#foamcc — Public Fediverse posts
Live and recent posts from across the Fediverse tagged #foamcc, aggregated by home.social.
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Consumptive coagulopathy during #ECLS
🔎 close monitoring & follow up pivotal during the #ECMO run
⛔️ giving platelets/clotting factors to fix numbers often worsens underlying process
🩸 low doses of anticoagulants may protect both circuit (vs thrombotic complications) & patient (vs bleeding & thrombosis)
⛔️ bleeding complications should NOT always prompt complete cessation of UFH
Detailed underlying pathophysiological process & physiological rationale free to read #FOAMcc
🔓 https://rdcu.be/dLmXO -
📢 June issue of Intensive Care Medicine is now available!!
💦 European Society of Intensive Care Medicine (ESICM) fluid therapy guidelines
🗺️ critical care in LMICs
🩸emergency chemotherapy for hematological patients in #ICU
🫘 #RRT in PedsICU
🧫 #sepsis & bloodstream infection
🫁 proning in #ECMO
🫁 Pes
🫀 #ECLS in cardiogenic shock
🧠 neuromonitoring
& more! Full texts free to read #FOAMcc if you follow the links we share in our social media posts... enjoy!
📎 https://bit.ly/ICMJun2024 -
What is happening in this 44-year-old man on VA #ECMO??
🚨 #ECPR after 30 min of refractory cardiac arrest post-myocardial infarction
🫀 recovered native cardiac activity but severe postresuscitation vasoplegia leading to important fluid filling to maintain #extracorporeal blood flow
🖥️ TEE showed right atrial collapse
…. cardiac tamponade?? Collapse reversed within seconds during a transient reduction in EBF
Free to read #FOAMcc #FOAMecmo on @ICM
🔓 https://rdcu.be/dJW8S -
What is happening in this 44-year-old man on VA #ECMO??
🚨 #ECPR after 30 min of refractory cardiac arrest post-myocardial infarction
🫀 recovered native cardiac activity but severe postresuscitation vasoplegia leading to important fluid filling to maintain #extracorporeal blood flow
🖥️ TEE showed right atrial collapse
…. cardiac tamponade?? Collapse reversed within seconds during a transient reduction in EBF
Free to read #FOAMcc #FOAMecmo on @ICM
🔓 https://rdcu.be/dJW8S -
What is happening in this 44-year-old man on VA #ECMO??
🚨 #ECPR after 30 min of refractory cardiac arrest post-myocardial infarction
🫀 recovered native cardiac activity but severe postresuscitation vasoplegia leading to important fluid filling to maintain #extracorporeal blood flow
🖥️ TEE showed right atrial collapse
…. cardiac tamponade?? Collapse reversed within seconds during a transient reduction in EBF
Free to read #FOAMcc #FOAMecmo on @ICM
🔓 https://rdcu.be/dJW8S -
What is happening in this 44-year-old man on VA #ECMO??
🚨 #ECPR after 30 min of refractory cardiac arrest post-myocardial infarction
🫀 recovered native cardiac activity but severe postresuscitation vasoplegia leading to important fluid filling to maintain #extracorporeal blood flow
🖥️ TEE showed right atrial collapse
…. cardiac tamponade?? Collapse reversed within seconds during a transient reduction in EBF
Free to read #FOAMcc #FOAMecmo on @ICM
🔓 https://rdcu.be/dJW8S -
What is happening in this 44-year-old man on VA #ECMO??
🚨 #ECPR after 30 min of refractory cardiac arrest post-myocardial infarction
🫀 recovered native cardiac activity but severe postresuscitation vasoplegia leading to important fluid filling to maintain #extracorporeal blood flow
🖥️ TEE showed right atrial collapse
…. cardiac tamponade?? Collapse reversed within seconds during a transient reduction in EBF
Free to read #FOAMcc #FOAMecmo on @ICM
🔓 https://rdcu.be/dJW8S -
Finding optimal tidal volume in #ARDS
🫁 is ΔP indicator of unsafe VT & does it directly impact on outcome?
