iiinova — where your digital self keeps evolving

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theelso.bsky.social @theelso.bsky.social · 02/12/2025

LEVOECMO RCT: early administration of levosimendan to facilitate weaning from VA #ECMO in severe but potentially reversible cardiogenic shock 🔍 205 adults/11 ICUs in 🇫🇷 ⚖️ early levosimendan administration did not significantly shorten the time to successful weaning of #ECLS at day 30 🔗 bit.ly/4iAwGwT

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Kaspar Bachmann @kasparbachmann.bsky.social · 01/11/2025

Thanks for sharing our review! Monitoring GI function when initiating / stepping up nutrition is key to prevent harm from too aggressive nutrition.

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Matt Siuba @zentensivist.bsky.social · 21/04/2025

New 📝 We know RV dysfunction occurs on VV-ECMO in ARDS despite ECMO mitigating many of the traditional RV dysfunction risk factors (hypercapnia etc) We don’t understand RV function dynamically over time on ECMO…

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Erin McCreary, PharmD @erinmccreary.bsky.social · 12/04/2025

@gurujosh.bsky.social presents the results of the MSSA domain of the SNAP 🫰 trial at #ESCMID2025 fluclox caused more acute kidney injury than cefazolin; early mortality favored cefazolin Absolutely Herculean effort by the entire global trial team and practice changing data #teamcefazolin

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Nick Mark, MD @nickmark.bsky.social · 31/12/2024

I got tired of opening a dozen PDFs to find the ECMO pressure/flow curve I need. So I made an app! Choose the cannula/size and you can see the max flow for a given pressure drop. Or compare multiple different cannula. Lmk what ya’ll think. Useful? What’s it need? onepagericu.com/ecmo-calcula...

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Maarten van Smeden @maartenvsmeden.bsky.social · 23/12/2024

Let us start 2025 in a positive mood: here are 10 methods things researchers can worry *less* about in 2025

media.tenor.com

a countdown clock with the number 10 in the center

ALT: a countdown clock with the number 10 in the center

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Lars Mølgaard Saxhaug @load-dependent.eurosky.social · 20/12/2024

This was a fun study leveraging social media to demonstrate the high prevalence in Impella malrotation among cases shared on old Twitter. If it's malrotated, but it works well, without suction alarms or other problems, do you change it? #cccsky #cardiosky #emimcc www.pcronline.com/News/Whats-n...

pcronline.com

Impella percutaneous ventricular assist device malrotation in social media: a call to action

This study suggests that correct Impella orientation is often overlooked, and that Impella malrotation is a common issue in real-world clinical practice, potentially associated with relevant complicat...

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Nate D @natedefelice.bsky.social · 17/12/2024

#MedSky #EMIMCC #IDsky #cardiosky @pulmcrit.bsky.social What is the culture at your hospital for potassium replacement? At most hospitals I'm at it seems to be a culture of replace to K 4.0 and the individual doctor makes the call. This paper confirms my bias... jamanetwork.com/journals/jam...

jamanetwork.com

Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery

This randomized clinical trial examines whether a lower serum potassium concentration trigger for supplementation is noninferior to a high-normal trigger for the prevention of atrial fibrillation afte...

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Kaspar Bachmann @kasparbachmann.bsky.social · 11/12/2024

Awesome and interesting work by the late Luciano Gattinoni and colleagues. #emimcc

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Nick Mark, MD @nickmark.bsky.social · 09/12/2024

#ADAPTtrial released & the results are interesting… Compared to SOC, Procalcitonin guided antibiotics in sepsis resulted in: - FEWER antibiotic days: 10.7 vs 9.8 (p=0.01) BUT - HIGHER 28 day mortality: 19.4% vs 20.9% (p=0.02) though this did not meet the pre-specified non-inferiority margin 🤔 1/

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Kaspar Bachmann @kasparbachmann.bsky.social · 11/12/2024

The #Renovate Trial was just published. Kudos to the authors for this large trial. HFNO was non-inferior to NIPPV in 1776 patients with acute respiratory failure. I have some comments and discussions; feel free to join in. 👇 1/n #emimcc #ccr

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Lars Mølgaard Saxhaug @load-dependent.eurosky.social · 11/12/2024

It's amazing that Esmolol can show such consistency in effect size that has never been seen in sepsis, while Landiolol has a natural variation across trials. Add to that that the single trials vary more than the larger multicenter trials and one might almost get suspicious... #emimcc

