Josh Durbach

@elonmusk We need those Tesla Diner everywhere Elon! These are legit awesome! From young kids to older adults, everyone seems to enjoy their experiences each time I go there!!

Interesting and definitely overlooked aspect contributing to MCI. Kudos to @_kylie9_ #dementia mediclinic.co.za/en/infohub-cor…

🫀 Applied physiology at the bedside: Are we underusing arterial pressure monitoring? Invasive blood pressure is often simplified to a single target: MAP 😑 However, this excellent review highlights that arterial pressure should be interpreted as a composite physiological signal, not just a safety threshold. 🔍 Key insights: 1. Each BP component reflects a different physiological domain • SAP → systolic performance / stroke volume • DAP → vascular tone • PP → dynamic flow marker 2. Pulse pressure as a dynamic tool • Surrogate of stroke volume • Marker of fluid responsiveness (especially in ventilated patients) 3. Diastolic pressure as a marker of vasoplegia • Low DAP → early sign of distributive shock • Useful to guide vasopressor initiation 4. Emerging indices for precision resuscitation 🔹 Diastolic Shock Index (HR/DAP) 🔹 VNEri (DAP / HR × norepinephrine dose) 👉 Potential tools to better assess vascular tone and vasopressor responsiveness 🎯 Take-home message: The arterial line should not be seen as a passive monitor, but as an active, real-time guide for individualized hemodynamic management. Bertrand et al. Annals of Intensive Care (2025) 15:192 doi.org/10.1186/s13613… #CriticalCare #Hemodynamics #ICU #Shock #Anesthesiology #POCUS #MedicalEducation

A Scoping Review of Validated Echocardiographic Methods for Grading Right Ventricular Dysfunction. 🫀 #CardiacAnesthesia #Echocardiography #RVFunction #JCVA jcvaonline.com/article/S1053-…

Let us never forget, we stand on the shoulders of giants. “They shall grow not old, as we that are left grow old. Age shall not weary them, nor the years condemn. At the going down of the sun and in the morning….We will remember them” For the Fallen by Laurence Binyon

@LosiggioRosario @PontilloD_ @alessanro_pruna @giovannilandoni @alebelletti1 @BaiardoMartina @MMarmiere @paternoster_g @FedericoMOliva @md_monaco @SRAnesthesiaICU @MountSinaiMiami Miami Beach, Florida Awaiting pharmacy approval

@JoshDurbach @PontilloD_ @alessanro_pruna @giovannilandoni @alebelletti1 @BaiardoMartina @MMarmiere @paternoster_g @FedericoMOliva @md_monaco Which center? Do you already know your start date? Possible future collaboration on this hot topic! @giovannilandoni @SRAnesthesiaICU @alebelletti1 @BaiardoMartina @alessanro_pruna

🚨 Just published our secondary subgroup analysis of the #PROtectionTrial! 🚨 💡 Does IV #AminoAcids infusion still offer #renal protection in cardiac surgery patients with prolonged #CPB? 📌 Full paper jcvaonline.com/article/S1053-… #AKI #CardiacSurgery #CriticalCare

@MotoGP our national anthem sung by Mateo Lopez at the #AmericasGP was phenomenal!! 🇺🇸 🏍️

💔 There are no words. May Kfir and Ariel’s memory be a blessing .

Been using driving Px and SI routinely but believe this along with Mechanical Power will be our lung protective strategy monitors in the upcoming 5-10yrs

Modified CALS including rescue-focused cardiac ultrasound and early institution of extracorporeal cardiopulmonary resuscitation instead of chest reopening.#ECMO #CALS #Cardiacarrest jcvaonline.com/article/S1053-…

This is great @Francoisuys and may this vault continue to grow

@coachyoann @geraldposner @trishaposner Done! Thank you for the recommendation

@JoshDurbach we were talking about this yesterday! This is the author I was talking to you about, I believe you'd love his work & books! Awesome author and an Awesome person (as I know him personally). His Wife, @trishaposner is an Incredible author and person as well! Check out their books! 👍

On this day in 1963, Lee Harvey Oswald ended his one week visit to Mexico City and bought a $20.30 ticket for a Transportes del Norte bus from Mexico City to Nuevo Laredo and then by Greyhound to Texas. The Soviet and Cuban embassies had rejected him over 4 tense visits in which Oswald had demanded a visa to travel to Cuba. Oswald was so furious that he could not get permission to go to Cuba that at one stage at the Soviet Embassy he had startled the KGB agents in the room by pulling out his .38 caliber revolver. He swung it in the air as he cried “See? This is what I must now carry to protect my life.” When he started sobbing, one of the agents seized the pistol and emptied its bullets. After Oswald had left the Soviet compound, the three KGB agents who dealt with him shared their impressions of their unusual visitor. They all agreed he was “psychotic.” “We were also of the unanimous opinion,” recalled Oleg Maximovich Nechiporenko, “that if this was not a person suffering from mental disorders, then he was unbalanced at the very least or had an unstable constitution.” Oswald’s fellow bus passengers later told the FBI that he grumbled about the bureaucrats at the border. The Oswald who returned to America was angry and frustrated. He had spent the previous summer on the sweltering streets of New Orleans trying in vain to get volunteers for his pro-Castro organization. Oswald had no job, very little money, and his Russian-born wife, Marina, had separated from him and was staying with a mutual friend outside Dallas. Retired Army General, Edwin Walker, the right winger who Oswald and tried and failed to assassinate in April, was still holding rallies around Dallas and attracting large crowds. Oswald, just over two weeks away from his 24th birthday, was at an all time low.

Absolute legend! Proud of you brother

Beyond one-size-fits-all in cardiogenic shock: microaxial flow pump, VA #ECMO or tailored use of mechanical circulatory support? 🫀VA ECMO should be reserved for selected patients with AMI & extreme CS 🫀 mAFP first? #Impella appears promising for CS due to STEMI & should be preferred #MCS 🪜 stepwise approach: initial mAFP in CS with LV failure + #ECLS in refractory cases or if severe RV failure may be promising (to be validated!) ⚠️ high complication rates associated with #MCS underscores need for personalized approach @CO_CriticalCare 🖇️ bit.ly/4ekPmyd

The results is fantastic!! With @giovannilandoni at #CCM24 Relative risk 0.85 p 0.002 Absolute risk reduction 5% Relative risk reduction 15% Number needed to treat 21 #Protectiontrial #CCM24

LETS GO DDP!!! #ufc297

4 RCTs published in the last few hours you can’t miss if you work with critically ill patients: #1 Fluids in septic shock #2 Mobilisation and long-term cognitive impairment #3 NIV for extubation of obese patients #4 Nutrition before extubation A thread 🧵👇 #FOAMcc #SCCM2023

I got approved for my last project as a resident, named Cardiogenic Shock Identification System. I’ll keep you posted if it works out.