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  1. Anyone have recommendations on good papers on critical illness neuropathy and myopathy? #emimcc #critcaresky #cccsky

  2. Systemic vascular resistance is not a realiable measure of left ventriclar afterload. In this study, noradrenaline actually decreased left ventricular wall stress even though SVR increased. Higher heart rate and contractility leads to a smaller LV, lower wall stress. #emimcc #cccsky #cardiosky

    Systemic vascular resistance: ...

  3. T-EDTA to prevent CVC thrombosis. Only difference is lower use of alteplase. Thoughts? #emimcc #ansky #cccsky jamanetwork.com/journals/jam...

  4. Thinking about this. Oblivious confounded, I’d bet a randomised trial would show a much smaller if any harm, but surely no benefit. We need that trial #emimcc #medsky

    RE: https://bsky.app/profile/did:plc:6e6vgoq35acl6g3repmc2z7y/post/3lfufichxqs2l

  5. Lo and behold, the 4 sepsis phenotypes proposed by Seymour (jamanetwork.com/journals/jam... ) based on cluster analysis aren't reproducible in a multicenter cohort. #emimcc #medsky #stats

    RE: https://bsky.app/profile/did:plc:lkvob3xue3vp5otbv6gpt6z5/post/3mncikuege226

  6. Never seen it. I joke that for each decaden of practice, you can drain 250ml more and hour. Once by accident drained 3l in an hour, patient was so satisified😅 #emimcc

    RE: https://bsky.app/profile/did:plc:23kyc35kxpg4b3fmejeicxm4/post/3mlvhdwvdmk2d

  7. RCTs have shown no benefit from IABP in acute ischemic cardiogenic shock, an observatiobal trial isn’t even hypothesis generating. No grounds for new IABP trials in this population in my opinion. #cardiosky #cccsky #emimcc

    Intra-aortic balloon pump vers...

  8. Agree with this

    All formulae for corrected calcium are imperfect

    Just measure ionized calcium

    pubmed.ncbi.nlm.nih.gov/420352

    #EMIMCC

  9. Agree with this All formulae for corrected calcium are imperfect Just measure ionized calcium pubmed.ncbi.nlm.nih.gov/42035248/ #EMIMCC

    Albumin-adjusted ("corrected")...

  10. Observational studies suggests higher mortality but lower thrombosis risk with VKA vs DOACs in CTEPH. What do people do? Personally I want a trial before switching to DOACs as standard of care here #emimcc #cardiosky

  11. Bayesian reanalysis can be a great way to assess a contested trial, by showing how strong a prior you need to nullify or inverse the results. I don't understand why they did not include a pessimistic prior here though (even as I see a sceptical one more realistic). #emimcc #cardiosky #cccsky #stats

    RE: https://bsky.app/profile/did:plc:77cp7kgakti2uthqnkkdaqum/post/3mkpw474mis2q

  12. Single arm pulmonary embolism intervention studies are useless for anything than assessing adverse events, perhaps even more so than the registry studies. Just look at the discrepancy in mortality between RCTs and observational data without inclusion criteria. #emimcc #cardiosky

  13. Cool study - an amp of sodium bicarbonate (50 ml 8.4%) raises sodium similar to a boils of 3% - as expected of course!

    pubmed.ncbi.nlm.nih.gov/419373

    #nephrology #emimcc

  14. In heterogeneous syndromes like ARDS and sepsis, I believe we generally are more likely to be able to find what causes iatrogenic harm than actual therapies. #emimcc #critcaresky

    RE: https://bsky.app/profile/did:plc:q5ogl3twkcqyhvz4zebonw3z/post/3migjy6ta5z2u

  15. Precision medicine in sepsis = correct antimicrobial coverage, source control and tailored haemodynamic support. #emimcc

    RE: https://bsky.app/profile/did:plc:u6ai4u2rvrdb5xjk62y2jpci/post/3mjflldtrf52m

  16. In a patient with high-risk pulmonary embolism, but no sign of hypoperfusion, would you start LMWH or UFH? #emimcc #cardisky #cccsky #critcaresky

  17. The most dangerous thing you can have is a non-septic shock misclassified as septic shock. #emimcc

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

  19. 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

    RE: https://bsky.app/profile/did:plc:vmwckmxogx3lipqxlmn76mbe/post/3mh67jqfw3z2h

  20. The end of the road for rivaroxaban? Shows how important direct comparative trials among drugs within the same pharmacologic class are. #emimcc #cardiosky www.nejm.org/doi/full/10....

  21. One thing that strikes me from these guidelines (which do have many good parts) is how many of the interventions have strong Ia recommendations based on purely observational evidence. Putting the cart before the horse #emimcc #cardiosky

    RE: https://bsky.app/profile/did:plc:pdj5upxe4ocjvjltlkdai7b4/post/3mfi3rdpwyc2t