MILPulm

New CardioCrit video! There might be another way to do pericardiocentesis — and it’s worth seeing. @KartikThinks @msenussiMD Curious? 👇 youtu.be/TnPddxOCG5o?si…

We recently published a study of nearly 300,000 patients hospitalized with acute PE and found a surprising rise in UFH use, discordant with guidelines. As a follow-up, we just published a qualitative study to find out....WHY? The results were interesting 🧵

🧵 A Cardiologist's Guide to Interpreting CPET 1️⃣ What is CPET? A cardiopulmonary exercise test (CPET) evaluates how well the heart, lungs, and muscles work together during exercise. It's key for diagnosing unexplained dyspnea and assessing functional capacity. 🚴‍♂️🏃‍♀️

Permissive hypercapnia in acute severe respiratory failure: should we target PaCO2, pH or both?? Safe thresholds in critically ill? 🩺mechanisms & management of hypercapnia requiring IMV 🫁 impact of hypercapnia on outcomes 🫁 🫀🧠significant physiological effects: RV & pulmonary circulation, brain & other organs Hypercapnic acidemia during lung-protective MV may have significant consequences, and perhaps should not be a goal per se, but prompt early consideration of adjunctive therapies. Open access #FOAMcc 🔓 bit.ly/49TxOY8

When using a bougie to facilitate intubation it’s important to know how to direct it Here’s a two minute video demonstrating two microskills that are worth knowing about Essential Bougie Microskills You Need To Know youtu.be/aMd8zeMnRSk

Refining our eCPR grab bag. Pack 1 and pack 2 layout. Down to a single dilator 16/26f for the arterial and venous cannulae respectively. @GSTT_ICU

Check out the new guidelines for corticosteroids in critically ill patients. 🎩 tip to the authors. I also knocked out a quick (<7 minute) podcast episode on the topic this morning. eddyjoemd.com/foamed/

ICU Hemodynamics Tips - Swan-Ganz catheters: This will not be a comprehensive thread. Just happened to place a couple of Swan-Ganz (SG) catheters this week, so it is a good time to emphasize few basic points/steps. I have made a mistake (more than once) in each one of them…

#POCUS guided subclavian vein cannulation: tips and tricks 🔗 acep.org/emultrasound/n… #FOAMed #MedEd #FOAMcc

Flail chest #MedX twitter.com/OR_ECMO/status…

🔥🔥🔥Hot off the press in @ATSBlueEditor - new ARDS guidelines🔥🔥🔥 What we addressed: 💊 Corticosteroids 🔃 VV-ECMO 💉 Neuromuscular blockade 🐥 PEEP +/- recruitment maneuvers 👀 Read on for the recs & how to best apply them to your patients 🧵 atsjournals.org/doi/abs/10.116…

Distinction between pre- & post-capillary pulmonary hypertension is important for guiding therapy. Here are some echo clues to help distinguish between these levels of PH. More info about ePLAR: Int J Cardiol. 2016 Jun 1;212:379-86. doi: 10.1016/j.ijcard.2016.03.035 #echofirst

As promised, here's a summary (?X-torial) from my talk at @accpchest this year.

Among hospitalized adults, the risk of acute kidney injury did not differ between cefepime and piperacillin-tazobactam, but neurological dysfunction was more common with cefepime. #IDWeek2023 ja.ma/3RYQHSD

Lung cancer surgery or SBRT for operable early stage NSCLC? Protocol for the Phase III - Valor study by @DrewMoghanaki and team just published in @accpchest 's CHEST Pulmonary @journal_CHEST @DrMCMiles @aggie07girl @udit_chaddha @CHESTOncology chestpulmonary.org/article/S2949-…

Thanks to @accpchest for the opportunity to present high risk #PE data from #FLAME 🔥 at #CHEST2023! (Finally have a good reason to use that emoji!) FT pts w significant decreased primary outcome and in-hospital mortality (1/3) @RosovskyRachel @roblookstein

British Thoracic Society recently published a must-read Statement on pleural procedures. It is 26 pages long & is accompanied by 13 online supplementary appendices

🧵regarding the 'figure-of eight' suture and also the 'pursestring' suture. We'll go over what they are for, some technical pointers, and errors that can be made while doing them. (1/ )

@TSACO_AAST @elliotthaut Currently only put in chest tube but may start lavage in my own practice this year…pubmed.ncbi.nlm.nih.gov/28930941/