important thread 👇

{norepi + vaso} can often induce a state of *normotensive* vasoconstrictive shock

this is why I dislike blind algorithms that start with NE, then pile on vaso on without considering global hemodynamics

for experts, there is no such thing as a “1st/2nd/3rd line” pressor #EMIMCC

Pressure support ventilation ( #PSV), aim of partially unloading the patient’s inspiratory muscles, over-assistance, under-assistance, patient self-inflicted lung injury ( #P-SILI), #pulmsky #emimcc #critcaresky
ccforum.biomedcentral.com/articles/10....

Do you cannulate ‘awake’ (non intubated) for VV ECMO? What’s your experience? Our findings using the ELSO registry match what we’ve seen @montefiorecritcare.bsky.social. About half of patients intubated at 24-hours. No mortality difference. Check it out! pmc.ncbi.nlm.nih.gov/articles/PMC... #emimccm

Bluesky crowdsource! Patient admitted with CO poisoning (carboxyhemoglobin 32%). Intubated for coma. Whats the benefit of hyperbaric in an intubated patient? How does it work? @nickmark.bsky.social @nickjohnsonmd.bsky.social @pulmcrit.bsky.social @pulmtoilet.bsky.social @avrahamcoopermd.bsky.social

3 brand new trials comparing IV to IO in OHCA. No survival differences. #ReSS24 #emimcc

Poster by Montefiore resident Jack Galfund on CT findings after in-hospital cardiac arrest! Many scans would find something that was not previously known, resulting in a change in management.
#ReSS2024 #emimcc
@almoskow.bsky.social

Quick synthesis of the recent trials on ppx antibiotics to prevent VAP

more evidence to support short-course antibiotic therapy after severe brain injury to prevent pneumonia 😃

small study, but consistent with PROPHY-VAP trial

prior evidence along this vein is reviewed here: emcrit.org/pulmcrit/pro... #EMIMCC

Next up! Looking at long term outcomes after the TTM 24 vs 48hr trial. #emimcc #ReSS24 @pulmcrit.bsky.social @tscquizzato.bsky.social @nickjohnsonmd.bsky.social @joshkimbre.bsky.social

Ceftriaxone 2 gm IV q12h for 3 days vs. matching placebo reduced early-onset pneumonia occurring ≤4 days after intubation in OHCA survivors treated with TTM and may reduce antibiotic resistance gene acquisition through a decrease in antibiotic exposure

#ReSS24 @ahascience.bsky.social

Late-breaking science session #ReSs24! First up the PROTECT trial examining ceftriaxone PPx after cardiac arrest @nickjohnsonmd.bsky.social @pulmtoilet.bsky.social @imcrit.bsky.social @pulmcrit.bsky.social

Excited to be at #ReSS24! Will try to live Blue-Sky all of the exciting science #emimcc

New ILCOR cardiac arrest evidence synthesis and recommendations just dropped! New recs on BP goals and seizure PPx post arrest among others. Take a look here and can comment. #emimcc @nickjohnsonmd.bsky.social @pulmcrit.bsky.social @nickmark.bsky.social @ercresus.bsky.social

Hey all! This thing on? Did you know avocado is an amazing source of thiamine?