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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 25/04/2025

After machine availability, I think image acquisition is the biggest barrier to widespread adoption of perioperative gastric POCUS.

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Reposted by Michael Hofkamp, MD, FASA

Dr Mary-Ann Fox BMBS FANZCA GChPOM @maffygirl.medsky.social · 25/04/2025

Ok it’s time for the second #AnSkyDebate featuring this article from @anaesjournal.bsky.social. Engage and discuss this very interesting paper. Tag @anaesjournal.bsky.social who suggested this topic. Follow and repost to increase exposure. This is so topical. Enjoy ☺️

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Reposted by Michael Hofkamp, MD, FASA

Anaesthesia @anaesjournal.bsky.social · 15/04/2025

Editorial: Best anaesthetic technique for prevention of postoperative cognitive dysfunction in older patients after hip fracture surgery – is the debate over? #AnSky #MedSky #OrthoSky doi.org/10.1111/anae...

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Reposted by Michael Hofkamp, MD, FASA

Anaesthesia Reports @anaesthesiareports.bsky.social · 13/04/2025

#POCUS is a valuable tool in #anaesthesia Here is a mini collection of our case reports highlighting its use. buff.ly/8TbXL4L buff.ly/ffAWKNx buff.ly/4sWYUTX buff.ly/K8LGMbY #AnSky #MedSky #regional #OBSky #RASky #AirwaySky #SurgSky #PainSky

buff.ly

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Reposted by Michael Hofkamp, MD, FASA

Susanna Stanford @susannastanford.bsky.social · 21/03/2025

The Snapshot Obstetric National Anaesthetics Research (SONAR) project investigating pain during Caesarean with neuraxial anaesthesia got underway this week. This NIHR portfolio project is something I have been agitating for over almost 10 years. Why? 1/

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Reposted by Michael Hofkamp, MD, FASA

International Journal of Obstetric Anesthesia @ijoajournal.bsky.social · 03/03/2025

We are on BlueSky! #ObAnes friends, give us a follow to keep up with the latest in Obstetric Anesthesia! @ruthilandau.bsky.social @oaa-anaes.bsky.social

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Reposted by Michael Hofkamp, MD, FASA

Marilena Marmiere, MD @mmarmiere.bsky.social · 20/02/2025

Think you know the SOFA score? Think again! 🧐 Our systematic review dives into its use as an endpoint in RCTs, uncovering the surprising variability in definitions, timing, and handling of missing data. It's time to take a fresh look at the SOFA score! #FOAMcc #FOAMed

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Reposted by Michael Hofkamp, MD, FASA

Anaesthesia @anaesjournal.bsky.social · 17/02/2025

What does ethical leadership look like? There are six main principles: • respect • accountability • service • honesty • justice • community #AnSky #MedSky #LeadershipSky doi.org/10.1111/anae.16561

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Reposted by Michael Hofkamp, MD, FASA

Anaesthesia @anaesjournal.bsky.social · 17/02/2025

"Toxic leadership: when culture sabotages clinical excellence" #AnSky #MedSky #LeadershipSky doi.org/10.1111/anae.16561

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Reposted by Michael Hofkamp, MD, FASA

Amit Pawa @dr-amit-pawa.bsky.social · 12/02/2025

This year the @RegionalAnaesUK #RAUK25 meeting will be in Leeds! 8-9th May It will be incredible & you will not want to miss it! Lectures, Demonstrations & Workshops galore- Plus Social events! Have you registered yet? 👇🏼 www.ra-ukmeetings.com #RAsky #AnSky #POCUSky #MedSky

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Reposted by Michael Hofkamp, MD, FASA

Anaesthesia @anaesjournal.bsky.social · 12/02/2025

Why might there be worse outcomes in after-hours surgery? • surgeon fatigue • resource availability • patient characteristics • types of surgeries scheduled • circadian rhythm disruption #AnSky #MedSky #SurgSky buff.ly/4aXXmE6

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Reposted by Michael Hofkamp, MD, FASA

Anaesthesia @anaesjournal.bsky.social · 10/02/2025

For those of you who missed the, ahem, discussion around ultrasound-guided neuraxial puncture last week, it's not too late to check out the editorial and join the debate! @decarvalhocc.bsky.social @elboghdadly.bsky.social #AnSky #MedSky #OBSky #PainSky #POCUS #RASky buff.ly/42LsEfd

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Reposted by Michael Hofkamp, MD, FASA

Anaesthesia @anaesjournal.bsky.social · 11/02/2025

Does the ROUTE that you give dexamethasone for rebound pain following peripheral nerve blocks matter? #AnSky #MedSky #PainSky #RASky buff.ly/3CMuXEs

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Reposted by Michael Hofkamp, MD, FASA

British Journal of Anaesthesia @bjajournals.bsky.social · 10/02/2025

What is the efficacy and safety of intraoperative controlled hypotension. New commentary by the authors of a recent systematic review. #BP #hypotension #blood #Ansky www.bjanaesthesia.org/article/S000...

