iiinova — where your digital self keeps evolving

Reposted by Dan Harrison, MD

April Sharp, MD @ansharp.bsky.social · 14/08/2026

Brain death is death. Same as when the heart stops.

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Dan Harrison, MD @danharrisonmd.bsky.social · 05/08/2026

Good luck! We're doing a (slightly) less ambitious 20 mile ride on the rail trail (on e-bikes)

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Reposted by Dan Harrison, MD

@IM_Crit_ @imcrit.bsky.social · 26/07/2026

Nothing good happens in the ICU at 3 am

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Reposted by Dan Harrison, MD

@IM_Crit_ @imcrit.bsky.social · 18/07/2026

Unpopular ICU opinion: When a patient becomes apneic during a spontaneous breathing trial, we often declare that the patient failed the trial Maybe not. Maybe we failed the patient by stopping the trial too soon, before sedatives had worn off and the respiratory drive had a chance to return

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Reposted by Dan Harrison, MD

Neurocritical Care Society @neurocritical.bsky.social · 06/05/2026

Thinking about Neurocritical Care fellowship? 🧠 Our latest Currents article breaks down how to evaluate programs and choose the training path that fits your career vision. Read here: bit.ly/4d0rAc2

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Reposted by Dan Harrison, MD

Neurocritical Care Society @neurocritical.bsky.social · 11/04/2026

🧠 New on Currents: Quantitative pupillometry may help predict neurologic deterioration in large MCA stroke. Explore the latest insights: bit.ly/3PSBUd6

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Dan Harrison, MD @danharrisonmd.bsky.social · 28/03/2026

@stevemagness.bsky.social writes about performance through the lens of sport, but these lessons are highly relevant to clinicians (and medical educators). Worth a follow!

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Dan Harrison, MD @danharrisonmd.bsky.social · 19/03/2026

We had 2 week NCC blocks but I think I did 4 or 5 of them. One of our ICUs was pretty intense (carrying up to 20 patients as the junior with help from a senior during the day, solo overnight). 4 week stretches would have been too much (but a single 2 week block definitely not enough).

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Reposted by Dan Harrison, MD

Emily Fridenmaker @emilyfri.bsky.social · 10/02/2026

Applications for our APP CCM fellowship open next week! One year, starting in September. Core ICU rotations include MICU, CICU, CVICU, SICU, STICU, NSICU. #emimcc www.camcmedicine.edu/departments/...

camcmedicine.edu

APP Critical Care Fellowship | CAMC Institute for Academic Medicine

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Dan Harrison, MD @danharrisonmd.bsky.social · 03/02/2026

Determination of Adult Critical Care Physician Core Knowledge and Skills: Results of a Multidisciplinary, Modified Delphi Process journals.lww.com/ccmjournal/f...

journals.lww.com

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Reposted by Dan Harrison, MD

Shematologist, MD @shematologist.medsky.social · 25/01/2026

This is now a political account because I can’t treat your heavy menstrual bleeding and iron deficiency appropriately if ICE disappears or executes you.

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Dan Harrison, MD @danharrisonmd.bsky.social · 24/01/2026

As a rule, I do not post about politics, but we must abolish ICE, boycott anyone supporting them, and vote for political candidates who mean business about standing up to this madness.

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Reposted by Dan Harrison, MD

Michael Burk, MD @mjburkmd.medsky.social · 02/01/2026

ICU documentation pet peeve: is there any cirrhosis that is not "liver cirrhosis"? This must be the "ATM machine" equivalent of medicine. #Medsky

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Dan Harrison, MD @danharrisonmd.bsky.social · 01/01/2026

Once you subscribe you get access to all the back issues. Next NCC edition is 2027 if you wanted to target subscribe for 1 year. But maybe @caseyalbin.bsky.social can wave a magic wand/advocate for a non-neurologist rate 🧚🏼‍♂️

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Dan Harrison, MD @danharrisonmd.bsky.social · 27/12/2025

Not sure. Many of these patients had demyelinating disease. Pathophys here is very different than most systemic indications for steroids

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Dan Harrison, MD @danharrisonmd.bsky.social · 26/12/2025

Not designed to directly compare pulse vs moderate dosing, but the ONTT comes to mind: www.nejm.org/doi/full/10....

