1/11 Invasive arterial blood pressure (IBP) – does the location of arterial catheter matter? Knowing BP when treating hemodynamically unstable patients is pivotal. Does the location of arterial catheter influence the adequacy of BP values? 🧵 link.springer.com/article/10.100…

Ok this clip about navigating the American Healthcare System from the recent South Park ozempic special (which was brilliant) needs to be the opening of every healthcare conference panel

❓Do your ECMO patients ride bikes? ❓What amazing things do your patients do on ECMO or on ventilator? This should be standard of care at all hospitals 🏥! This is amazing Marco a 9 y.o. cancer🎗️survivor waiting for lung top! See his amazing mom & page! @graziellahannan

For people who love heart 🫀 surgery Ascending aortic aneurysm !

Standardized myocardial segmentation and nomenclature. #FOAMed #FOAMcc #POCUS #MedEd Look at the PSAX first and imagine the plane of apical views. Makes it much easier to comprehend. Img source: ecgwaves.com/topic/left-ven…

If you intubate you need to read the #PREOXI trial! -n=1301 people requiring intubation in ED/ ICU were randomized to preoxygenation with oxygen mask vs non-invasive ventilation (NIV) -NIV HALVED the risk of hypoxemia: 9 vs 18% -NIV reduced mortality: 0.2% vs 1.1% #CCR24 🧵 1/

Fresh blog: PPIs are safe and effective for GI prophylaxis… the end. 😁Review of SUP-ICU, PEPTIC & REVISE 😁PPIs are effective & safe (no increase in PNA or CDiff) 😁Mortality trends are statistical noise (REVISE shows *less* mortality w/ PPIs) blog: emcrit.org/pulmcrit/revis…

Guidelines recommend use of alternatives to UFH in acute PE due to the unpredictable pharmacokinetics of UFH (the rollercoaster) & resource intensity. we looked at nearly 300,000 patients hospitalized w/acute PE to see if we're doing that AnnalsofEM authors.elsevier.com/a/1jHL3ib7EM8JM (1/)

🩸Recent systemic thrombolysis per sè should NOT be considered contraindication for initiating #ECLS in high-risk PE. Study including pts undergoing/not to pre #ECMO cannulation thrombolysis: no difference in survival/bleeding risk #FOAMcc Intensive Care Medicine 🔓 rdcu.be/dLOBk

Aneurysm of the left ventricle A left ventricle aneurysm occurs when part of the heart wall weakens and bulges out, often due to a heart attack. This can lead to heart failure or dangerous arrhythmias. Early detection and treatment are crucial!

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How would you handle this one PERT colleagues ? John Moriarty James Horowitz myda Parth Rali F Mae West, MD MS

STRIKE-PE trial data drop: Impressive improvements in QOL post PE-intervention. Thx patients and investigators on 3 continents, more to come soon! sciencedirect.com/science/articl…. JVIR Society of Interventional Radiology PERT Consortium UCLA IR UCLA Pulmonary Vascular Disease Program UCLA Health

This is how lungs 🫁 look after smoking for a prolonged period of time.

#POCUS in skin and soft tissue infections. #MedEd #ultrasound #FOAMcc 🔗 pubmed.ncbi.nlm.nih.gov/39082276/

Heart coming out of ventricular fibrillation!! 🫀⚡️

Pitfalls in Echocardiography by Fabian Knebel at #ESCCongress2024 (1) Missing apical pathology Unenhanced TTE can miss apical masses. Contrast agents can help identify these masses, especially in non-standard / deliberately off-axis apical views

Landmark PERSEVERE trial announced European Society of Cardiology 2024 RCT for high risk massive PE: large bore thrombectomy vs standard of care. Mortality 20-30% with standard of care 1 past RCT in this group with only 8 patients. The “Golden Era of PE RCT” continues! sciencedirect.com/science/articl…

Asher Mendelson, MD PhD Oren Friedman European Society of Cardiology protocol-specified absolute CI are trial exclusions. These include intracranial malignancy, active bleeding, stroke within 14 days, and spine/brain surgery within 14 days. Goal is for pragmatic, strategy trial so other high risk features for bleeding will ideally be randomized

What to do with an ICH patient who bled while on AC for a mechanical heart valve? When and how to restart AC? This is a cool study showing that the risk of bleeding complications far outweighs the risk of thromboembolism overall Plus the risk of ICH is highest when IV heparin