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This should be the death of Impella outside of severe cardiogenic shock.
High probability it increases mortality. #cardiosky #cccsky

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Check out the @accintouch.bsky.social #ACC26 hands on learning #vaECMO #mcs this morning with me and my #CCC colleagues. Some fun, challenging cases to troubleshoot! #ACCcriticalcare #criticalcarecardiology #medsky #cccsky #cardiosky #cardiology

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Excited for #ACC26 in #NewOrleans! Lots of #ACCcriticalcare activity to participate in, especially the #criticalcarecardiology simulation sessions on #mcs #vaECMO #shock @accintouch.bsky.social #cccsky #medsky #cardiosky

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Can we please stop referring to lactate as a perfusion marker? It’s no more so and no better than blood pressure. #emimcc #cccsky

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#cccsky

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One point that isn't mentioned here but too often forgotten when noradrenaline seemingly isn't working:
Are you actually using a representative blood pressure? Not so rare that a better (more central or better line) fixes the problem. Look at the whole patient, not just a number!
#emimcc #cccsky

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#emimcc #cccsky

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Excited for #ACC26! A few days of learning, sharing ideas, and connecting with #ACCcriticalcare friends & colleagues.

Debating #shock phenotypes and #MCS strategies over coffee & beignets.

See you in #NewOrleans!

@accintouch.bsky.social @escardio.bsky.social #CardioSky #MedSky #cccsky

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Transcatheter aortic valve-in-mechanical valve replacement: a first-in-human study Surgical aortic valve replacement has progressed considerably since the 1950s.1,2 Although mechanical valves offer superior durability, the preference for

Can't wrap my head around how this is even possible! TAVI in mechanical valves. #cardiosky #cccsky
academic.oup.com/eurheartj/ad...

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#cccsky #cardiosky

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Vasopressin in septic shock: an individual patient data meta-analysis of randomised controlled trials - Intensive Care Medicine Purpose We performed an individual patient data meta-analysis to investigate the possible benefits and harms of vasopressin therapy in adults with septic shock both overall and in pre-defined subgroup...

What is worse, digital ischemia or atrial fibrillation? #emimcc #cccsky link.springer.com/article/10.1...

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Diastolic Dysfunction in Acute and Critical Illness: Acute Pathophysiology to Chronic Heart Failure

To write a "state-of-the-art review" of diastolic dysfunction in acute and critical illness with an emphasis on SGLT2-inhibition and not mention the DEFENDER trial is quite something. #cardisky #emimcc #cccsky www.jacc.org/doi/10.1016/...

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#cardiosky #cccsky #emimcc

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Truth
#echosky #cccsky #cardiosky

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#cardiosky #emimcc #cccsky

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#emimcc #cccsky

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Excellent review of CVP measurement. #emimcc #cccsky #cardiosky www.sciencedirect.com/science/arti...

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Does anyone have a good paper on pearls and pitfalls of CVP measurements? #emimcc #cccsky

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Honored and excited to serve as a member of the @accintouch.bsky.social Competency Management Committee. Looking forward to collaborating with colleagues to advance standards, education, and excellence in patient care. #CardioSky #CCCSky #MedSky #Cardiology #ACC #CriticalCare

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#emimcc #cccsky

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Levosimendan to Facilitate Weaning From ECMO in Patients With Severe Cardiogenic Shock This randomized clinical trial assesses the effect of levosimendan on weaning from venoarterial extracorporeal membrane oxygenation (VA-ECMO) within 30 days among patients with severe but potentially ...

Levosimendan is quite often seen as a "safe" inodilator with respect to ventricular arrhythmias. I don't think it is, and this trial in my view supports that. Also, drugs with very long half lives are generally not a good idea in the critically ill #cardiosky #emimcc #cccsky

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New results from DanGer Shock ,shows it's those with the lower systolic pressure (the sicker patients) that benefit from Impella. #emimcc #cardiosky #cccsky jamanetwork.com/journals/jam...

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I’m reading up on the risk of increased intrapulmonary shunting and hypoxia posed by nitroprusside, and thinking, should this not also apply to other vasodilators like nitroglycerine and milrinone? Can only see it described for nitroprusside #emimcc #cccsky

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One of my strong pet peeves: never start vasopressin based on a fixed cutoff for noradrenaline and never without an echo. I strongly oppose the algorithm proposed here #emimcc #cccsky

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#foamed #foamcc #meded #Medsky #cccsky #emimcc #ECG

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