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Neurocritical Care Society @neurocritical.bsky.social · 23/12/2025

Catch up on the latest NCS podcast episodes wherever you listen to podcasts to hear the latest scientific findings, perspectives from experts in the field and conversations on hot topics in ncc: bit.ly/4gU1tCr

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Dan Harrison, MD @danharrisonmd.bsky.social · 23/12/2025

For me, depends on timing/resources. If the patient is nadiring and I can only get NIFs once per shift, then a page from the nurse prompting an assessment could lead to an acute intervention (intubation). If the patient is past their nadir or already intubated, they probably don't need neurochecks

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Reposted by Dan Harrison, MD

Richard Choi, DO, FNCS @rkchoi.bsky.social · 08/12/2025

Important text to read re: #braindeath www.neurology.org/do...

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Dan Harrison, MD @danharrisonmd.bsky.social · 09/12/2025

Almost never, but in manuscripts with good science that need a lot of grammar work, I will at least acknowledge that they "require grammatical correction throughout prior to publication"

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Dan Harrison, MD @danharrisonmd.bsky.social · 06/12/2025

Is the peace prize here in the room with us?

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Reposted by Dan Harrison, MD

josh farkas 💊 @pulmcrit.bsky.social · 28/11/2025

updated the acute liver failure chapter biggest change is increasing support for early CRRT to remove NH3 (to reduce elevated intracranial pressure) now rec'd for clinically overt encephalopathy (Grade 2-4) if admitting to ICU for ALF & encephalopathy, just dialyze emcrit.org/ibcc/alf/ #EMIMCC

article: https://pubmed.ncbi.nlm.nih.gov/37377263/

IBCC chapter about acute liver failure: https://emcrit.org/ibcc/alf/

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Dan Harrison, MD @danharrisonmd.bsky.social · 23/11/2025

First "clamp rounds" in NCC with my senior fellow was a huge success! But what is the NCC equivalent? Don't typically hook the EVD up to suction ☠️ Clamp, 20/open, 10/open? Not quite as slick. Either way, thanks for the idea/analogy @gbosslet.bsky.social!

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Reposted by Dan Harrison, MD

Andy Webb @ajwpharm.bsky.social · 17/11/2025

Excited to share our newest work on free VPA: improving ability to predict levels with the Fraser equation. We reveal that the orig eq. is modestly accurate in an external cohort and make improvements to the eq, but confirm measurement remains ideal @cbthepharmd.bsky.social doi.org/10.1002/phar...

Standard (A) and modified (B) Bland–Altman plots representing the performance of the Fraser equation in an external cohort. In the standard Bland–Altman plot (A), the x axis represents the actual (measured) free valproate concentration while the y axis represents the difference between the Fraser predicted and the actual free valproate concentration. The solid black line represents a difference of 0 mg/L (i.e., an accurate prediction) and the dashed lines represent the 95% confidence interval of the mean difference between the predicted and actual values. Individual dots represent a single valproate concentration. In the modified Bland–Altman plot (B), the x axis represents the actual (measured) free valproate concentration, and the y axis represents the Fraser predicted free valproate concentration. The dashed line represents a perfect y = x correlation while the solid line represents the observed linear relationship between the actual and predicted concentrations. Both figures depict the worsening under-estimation as measured free valproate increases.

Standard (A) and modified (B) Bland–Altman plots representing the performance of the modified Fraser equation with patient effect.In the standard Bland–Altman plot (A), the x axis represents the actual (measured) free valproate concentration while the y axis represents the difference between the Fraser predicted and the actual free valproate concentration. The solid black line represents a difference of 0 mg/L (i.e., an accurate prediction) and the dashed lines represent the 95% confidence interval of the mean difference between the predicted and actual values. Individual dots represent a single valproate concentration. In the modified Bland–Altman plot (B), the x axis represents the actual (measured) free valproate concentration, and the y axis represents the Fraser predicted free valproate concentration. The dashed line represents a perfect y = x correlation while the solid line represents the observed linear relationship between the actual and predicted concentrations. Performance with the modified equation was significantly improved when individual patient effect was included.

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Reposted by Dan Harrison, MD

JAMA @jama.com · 29/10/2025

📊 Research Summary: Personalized resuscitation targeting capillary refill time modestly improved organ support–free days and composite outcomes in early septic shock, but showed no difference in mortality vs usual care. #LIVES2025 @esicm.bsky.social ja.ma/4huvHOa

JAMA Research Summary: "Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock." The study analyzes 1467 adults with septic shock. CRT-PHR showed 131,131 wins (48.9%) vs. Usual Care with 112,787 wins (42.1%).