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Casey Albin, MD @caseyalbin.bsky.social · 10/12/2024

1/ Anemia happens frequently in our aSAH patients. These patients are at risk for delayed cerebral ischemia and other neurologic insults It would seem having adequate oxygen to the brain tissue would be a good thing to prevent such injury. But how much hgb is adequate? A #skytorial on SAHARA

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Gabriel Bosslet @gbosslet.bsky.social · 10/12/2024

#PCCMSky Update 146 members- only 4 more slots in this starter pack Repost so the noobs know who the cool PCCM kids are Reply if you are not included and should be (make sure your creds are in your bio I am not putting randos on here) go.bsky.app/88wg6oG

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Caroline Dew @caro-icu.bsky.social · 17/11/2023

👇ICU strain is measurable & impacts outcomes. “Measuring the Impact of ICU Strain on Mortality, After-Hours Discharge, Discharge Delay, Interhospital Transfer, and Readmission in Australia With the Activity Index.” David Pilcher et al. 🩺Critical Care Medicine. 🔗 journals.lww.com/ccmjournal/f...

journals.lww.com

Measuring the Impact of ICU Strain on Mortality,... : Critical Care Medicine

tive national registry-based cohort study. SETTING: One hundred seventy-five public and private hospitals in Australia (June 2020 through March 2022). SUBJECTS: Two hundred seventy-seven thousan...

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josh farkas 💊 @pulmcrit.bsky.social · 06/12/2024

Skytorial: pH management in DKA! I've been following debates about this for a *long* time (eg wrote this blog in 2016, which stands up pretty darn well: emcrit.org/pulmcrit/bic...) after years of arguing, lemme break down my take on this 😁

media.tenor.com

a cartoon of donald duck with the words " do you want to fight lets get it on then "

ALT: a cartoon of donald duck with the words " do you want to fight lets get it on then "

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Kaspar Bachmann @kasparbachmann.bsky.social · 02/12/2024

Sadly, one of the great minds of intensive care medicine, Luciano Gattinoni, has passed away. His work is beyond impressive and has shaped many concepts that remain a hallmark of critical care. www.esicm.org/obituary-luc...

esicm.org

Obituary: Luciano Gattinoni - ESICM

In Memory of Professor Luciano Gattinoni

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Brian Elliott @brianelliottmd.bsky.social · 01/12/2024

Since we’re entering the last month of 2024, here is a non-systematic review of #pulmcrit trials published this year that I found particularly noteworthy. Not comprehensive, so please include any that I may have missed! (🧵1/11) #emimcc #critcare #pulmsky #medsky

media.tenor.com

a man in a blue shirt and tie is standing in front of a bulletin board with papers on it .

ALT: a man in a blue shirt and tie is standing in front of a bulletin board with papers on it .

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Kaspar Bachmann @kasparbachmann.bsky.social · 30/11/2024

This is a not uncolmon scenario in the ICU. I have seen this in long term neuro ICU patients on valproat with sepsis during their ICU stay and mero being because of suspected multiresistant bacteria.

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Dilip Jayasimhan @dilipj1.bsky.social · 27/11/2024

A thread 🧵 on trials I think have changed or will change ICU practice (at least my own). #emimcc

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Kaspar Bachmann @kasparbachmann.bsky.social · 28/11/2024

#POCUSky The M-Mode of Olympic Timekeeping: the same prinicple applies by sampling a line at multiple timepoints rather than sampling multiple lines (i.e. 2D image) at one timepoint. youtube.com/shorts/7SkiL...

youtube.com

Noah Lyles won the 100m by point zero zero five seconds

YouTube video by Howtown

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josh farkas 💊 @pulmcrit.bsky.social · 28/11/2024

high-flow for preox is so 2023… all the cool kids are using bilevel now PREOXI trial: emcrit.org/pulmcrit/bsi #EMIMCC

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Kaspar Bachmann @kasparbachmann.bsky.social · 26/11/2024

Definitely worth a read if you‘re interested in venous return physiology and how it relates to Vexus.

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josh farkas 💊 @pulmcrit.bsky.social · 26/11/2024

Skytorial: Piptazo vs Cefepime 😁 Recently this JAMA-IM paper correlating piptazo with mortality has gained a weird amount of attention (It's been out for months so it's not really new) This one of the most methodologically horrific papers I've ever seen Lets talk real quick about the paper...

