#criticalcare — Public Fediverse posts

I did a talk for cardiologists about #criticalcareecho, emphasising the difference between outpstient/normal data and the critical ill. Supeisingly well recieved and I’ll reiterate my main points:
- Most important use for echo in critical illness is differentiating shock types, and detecting “black swan” conditions like LVOT obstruction and acute valvular pathologies
- Always combine echo with clinical findings.
1/
#echocardiography #CriticalCare #physiology

Interesting review of diastolic function grading in critically ill patients, basically arguing for left atrial strain. Some comments follow : https://onlinelibrary.wiley.com/doi/10.1111/echo.15773 #echocardiography #CriticalCare #cardiology

I see this assertion repeatedly made, but it cannot both be true that a measure is load indepenendent and that it also tracks left atrial pressure! #echocardiography #CriticalCare #CritCareEcho

Suspicion of #PFO in #ARDS: if agitated saline is injected through CVC located in the SVC, #TEE is required to rule out the diagnosis.

If #TEE shows the presence of an #Eustachian valve, injection in a catheter located in the IVC territory is required.

Important data and reminder in #CriticalCare

#ICU #echocardiography #pocus #foamcc

https://ccforum.biomedcentral.com/articles/10.1186/s13054-023-04670-9

A very interesting paper evaluating the effect of correcting low preload in critically ill patients, appropriately pointing out that global longitudinal strain alone cannot be used in this cohort to diagnose cardiac dysfunction. Preload induced change in GLS follows change in CI. https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-018-0376-8
#CriticalCare #CardiacDysfunction #GlobalLongitudinalStrain #echocardiography #POCUS #cardiology

Reposting this fasctinating study here that I shared last year, on the effects on RAP and PCWP of rapid fluid loading (100-200ml/min 1L + 1L warm NS), in a first in healthy younger and older (>50yo) subjects. Striking results, with marked increases in pressures despite absence of heart failure. #echocardiography #cardiology #CriticalCare #Physiology https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.112.111302

A good idea and its validation.

Because LVOT area is related to body surface area:

echoVTI x HR x k = indexed CO

https://pubmed.ncbi.nlm.nih.gov/36496041/

#POCUS #CriticalCare #Echocardiography #Hemodynamics #CardiacOutput #PAC #SwanGanz

Confusion between #AcuteCorePulmonale and #RightVentricularDysfunction is common in #ICU.

A very important reminder that anyone using #Echocardiography to assess #RightVentricularFunction in critically ill patients should read and share.

https://pubmed.ncbi.nlm.nih.gov/35737442/

#POCUS #CriticalCare #Hemodynamics #ThePeoplesVentricle #RightVentricle #RV #Anaesthesia #FOAMcc

Association between the early use of #Echocardiography in #ICU and outcomes in the patients with respiratory and hemodynamic support

#POCUS #CriticalCare

https://www.sciencedirect.com/science/article/pii/S0883944122001897

1st day of #adventarticles, sharing some of my all time favourite papers:
"Ejection Fraction Revisited" from Robotham et al, THE paper to read on ejection fraction.
One of many key takeaways:
Hyperdynamic LV/supranormal EF is not a sign of low preload, on the contrary EF is relatively preload insensitive and if anything very low preload lowers EF.
https://pubs.asahq.org/anesthesiology/article/74/1/172/31892/Ejection-Fraction-Revisited #physiology #criticalcare #echocardiography

#introduction to new instance!
I'm an end stage #cardiology trainee working in Trondheim, Norway, finishing up a PhD in #POCUS in stroke care, aiming to subspecialise in #cardiaccriticalcare and #imaging. Obsessed with #criticalcare #echocardiography, fascinated by #physiology and #statistics, concerned about the future of our #publichealthcare system, #socialdeterminantsofhealth and #climatechange
Toots in English, Norwegian, Danish and French.