🫁 what factors can influence CRS + interplay between VT & ΔP?
We should continue using protective mechanical ventilation but, rather than fixed cut-of (6 ml/kg PBW) it may be more advantageous individualize VT considering multifactorial contribution of ∆P, CRS, ECW, PEEP + regional lung mechanics.
Free to read #FOAMcc on @ICM
🔓 https://rdcu.be/dHUzd -
Cardiogenic shock in 2024:
🫀 #extracorporeal life support #ECLS
🫀 left ventricular unloading strategies in #ECMO
strategies & evidence from recent trials (& beyond)
Free to read #FOAMcc #FOAMecmo on @ICM
🔓 https://rdcu.be/dHzLz -
Prone positioning on #ECMO for severe #ARDS??
🚦PRO: Performed in experienced/highly specialized centers, PP feasible/safe promising option
🔓 https://rdcu.be/dGIMf
🚦CON: according to PRONECMO trial results, PP during #ECLS did not yield significant benefits vs supine position.
🔓 https://rdcu.be/dGILB
🚦NOT SURE: How to reconcile the results of high-quality, negative RCT with preexisting favorable observational data?
🔓 https://rdcu.be/dGINm
All free to read #FOAMcc #FOAMecmo on @ICM -
🧠 🫁 Mitigating/managing cerebral complications of #ARDS?? Clinical decision making must integrate neuromonitoring-guided evaluation & selection of lung protective interventions with consideration of individual patient cerebral physiology. Individualized approach could prevent additional brain injury, improving neurological outcomes in survivors, potentially impact on post-intensive care syndrome outcomes.
Free to read #FOAMcc on @ICM
🔓 https://bit.ly/4djO8mh -
Safe ventilation in #ARDS?? Elusive... justifying use of #ECLS. Challenge is to treat lung disease effectively while mitigating injury risks. Free to read #FOAMcc on @ICM
🔓 https://rdcu.be/dGq5pIn reply to
🔓 https://rdcu.be/dGq6nAll refers to editorial on VILI
🔓https://rdcu.be/dGq6G -
Prone positioning?? Used since 70s to improve oxygenation in patients with #ARDS. Beyond oxygenation benefits, it plays crucial role in preventing VILI + in preserving/improving
hemodynamics, leading to reduced mortality in selected patients. Here concise overview:
🫁 main pathophysiological findings
🫁 supporting evidence & practical considerations for use
🫁 awake proning in non-intubated patients
Free to read #FOAMcc on Intensive Care Medicine
🔓 https://rdcu.be/dFIdO -
Optimizing PEEP in #ARDS, physiological evidence, bedside strategies & clinical applications:
❓ why do we apply PEEP?
🫁 definition of lung recruitability
🔍 what does the evidence say about PEEP setting?
🫁 practical & pragmatic approach
⚙️ advanced methods
No one among available options for tailoring PEEP proved to be superior to others... so clinical practice is highly variable; integration into clinical settings may be challenging.
Free to read #FOAMcc on @ICM
🔓 https://rdcu.be/dDFbN -
DoN'T miss March issue of Intensive Care Medicine
🩸managing major haemorrhage in #ICU
🧫 infections in immunocompromised patients
🫁 #ECMO in #ARDS & 🫀cardiogenic shock
🧠 traumatic brain injury
🌱 environmental sustainability
📷 Imaging in ICM & more...
