU

YT link here youtu.be/Supq1q7J28w?...

Also on your fav podcast platforms

Jesse Jackson Made It Possible for Democrats to Speak About Palestine Activist James Zogby pays tribute to his late friend, who was the first politician to welcome Arab Americans into the Democratic Party - and even met with Yasser Arafat when others wouldn't.

"Jesse Jackson Made It Possible for Democrats to Speak About Palestine"

Activist James Zogby pays tribute to his late friend, who was the first politician to welcome Arab Americans into the Democratic Party - and even met with Yasser Arafat when others wouldn't.

Cardiac Output During Exercise: Thermodilution Versus Direct Fick | Journal of the American Heart Association

www.ahajournals.org/doi/full/10....

We looked at thermo vs Direct Fick during exercise and the results might surprise you!

Still discordant for absolute values but possibly good enough to classify patients with eg exercise PH or exercise HFpEF based on slope calculations

The Wicked Problem of Surgical Failure Or: Why the Best Surgeons Cannot Escape Variance, and What That Teaches Us About Learning in Complex Systems1.    The Ether Dome and the StatisticianOn October 16, 1846, William Morton administered et...

Thanks to @zentensivist.bsky.social for the HT

This is utterly, utterly, brilliant

www.leezhaomd.org/post/the-wic...

We don’t have it in cleveland due to $$$

We need health care for all, not militarized immigration enforcement that destabilizes communities across the country.

You have to read this. Firsthand affidavit from one of the women who was there and recording the video. She talks about how Alex Pretti was directing traffic when she arrived. She watched him be killed in front of her. She's afraid to go home, worried she'll be arrested.

I will adopt this in the future!

ive seen more articles this week about how the phrase “abolish ice” could hurt dems in the midterms than ive seen articles about how paramilitary death squads terrorizing cities will hurt republicans in the midterms

Another journal asked me to change the background color of the visual abstract and then resubmit. And then desk rejected it!!

Nice work by a stellar team of trainees

journals.lww.com/ccmjournal/f...