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Jan @jbilk.bsky.social · 26/11/2024

State the obvious! 🏥ℹ️ High turnover of nurses and doctors suggests a potential risk for patients. Therefore, retention of healthcare staff should be a priority to improve continuity and quality of care for patients. #medsky doi.org/10.1136/bmj....

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Sean Ong @seanong.bsky.social · 21/11/2024

Feels right that my 1st post here should be to share this incredible RCT, led by my PhD supervisor Nick Daneman: www.nejm.org/doi/full/10.... Main takeaway: 7-days of abx should be the standard of care for patients with uncomplicated non-S. aureus BSI. A deep dive 🧵: #IDsky

nejm.org

Antibiotic Treatment for 7 versus 14 Days in Patients with Bloodstream Infections | NEJM

Bloodstream infections are associated with substantial morbidity and mortality. Early, appropriate antibiotic therapy is important, but the duration of treatment is uncertain. In a multicenter, non...

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Kaspar Bachmann @kasparbachmann.bsky.social · 22/11/2024

This was a PA/PAOP tracing of a patient with severe mitral regurgitation. In mitral regurgitation, there can be a high V wave when the PAC is in Wedge/PAOP position. If not recognised properly, this can easily be missed. Check out rdcu.be/d05K0 for more insights into estimating LAP.

rdcu.be

Bedside assessment of left atrial pressure in critical care: a multifaceted gem | Critical Care

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Sarah Sanghavi @sarahsanghavi.bsky.social · 21/11/2024

Just saw 2 ICU hyperNa cases, so here's a #medsky #nephsky🧵 on why... 🤨 Out: Solute-free H2O clearance 😎 In: Electrolyte-free H2O clearance 🫘 1st was recovering from AKI -->⬆️ filtered urea load as the BUN ⬇️ 🥩 2nd was receiving very high protein tube feeds -->⬆️ filtered urea load with stable BUN

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Gabriel Bosslet @gbosslet.bsky.social · 21/11/2024

#PCCMSky Update Up to 95 members Repost so those new to this place can populate their following list with good PCCM people Reply if you are not on this list and should be go.bsky.app/88wg6oG

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Kaspar Bachmann @kasparbachmann.bsky.social · 21/11/2024

How do you define parenteral nutrition? What seems intuitive for clinical practice, is not well defined in research. Read our latest correspondence here: ccforum.biomedcentral.com/articles/10.... We need a global consensus on a detailed definition of PN. #FREM #emimcc #CriticalCare #Nutrition

ccforum.biomedcentral.com

How to define parenteral nutrition - Critical Care

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Kaspar Bachmann @kasparbachmann.bsky.social · 20/11/2024

www.bjanaesthesia.org/article/S000... An important piece of work that I think everyone in Academia (or close to it) should read! #MedSky Misconduct is a serious issie we all should be aware of and should be talking about. Congrats to the authors for writing and publishing this!

bjanaesthesia.org

DEFINE_ME

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Gabriel Bosslet @gbosslet.bsky.social · 20/11/2024

#PCCMSky starter pack update 66 of us We could use more Reply if you are not on it and I will remedy Use it to find good folks to follow And feel free to REPOST so others see it (there is not algorithm here so liking stuff doesn't make it get seen anymore than not)

buff.ly

PCCMSky Starter pack

Join the conversation

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Matt Siuba @zentensivist.bsky.social · 11/11/2024

Bringing one of our recent pubs to this platform for those interested in #ThePeoplesVentricle emimcc doi.org/10.1002/pul2...

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Shockwaves.icu @shockwavesicu.bsky.social · 18/11/2024

First chapter to launch: PAC-based cardiac output measurements authored by Eugene Yuriditsky, MD #emimcc shockwaves.icu/app/page/1uw...

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Kaspar Bachmann @kasparbachmann.bsky.social · 18/11/2024

So here goes my first "#skytorial" on one of our studies. Looking forward to your feedback and the discussions (1/n): Interested in how the RV adapts to preload and afterload changes? rdcu.be/d0AT7

rdcu.be

Mechanisms maintaining right ventricular contractility-to-pulmonary arterial elastance ratio in VA ECMO: a retrospective animal data analysis of RV–PA coupling | Journal of Intensive Care

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🇳🇴Asbjørn Støylen🇩🇰 @strain-rate.bsky.social · 14/11/2024

For those unfamiliar with the geometric concepts of ventricular strain, here's a cheatsheet for quick reference

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Kaspar Bachmann @kasparbachmann.bsky.social · 17/11/2024

Post a picture you took (no description) to bring some Zen into the timeline.

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