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Reposted by Michael Hofkamp, MD, FASA

Amy Diehl, Ph.D. @amydiehl.bsky.social · 04/02/2025

Study (N=462) finds even though girls and boys performed equally on a task, girls didn't believe they had done as well as boys. Boys overestimated their competence (relative to girls & reality) & negotiated for a larger reward than the girls. @kimelsesser.bsky.social www.forbes.com/sites/kimels...

forbes.com

Boys More Likely Than Girls To Negotiate For Bigger Rewards, Study Finds

A new set of studies reveals that boys begin asking for more than girls in negotiations as early as elementary school.

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Reposted by Michael Hofkamp, MD, FASA

jenna ruddock @ruddock.bsky.social · 03/02/2025

Congressional delegation outside USAID now: “We are here to shed a light on a crime unfolding before our eyes.”

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Reposted by Michael Hofkamp, MD, FASA

Lauren Kriger Groner @laurengroner.bsky.social · 03/02/2025

Happy #NationalWomensPhysicianDay 💕💗💖💞 Grateful to work with this brilliant and talented all⭐️ group of 🚺 #chestrads and #cardiacimagers @weillcornell.bsky.social 🫀🫁

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Reposted by Michael Hofkamp, MD, FASA

💉Josh Rubin, MD @drsandman11.medsky.social · 03/02/2025

About to be a rare commodity

A can of Canada Dry Zero Sugar Ginger Ale

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Reposted by Michael Hofkamp, MD, FASA

Claudia Gómez, MD @cpaolag.bsky.social · 03/02/2025

#AnSky Preoperative estimated glomerular filtration rate to predict cardiac events in major noncardiac surgery: a secondary analysis of two large international studies - British Journal of Anaesthesia www.bjanaesthesia.org/article/S000....

bjanaesthesia.org

Preoperative estimated glomerular filtration rate to predict cardiac events in major noncardiac surgery: a secondary analysis of two large international studies

Optimised use of kidney function information might improve cardiac risk prediction in noncardiac surgery.

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Reposted by Michael Hofkamp, MD, FASA

Erin Reed @erininthemorning.com · 22/01/2025

Hey everyone! Incredible news! Trans Scouts selling GS cookies this year on my list have sold over 50,000 boxes of GS cookies! If you want girl scout cookies, consider buying from a trans girl scout this year! They'll mail them to you! This is literally my fav thing to do every year :)

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 21/01/2025

4 years ago, I bet a skeptical buddy that Joe Biden would complete his term. This was subject to Biden dying, resigning, being impeached, etc. Joe came through and so did my buddy with this check! (And he did settle the bet with cash!) Thank you Mr. President for your service.

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 20/01/2025

Fellow investigators: thoughts on open access journals that levy an article processing charge (APC)? My philosophy is that I will review for free if I can submit/publish for free. 🤔 #medsky #ansky #obgynsky

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

And thank you to Dr. Ruth Landau, the editorial staff, and reviewers at IJOA for their hard work in the peer review of our manuscript. Science wouldn’t happen without people doing this often unrecognized work

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

And special thanks to @emilysharpe.bsky.social for her contributions as a co-author. She was instrumental in getting the manuscript across the finish line. I’m looking forward to her upcoming #Ostheimer lecture at #SOAPAM2025!

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

Congratulations to Dr. Jessica Litman on leading this study! She was an OB/GYN intern when this study was conducted and she tirelessly went to the bedside before, during, and after her shifts to collect this data.

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

The only practical modifiable variable in our study was anesthetic technique. We should continue to investigate our standard practice of activating epidurals for cesarean delivery and search for better ones. @sas-imran.bsky.social

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

We had high PDCD but we believe that we practice within the parameters of contemporary #OBAnes in regards to anesthetic technique and dosages of medication. We encourage other investigators to use the 30 mm VAS methodology in future PDCD studies.

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

Our study was limited by small sample size (110 pts), single-center, and that we train residents. Our 30 mm VAS definition was novel for PDCD. Our assessment of catastrophizing/anxiety in postpartum setting may have been biased

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

We were disappointed to find that Black race (versus White) was associated with PDCD. Butwick et al reported that Black pts were more likely to have GA for CD. This is the first study to our knowledge that reported Black race associated w/ PDCD t.co/ogXhXcP4dR

t.co

https://pubmed.ncbi.nlm.nih.gov/26797554/

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

We really thought that catastrophizing would be associated with PDCD, but it was not. Anxiety assessed by the STAI-6 wasn’t either. BUT, a history of anxiety (eg included in problem list or PMH) was.