most free to read 🔓 #FOAMcc (just follow links in our #SoMe posts)
🖇️ bit.ly/ICMMar2024 -
Electrical impedance tomography-guided personalized PEEP titration in #ARDS, systematic review & meta-analysis:
🔍 13 studies (January 2012-May 2023) included, involving > 600 patients
🫁 EIT effective in guiding mechanical ventilation setting in patients with ARDS
🫁 real-time lung function assessment facilitated by EIT allows for personalized PEEP, resulting in enhanced lung compliance + reduced MP/DP
Free to read #FOAMcc on @ICM
🔓 https://rdcu.be/dB6Fr -
Bedside strategies to personalise approach minimizing patient-self-induced & ventilator-induced lung injury (so risk of lung injury progression) in #ARDS patients
🫁 safer use of noninvasive respiratory support
🫁 safer use of controlled mechanical ventilation: tidal volume and driving pressure, prone position, PEEP & recruitability, transpulmonary pressure and end‑inspiratory lung stress
🫁 safer use of assisted modes & spontaneous breathing
Free to read #FOAMcc on @ICM
🔓 https://rdcu.be/dBK1u -
Age & associated outcomes among pts receiving VA #ECMO, (Bayesian) analysis of ELSO Registry:
🏥 > 15K pts/440 centers
📈 increasing age strongly associated with higher mortality or complications
📈 statistically higher risk emerging as early as 40 y
🔓 https://rdcu.be/dqhb5With editorial:
🍂 How old is too old for #ECLS in cardiogenic shock? In the age of #machinelearning medicine remains art of probability & science of uncertainty.
🔓 https://rdcu.be/dqhbq -
#ECLS for #ARDS, systematic review & meta-analysis focused on long-term patients' outcomes:
📖 1 RCT + 31 observational studies included; lack of high-quality data: limited overall quality of evidence
⚠️ major sequelae common: 49% of survivors returning to work, 23% need home assistance
⚖️ #ECMO vs conventional mechanical ventilation? no significant difference in HRQoL, cognitive function, mental health, functional status, respiratory symptoms #FOAMcc #FOAMecmo on @ICM
🔓https://rdcu.be/dw7XC -
🧠 Early methylprednisolone in comatose #OHCA patients: may improve outcome?? STEROHCA RCT on 🚑 prehospital single high-dose IV (250 mg) vs placebo
Full results #FOAMcc on @ICM
🔓 https://rdcu.be/dqJU7
Editorial
🔓https://rdcu.be/drREl
⬇️ Below visual abstract -
Osler CPD Home now accredited by the Australian Medical Council
https://oslercpdhome.com.au/blog/osler-accredited-cpd-home
#medtwitter #meded #FOAMed #FOAMcc #juniordoctors #juniordocs #tipsfornewdocs #ausdoctors #ausdocs #ausmed #CPDHomes #CPDHome #ausmedicine #intensivist #emergencyphysician #physician #medmastodon
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Decidual stromal cells in severe #COVID19 related #ARDS: in this pilot study from 🇨🇦, treating critically ill patients on mechanical ventilation with placenta-derived DSC appeared feasible & safe. In DSC-group, trend to increased survival to #ICU discharge, with no significant difference in #ICU stay; significantly higher survival to hospital discharge.
Free to read #FOAMcc on @ICM
🖇️ https://rdcu.be/drgkR -
Excellent new podcast from Critical Care Time now live and free on Osler - The Physiologically Difficult Airway
https://osler.app.link/hk30zQ8jVBb
#medtwitter #intensivist #FOAMed #juniordoctors #tipsfornewdocs #emergencymedicine #intensivecare #ICU #FOAMcc #emergencyphysician
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🧪 Genetic profile & blood-based biomarkers involved in #ARDS? This study highlights that adding 4 blood genes & 5 immune cell proportions significantly enhanced the precision of acute respiratory distress syndrome risk prediction. These findings present a promising prediction model with potential clinical utility for risk assessment, early detection, and potential guidance of intervention strategies in the management of ARDS.
