This story is absolutely shocking.

Philip Morris International (PMI) spent millions to influence medical education by buying a series of “CMEs” at Medscape!

How else has big tobacco tried to normalize vaping & influence the medical community?

🧵
1/
theexamination.org/articles/medsc…

Effect of Urine Output on the Predictive Precision of NephroCheck in On-Pump #CardiacSurgery with Crystalloid Cardioplegia: Insights from the PrevAKI Study #AKI

jcvaonline.com/article/S1053-…

9/9 Congratulations to Filippo D'Amico Todd C. Lee Giovanni Landoni, MD for such a monumental work. I am also very grateful to them for inviting me to participate in this meta-analysis! Great people. Thank you for reading and have a good day! #FOAMed #criticalcare #intensivecare #ICU …

2/6 In meta-analyses that include both randomized and non-randomized studies, RCTs appear to have an opposite direction compared to non-randomized studies.

NephroCheck results may be influenced by urine output and hemodilution

Do we need different thresholds in different populations?

Our experience now published on Journal of Cardiothoracic and Vascular Anesthesia

San Raffaele Anesthesia and Intensive Care
Fabrizio Monaco, MD paulemann Rosa Labanca Stefano Fresilli Rinaldo Bellomo

We're looking for centers in South and Central America to enrol 50 patients in the STARGATEstudy

If you are interested visit stargatestudy.com or contact Vincenzo Russotto

Orlando R. Pérez-Nieto
Otavio Ranzani
ECMO Heart Team Mx
Fernando Zampieri
Dra Ludhmila Hajjar
SACH
sopemi…

Patrick Wieruszewski Erin Wieruszewski Mayo Clinic Department of Anesthesiology Mariam ElSaban very interesting!

propofol-free ICU might become reality in some centers

or at least ‘not propofol as a first agent in all patients’

pubmed.ncbi.nlm.nih.gov/37046269/

This awesome paper provides a theoretical rationale for the results of the newly published meta-analysis journals.lww.com/ccmjournal/abs… Filippo D'Amico Giovanni Landoni, MD

Have you used volatiles in ICU? INSPiRE-ICU 1 trial just finished enrolling, #2 almost done, results to follow soon. Possible NDA to be submitted FDA early 2025.

Check out this outstanding timely review led by Erin Wieruszewski

🔗 pubmed.ncbi.nlm.nih.gov/38633473/

Mayo Clinic Department of Anesthesiology Mariam ElSaban

3/9 RESULTS: 28 RCTs were analysed (15,672 pts). There were 12 critical care studies and 16 perioperative studies. Most of the studies had low risk of bias. The lower BP targets were associated with a SIGNIFICANT 7% relative reduction in mortality. Number needed to treat = 100

2/10
⚠️Important clarification:
In our meta-analysis, patients were not treated specifically to achieve lower BP targets.

Our findings do not advocate for inducing hypotension, but rather for reevaluating existing blood pressure understanding and management strategies.

Gonna have to read this. Any info on microcirculation? Because strategies to increase BP are not hemodynamically equal, so broad statements become almost meaningless…

Philippe Rola Good point!

Not all hypotension are the same

Flow=MAP-CVP/R

MAP=CO x R + CVP

Increasing MAP through resistance could reduce flow

2/

#ECPR is the last rescue therapy when despite high-quality conventional CPR it is not possible to achieve ROSC.

In such situations, OHCA is considered refractory and E-CPR recently demonstrated to improve outcomes in selected patients.

#ResusTwitter twitter.com/tscquizzato/st…

It’s on my reading list. #LessIsMore can be beneficial in many ways.

8/10
🚀 Overwhelming Evidence!
20 out of 21 sensitivity analyses demonstrated a similar magnitude and direction for mortality in favor of lower targets.

🎯 10 of these analyses are statistically significant, proving the power and reliability of our findings.

3/10
🦣Our meta-analysis is the largest ever on blood pressure management in critically ill and perioperative setting

- 28 RCTs

-15,672 patients

It's the first to include both critically ill and perioperative populations, evaluating each group separately.

Wonderful team at #RetreatOSR2024

💪🏻Nothing strong as team spirit!

6/10
📉The Absolute Risk Reduction indicates 10 fewer deaths per 1000 patients , which translates to an Number Needed to Treat of 100.

⚰️For every 100 patients where we choose lower blood pressure targets (defined as the minimum tolerated level), we prevent one death.

Congratulations to the OLV Alast Clinic, Aalst, Belgium, on reaccreditation to host the EACTAIC Basic Fellowship Programmes in Cardiothoracic and Vascular Anesthesia or four years for one trainee at each training year.