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Dan Harrison, MD @danharrisonmd.bsky.social · 29/10/2025

Neurologist: It has to be more concentrated than normal saline to work. Intensivist: Ok, how much more concentrated? Neurologist: Oh, man. I don't know. Probably a lot. Like... 26 times more concentrated! Pharmacist: As you wish

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Reposted by Dan Harrison, MD

josh farkas 💊 @pulmcrit.bsky.social · 28/10/2025

Largest ever study of peripheral 23.4% NaCl with 863 administrations 😀 Some extravasation did occur, but it *didn't* lead to any major problems (tissue necrosis etc) If someone is having an ICP crisis, you should worry about their BRAIN and not their ARM - their arm will be fine #EMIMCC

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Reposted by Dan Harrison, MD

Neurocritical Care Society @neurocritical.bsky.social · 17/10/2025

Today, on World Trauma Day, empower your team and colleagues to improve patient outcomes during the critical first hours of a patient's neurological emergency. Designed for multidisciplinary practitioners, ENLS provides a consistent set of protocols, checklists and more: bit.ly/42HBcE3

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Reposted by Dan Harrison, MD

Andy Webb @ajwpharm.bsky.social · 07/10/2025

Do you use vasopression for MAP augmentation in your SCI patients? In our newly published series, we describe significant hyponatremia frequently develops when used just to push up the MAP - quite literally induced SIADH pubmed.ncbi.nlm.nih.gov/41051384/

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Dan Harrison, MD @danharrisonmd.bsky.social · 05/10/2025

This is not an unreasonable point

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Dan Harrison, MD @danharrisonmd.bsky.social · 24/09/2025

This would be an amazing advance in the care of patients with neurologic disease if true (and accessible to patients)!

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Reposted by Dan Harrison, MD

Michael Okun @michaelokun.bsky.social · 24/09/2025

A gene therapy buzz: Did AMT-130 really slow Huntington's disease by 75% at 36 months? A press release say YES. The data not yet been subjected to peer review and publication. uniqure.gcs-web.com/news-release...

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Dan Harrison, MD @danharrisonmd.bsky.social · 24/09/2025

Come train with us! The BU/BMC NCC fellowship has an opening for a 1 or 2 year fellow beginning July 2026. Visit sfmatch.org/vacancies or message for details!

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Reposted by Dan Harrison, MD

Cathy Gao-Howard MD MS @catgaohow.bsky.social · 22/09/2025

During my own job search, I was struck by how wildly academic offers vary—from $0 startup 😬 to multi-million-dollar packages 💰. Inspired by online datasets (ex: www.reddit.com/r/AskAcademi...), we surveyed PCCM physicians about their offers 📊.

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Reposted by Dan Harrison, MD

Neurocritical Care Society @neurocritical.bsky.social · 20/09/2025

INCC Keynote speaker Dr. Altaf Saadi presenting her keynote this morning, "Bending the Arc: How Health Care Professionals Can Speak Up and Out for Change." #NCS2025

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Reposted by Dan Harrison, MD

Neurocritical Care Society @neurocritical.bsky.social · 20/09/2025

Dr. Brian Coffey, this year's DEI Abstract Award Winner, presented on his abstract, "Toward Equitable Care After Cardiac Arrest: The Impact of Race, Ethnicity and Insurance on Outcome at Two Safety Net Hospitals." #NCS2025

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Reposted by Dan Harrison, MD

Intensive Care Medicine Journal @intenscaremed.bsky.social · 21/09/2025

Switching from 1% to 2% propofol in ICU sedation cut greenhouse gas emissions, waste, and costs, with savings equal to over seven Paris–New York flights annually, showing concentration adjustment as a path to greener critical care. zurl.co/DHWbi

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Dan Harrison, MD @danharrisonmd.bsky.social · 18/09/2025

The COMA (certain of missing awesome) has begun 😭 Hoping for a productive meeting for all my friends and colleagues at #ncs2025 @caseyalbin.bsky.social @namorrismd.bsky.social @ajwpharm.bsky.social

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Neurocritical Care Society @neurocritical.bsky.social · 18/09/2025

Afternoon workshops on ENLS simulation and 2025 informatics/big data/AI have kicked off! Annual Meeting workshops provide attendees the opportunity to learn in small-group settings and gain expertise from neurocritical care professionals with hands-on engagement. #NCS2025

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Dan Harrison, MD @danharrisonmd.bsky.social · 16/09/2025

In academia, this fleeting moment of internally derived self-worth is quickly followed by reviewer 2's feedback:

media.tenor.com

a man in a suit says this is the worst

ALT: a man in a suit says this is the worst

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