Free to read #FOAMcc on @ICM 🔓 https://rdcu.be/dqoxX -
A critically ill 45 year old woman is intubated in the ICU. A procedure is performed and the following test is conducted
What was the procedure?
https://osler.app.link/f9ZienD7Exb
#medtwitter #meded #tipsfornewdocs #FOAMed #FOAMcc #intensivecare #ICU #intensivist #criticalcare #criticalcaremedicine #juniordoctors #juniordocs #medstudenttwitter #medstudents #medmastodon
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🫘 Initiation of renal replacement therapy in #ICU? Optimal modality to deliver of #RRT to critically ill patients with severe acute kidney injury controversial: any potential link between RRT modality and kidney recovery?? In this retrospective analysis of STARRT #AKI trial CRRT vs IHD associated
with significant reduction of risk of death or RRT dependence at 90 days.
Free to read #FOAMcc on @ICM 🔓 https://rdcu.be/dosj9 -
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
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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
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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
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A 60 year old man presents to emergency with shortness of breath, increasing over a number of days.
A Chest X-ray is taken to evaluate the cause.
What does it show?
https://osler.app.link/76dPlZL3BDb
#meded #medtwitter #FOAMed #FOAMcc #medstudent #medstudents #tipsfornewdocs #tipsfornewinterns #juniordocs #juniordoctors #emergencymedicine #intensivecare #ICU
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A 60 year old man presents to emergency with shortness of breath, increasing over a number of days.
A Chest X-ray is taken to evaluate the cause.
What does it show?
https://osler.app.link/76dPlZL3BDb
#meded #medtwitter #FOAMed #FOAMcc #medstudent #medstudents #tipsfornewdocs #tipsfornewinterns #juniordocs #juniordoctors #emergencymedicine #intensivecare #ICU
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A 60 year old man presents to emergency with shortness of breath, increasing over a number of days.
A Chest X-ray is taken to evaluate the cause.
What does it show?
https://osler.app.link/76dPlZL3BDb
#meded #medtwitter #FOAMed #FOAMcc #medstudent #medstudents #tipsfornewdocs #tipsfornewinterns #juniordocs #juniordoctors #emergencymedicine #intensivecare #ICU
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A 60 year old man presents to emergency with shortness of breath, increasing over a number of days.
A Chest X-ray is taken to evaluate the cause.
What does it show?
https://osler.app.link/76dPlZL3BDb
#meded #medtwitter #FOAMed #FOAMcc #medstudent #medstudents #tipsfornewdocs #tipsfornewinterns #juniordocs #juniordoctors #emergencymedicine #intensivecare #ICU
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What is the optimal strategy for managing blood glucose in the ICU?
We'll review the TGC-FAST study in this episode of Osler Shortcuts
#ICU #FOAMed #FOAMcc #intensivecare #intensivist #criticalcare #criticalcaremedicine #ICURN #ICUNurse
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What does "fluid responsiveness" mean, how does it work, and why is it important?
Another great Osler Shortcut : https://youtu.be/x3N9LKdj06w
#meded #medtwitter #tipsfornewdocs #juniordoctors #emergencymedicine #emergencyphysician #intensivist #ICU #intensivecare #intensivecaremedicine #FOAMed #FOAMcc #criticalcaremedicine #criticalcare
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How do you learn procedures as a junior doctor? Here's some of the challenges that lie ahead of them
#meded #medtwitter #medstudenttwitter #medstudent #juniordoctors #juniordoctor #tipsfornewdocs #tipsfornewinterns #FOAMed #juniordocs #jdocs #FOAMcc
https://www.oslercpdhome.com.au/blog/learning-procedures-as-a-junior-doctor-challenges
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How do you learn procedures as a junior doctor? Here's some of the challenges that lie ahead of them
#meded #medtwitter #medstudenttwitter #medstudent #juniordoctors #juniordoctor #tipsfornewdocs #tipsfornewinterns #FOAMed #juniordocs #jdocs #FOAMcc
https://www.oslercpdhome.com.au/blog/learning-procedures-as-a-junior-doctor-challenges
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How do you learn procedures as a junior doctor? Here's some of the challenges that lie ahead of them
#meded #medtwitter #medstudenttwitter #medstudent #juniordoctors #juniordoctor #tipsfornewdocs #tipsfornewinterns #FOAMed #juniordocs #jdocs #FOAMcc
https://www.oslercpdhome.com.au/blog/learning-procedures-as-a-junior-doctor-challenges
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How do you learn procedures as a junior doctor? Here's some of the challenges that lie ahead of them
#meded #medtwitter #medstudenttwitter #medstudent #juniordoctors #juniordoctor #tipsfornewdocs #tipsfornewinterns #FOAMed #juniordocs #jdocs #FOAMcc
https://www.oslercpdhome.com.au/blog/learning-procedures-as-a-junior-doctor-challenges
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Today is RU OK day.