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

I’m a big believer in removing epidural catheters that have less than perfect functioning. Shepherd et al showed the superiority of this technique at my hospital. We didn’t have enough statistical power to show this in the current study t.co/uGhlsWGaVw

t.co

https://pubmed.ncbi.nlm.nih.gov/37334089/

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

I have always believed that activation of an indwelling labor epidural is a lousy way to provide anesthesia for CD. Sanchez et al also reported this in their study t.co/6VUZqQABdi

t.co

https://pubmed.ncbi.nlm.nih.gov/37865217/

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

In a previous study, we also found that length of surgery was associated with PDCD. We believe that this is a surrogate marker of surgical complexity that may be associated with more forceful manipulation of intra abdominal organs t.co/SnJuQ6Tnz4

t.co

https://pubmed.ncbi.nlm.nih.gov/35991734/

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

We used a multivariate logistic regression to control for several variables and found that length of surgery, activation of epidural, hx of anxiety, and Black race were independently associated with PDCD.

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

Using this definition of PDCD, we found that 40 (36%) reported PDCD. We also found that 12% of pts indicated that their pain was “worse” or “much worse” than they expected. Other methodologies of PDCD might have captured a lower % of PDCD in our pts

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

We defined PDCD as 30 mm or greater. This was a novel methodology to assess PDCD. Other studies have used yes/no methodology or Likert scales. We believe that these types of questions are potentially leading. Our VAS scale did not reveal our cut off for pain

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

We surveyed pts 24-72h after CD and gave them a 13 item catastrophizing questionnaire along with a 6 item anxiety questionnaire (STAI-6). We then asked them how their pain was relative to their expected pain and then asked them to indicate their pain on a 100 mm VAS

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

Published in International Journal of OB Anes: Patient and clinical characteristics associated with pain during cesarean delivery (PDCD). We found that hx of anxiety, length of surgery, activation of epidural and Black race associated w/ PDCD #AnSky #OBGYNsky 🧵 sciencedirect.com/science/articl…

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 18/01/2025

I’m a casual user of Tik Tok here in the United States. I acknowledge that it is the “empty calories” of how one can spend time. I think that politicians tried to make political hay of bashing/banning it and those chickens are absolutely coming home to roost tomorrow if it goes dark.

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 31/12/2024

A very public and ugly falling out between Musk and Trump. (and Trump will emerge with the upper hand)

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 30/12/2024

My research and my mentees are “bigger” than me but as I said, this series of threads has shown me that BlueSky > X for dissemination of research

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 29/12/2024

It’s wild what is happening on X right now. Conservative firebrand Laura Loomer has had her blue check revoked, allegedly for criticizing Musk for his advocacy of H1B programs. Apparently some animals “are more equal than others” in regards to free speech over there www.nbcnews.com/news/amp/rcn...

nbcnews.com

Elon Musk accused of censoring Laura Loomer, MAGA Republicans on X

The claims came after Elon Musk was involved in a public feud with some Republicans over immigration.

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 28/12/2024

I think the downstream outcomes (eg morbidity/mortality, time to hospital discharge) are similar when an experienced anaesthetist uses either DL with VL immediately available or VL on first attempt. I think there are more pressing areas of investigation to invest our research dollars

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 28/12/2024

To use an example, I think there should be universal US for central lines. But DL gives you a real time view of the glottis. I think there should be universal VL back up so that if DL is not going well, you can quickly switch to VL

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 28/12/2024

For me, this is an inflection point for dissemination of research on X vs here. I did identical threads on each platform w/ significantly more engagement here (albeit I don’t have a blue check on X). I’m not yet at a point of not posting on X, but my time is much better spent here #ansky #medsky

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 28/12/2024

We collected data on the training of the intubating provider but didn’t report it in the manuscript because it was impossible to compare nurse anesthetists to residents. Some of my CRNA’s have 30+ yrs experience, some are fresh out of school

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Reposted by Michael Hofkamp, MD, FASA

Bob Funnekotter @bobfunn.bsky.social · 28/12/2024

😃 I don’t doubt it. I liked Stu’s comparison: @hypoxicchicken.bsky.social bsky.app/profile/hypo...

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Michael Hofkamp, MD, FASA @hofkampmichael.bsky.social · 28/12/2024

My goal in this paper was just to report “what happened” - there was no way I could compare which technique (DL vs VL) was better. The take home point was that DL was selectively used on healthier pts w/ great success. This speaks against universal VL in my opinion

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Stu Marshall @hypoxicchicken.medsky.social · 28/12/2024

1/9 This is a really interesting observational study looking at VL and DL use. Comparison of success rates is flawed - the choice to use VL or DL was dependent on the complexity of the case - the populations aren't comparable But I think there are other lessons analogous to surgical technique #AnSky

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