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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 27

Daily on X, LinkedIn, and Instagram. I appreciate your support!

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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 24

Goodbye, @bsky.app!

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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 24

Setting the PEEP on patients who are on ventilators is something we cannot get wrong. Although the vast majority of patients are just fine with the baseline 5 we typically use, patients with severe ARDS need far more love. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 23

The differential for cardiogenic shock is far broader than AMI. This image from the ELSO Guidelines for ECMO in cardiac patients highlights other etiologies that we need to consider in black and white. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 22

If you provide patients with blood transfusions in the ED or ICU, it's worth your while to check out these new guidelines from CHEST. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 21

We've all come across incidental findings of a renal mass in our patients. Right off the bat, renal cell carcinoma comes to mind. Here are the next steps in management. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 20

Need some strategies to manage a patient with an intermediate or high-risk pulmonary embolism? Here you go! 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 19

In the effort to save the kidneys, different biomarkers have joined the party. After all, many illnesses that bring patients to the ICU, and many of our interventions, may provide a one-two punch to the beans. Are they worth it? 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 18

We've been learning about tumor necrosis factor for almost 50 years, but haven't quite sorted out if it's good or evil in sepsis. This paper attempted to answer that question, but we're all left with more questions. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 17

We practice in a field of medicine where, despite our best efforts, outcomes are not always positive. In those cases, focusing on patient comfort & family support is the primary goal. Our palliative care teams can help us get there. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 16

l've seen toxic shock syndrome a number of times in my career. Things can get ugly pretty quickly, especially in the desquamation phase. Don't forget to add an antitoxic agent to the mix. The jury is still out on IVIG. tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 15

Many patients who present to our hospitals after suffering a cardiac arrest develop acute lung injury. Although we may oversimplify and assume that the patient aspirated, there's more to it than that. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 14

Do you make your patients NPO 6 hours before a cath lab procedure, such as PCI, which requires moderate sedation? Or even NPO after midnight for an AICD placement? Here's the data to show that fasting is not necessary for these procedures. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 12

When we care for patients with cardiogenic shock, we in the ICU oftentimes have no immediate tools other than vasopressors and inotropes. Although these temporarily make the numbers pretty, they likely do not address the etiology. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 11

Arbitrary, overly-aggressive IV fluid resuscitation without a hemodynamic target outside of MAP has never sat well with me. This concise and to-the-point paper examines the data on why we shouldn't open the floodgates. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 10

When patients with chronic liver disease decompensate and end up in our ICUs, they tend to shut down other organs in the process. Here's how to try to fix those other organs. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 9

Does it ever seem that the way fresh frozen plasma (FFP) and platelet transfusion takes place is a bit more arbitrary than you'd like? CHEST published this guideline to tidy up practice. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 8

If you've ever wondered why we spend incredible resources on septic shock, at the expense of cardiogenic, look no further. It becomes a distribution game (pun intended), with distributive accounting for 66% of shock cases. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 7

Knowing the significant potential adverse effects of using paralytics, it is crucial to optimize management of patients w/ARDS before administering them. However, if the patient needs them, then they need them. Have an exit strategy. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 6

It becomes unfortunately inevitable that our patients are going to become incredibly weak during their ICU stay. Being aware of the factors that lead to ICU-acquired weakness could help us improve outcomes. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 5

A variety of cells are invited to the party in critically ill patients. Unfortunately, not all behave as they should. Some party too hard and trash the place. This paper tackles the innate immune response in critically ill patients. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 4

Using the eyeball test when performing bedside POCUS for heart failure can be helpful, but taking our skills up a notch can prove to be worthwhile for our patients. Here are some key points to consider. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 3

I would like to poll the audience to gauge the prevalence of indirect calorimetry in the real world, as I don't have access to this technology. I've been reading about it for years, and the data suggest that benefits exist. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 2

Delirium is amongst the most frustrating things our patients and their families experience in their ICU stay. This table could prove helpful in demonstrating to them why their behavior is as it is. 🎩 tip to the authors.
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Eddy Joe Gutierrez @eddyjoemd.bsky.social · Sep 1

The 20th monthly Saving Lives Newsletter has just been sent out. Here's the link to view it and consider subscribing.
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The Saving Lives Monthly Newsletter #20

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