Please check in on your friends and colleagues today and ask themConsider these 4 steps
- ask RU OK
- listen
- encourage them to act
- check inThese four steps can change, and even save, a life
https://osler.app.link/tPaedlNJ4Cb
Please share this with your colleagues, juniors, seniors, friends
#meded #medtwitter #medstudenttwitter #medstudents #tipsfornewdocs #tipsfornewinterns #juniordoctors #juniordocs #FOAMed #FOAMcc #medmastodon
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Vasopressors 101 (part 2)
Another exceptional episode of the Care Time podcast by Nick and Cyrus, now available on Osler
https://osler.app.link/hk30zQ8jVBb
#medmastodon #meded #medtwitter #FOAMed #FOAMcc #FOAMresus #FOAMems #criticalcare #criticalcaremedicine #intensivist #ICU #intensivecare
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New quiz!
54 yo ♀️, septic shock due to pneumonia. D3 liver function tests are shown - what is the likely cause?
Free answer / tutorial here!
https://osler.app.link/OT61uuck1Cb
#meded #medmastodon #medtwitter #FOAMed #FOAMcc #medstudenttwitter #medstudents #juniordoctors #tipsfornewdocs #intensivecare #intensivist #ICU #ICURN #ICUnurse #criticalcare #criticalcaremedicine
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#Albumin Should Be Remembered When Patients With #SepticShock Are Resuscitated
“Although no significant difference in 28-day mortality rate or 90-day mortality rate was observed between the use of albumin and #crystalloids, #colloids appeared to be more effective than crystalloids in stabilizing hemodynamic end points”
I couldn't agree more. Sometimes you have to find what to do at the moment. It is safe and may help.
https://journal.chestnet.org/article/S0012-3692(23)00654-2/fulltext
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Osler has just released its latest platform upgrade.
Here's 5 great new features for you to take advantage of
https://osler.app.link/to5PXpmkHCb
#meded #meducation #medmastodon #medtwitter #AMEE23 #doctors #tipsfornewdocs #CPDHome #CPDHomes #CPDHours #FOAMed #FOAMcc #juniordoctors #juniordocs #ausdoc #ausdoctors #ausmed #ausmedicine #tipsfornewinterns
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Osler shortcut - how to move the ultrasound probe. Essential for any #POCUS beginner
#medtwitter #meded #POCUS #ultrasound #tipsfornewdocs #tipsfornewinterns #medstudents #medstudent #medschool #juniordoctors #juniordocs #emergencymedicine #intensivecare #anaesthesia #anesthesia #FOAMed #FOAMcc
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Osler shortcut - how to move the ultrasound probe. Essential for any #POCUS beginner
#medtwitter #meded #POCUS #ultrasound #tipsfornewdocs #tipsfornewinterns #medstudents #medstudent #medschool #juniordoctors #juniordocs #emergencymedicine #intensivecare #anaesthesia #anesthesia #FOAMed #FOAMcc
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Osler shortcut - how to move the ultrasound probe. Essential for any #POCUS beginner
#medtwitter #meded #POCUS #ultrasound #tipsfornewdocs #tipsfornewinterns #medstudents #medstudent #medschool #juniordoctors #juniordocs #emergencymedicine #intensivecare #anaesthesia #anesthesia #FOAMed #FOAMcc