Alex_RG

I've been saying this for a long time Using fluid restriction to treat heart failure is ineffective and unkind Patients will inevitably drink ad librium when they go home, you need to figure out how to treat their heart failure in a sustainable way #DiuresisJedi

Our new work just published in Hearts: “Why and How to Measure Left Ventriculo-Arterial Coupling in Rapidly Altered Hemodynamic States.” VAC (Ea/Ees) links ventricular contractility and arterial load, helping explain why BP, EF or CO alone often mislead in shock. A step toward mechanism-guided haemodynamic management. 🔗 mdpi.com/2673-3846/7/1/… #CriticalCare #EchoFirst #POCUS #Hemodynamics

Revisiting Light's criteria: a validated blood-free triple combination matches diagnostic accuracy in over 7000 patients publications.ersnet.org/content/erjor/…

Nuanced presentations of dynamic LVOTO coming soon to CV EMCrit!

Ten rules for the medical resident 1. Be truthful. Practice medicine the way you would want it practiced on you. Integrity in thought, speech, and action is non-negotiable. 2. Stay organized. Your cognitive bandwidth is finite. Use systems (calendars, lists, routines) to reduce chaos and prevent avoidable errors. 3. Learn from mistakes. You will err. Analyze failures honestly, correct course, and do not repeat them. Reflection is a professional obligation. 4. Ask. Ignorance concealed is dangerous. Seek input from seniors, peers, nurses, and allied staff early and without embarrassment. 5. Communicate clearly. Medicine fails when communication fails. Be precise, listen actively, avoid jargon, and confirm understanding. 6. Listen to patients. Symptoms, fears, and values are data. Attention is not optional; it is diagnostic and therapeutic. 7. Stay sane. You will encounter suffering, injustice, and death. Remain lucid and mentally intact. Protect time for recovery, burnout helps no one. 8. Stay curious. Clinical competence decays without inquiry. Read, question, and adapt as evidence evolves. 9. Stand up. Have principles. Authority does not equal correctness. Advocate for patients and for sound medicine, even when uncomfortable. 10. Be sincere. Remember why you entered medicine. Let purpose, not convenience or fear, guide your conduct. "A good doctor in a privileged or shitty hospital is still a good doctor" taken from my good @nihardesai89

EMCrit 411 - You Need to Understand the Andromeda-Shock-2 RCT for Septic Shock Personalized Hemodynamic Optimization based on Cap Refill On this episode, I discuss the ins and outs of the entire trial--next week I speak with the study authors #ANDROMEDASHOCK emcrit.org/411

Finally out! 4 years of hard work, building friendship, trust and creating an aweosome community with the ANDROMEDA family!!! Thanks @ESICM and @JAMA_current!!!

1/ 🚨 NEW #5Pearls: Hepatorenal Syndrome (HRS) part 1️⃣ AKI + portal HTN 🟰hepatorenal syndrome 🖥️: coreimpodcast.com/2025/10/15/hep…

Comprehensive biologic characterization of a 117-year old supercentenarian, the world's oldest living person cell.com/cell-reports-m…

@EvaTH_EM @upadelnorte @ACCinTouch Muchas gracias!

@Dr_Insonando @upadelnorte @ACCinTouch Felicidades!!! Super merecido!!

El HGT en ACC LATAM 2025. En los tiempos donde la tecnología avanza, no debemos dejar atrás la clínica que es el pilar de esta hermosa profesión, el UPA es otro aliado en la exploración física. #Endocarditis #INSONA @upadelnorte @upandolatinoamerica @ACCinTouch @EvaTH_EM

@ewanbirney 🤯

Another great commentary on our paper from Wednesday on AI in Healthcare.

#POCUS #Nephpearls

𝐓𝐲𝐩𝐞 𝟏 𝐝𝐢𝐚𝐛𝐞𝐭𝐞𝐬 is a chronic autoimmune disease caused by the immune-mediated destruction of insulin-producing pancreatic beta cells. After beta cells are destroyed, lifelong insulin replacement is required. Physiological consequences of inadequate handling of glucose are microvascular and macrovascular dysfunction, affecting multiple tissues. Manifestations include retinopathy, neuropathy, nephropathy, coronary vascular disease, peripheral vascular disease, cerebrovascular disease, poor wound healing, and susceptibility to infections. To learn more about this NEJM Illustrated Glossary term, read the editorial “Replacement of Beta Cells for Type 1 Diabetes” by Kevan C. Herold, MD, and Jordan S. Pober, MD, PhD, from @yale: nej.md/469fCbF Explore more terms: nej.md/glossary

@doctorthierry Tijuana! 🤠

Vacante. Estoy abierto a nuevos proyectos de trabajo.

Another thing I hear often in the ICU is this: The patient is on high-flow nasal cannula (HFNC) (or high-flow oxymask) When I specifically ask "how many liters?", often the answer is: 6 or 7 l/min HFNC is a respiratory support system delivering heated-humidified O2 @

Con todo mi hermano @PavelPichardoMD 🥳🙏🎆😍

Imagenes que dan ....