Tyler Peck

@davidhuey You're doing it wrong if you are exposing yourself to the testing reagent liquid....

Remember when it was a conspiracy theory that these tests were going to get you sick?

CTEPH is not a more common long-term complication after COVID-19-associated PE than after PE in non-COVID-19 patients, and thrombus resolution did not seem to be different from non-COVID-19-associated PE bit.ly/3IjvWL3

@JMKimMD Really nice explanation for why the mPAP and PVR cutoffs have changed in recent guidelines -- prior cutoffs were somewhat arbitrary and new cutoffs do correspond to increased mortality.

An updated primer on the diagnosis and management of pulmonary HTN - particularly helpful for fellows and other trainees like myself. Highly recommend! A joy to read and learn from #BradMaron ahajournals.org/doi/full/10.11…

Pericardiocentesis can be done in select cases, helpfully guided by hemodynamic monitoring with PA catheter in place, removing small aliquots of fluid and reassessing response (case report of this linked here, including my colleague #NoahSchoenberg) atsjournals.org/doi/10.1513/An…

Saving this great example case for future discussions about pericardial effusion drainage in PH, as this is a frequent question - high risk to worsen RV dilation, further impairing LV filling = ⬇️ cardiac output

V-PA ECMO for RV-protective support in ARDS? No data to compare with other ECMO modalities, but certainly addresses problems in a subset of our ARDS population. @MHayes_MD @david_furfaro journals.lww.com/asaiojournal/F…

Thorough breakdown here of recent data on dropping US life expectancy - our system is NOT working

@capitalsteward Happened in Massachusetts, too - triggered automatically by law due to a budget surplus - forbes.com/advisor/person…

Great idea! I don’t think I’ve ever seen a government give a refund because they had “too much money” …what if this became a more normal attitude?

@dennisnahas @MBTA @MoxieLovesFancy Is the @MBTA East Boston ferry running? The T website says no, but press releases from last year say it would restart 3/1/23. Any insight @adrianmadaro @LydiaMEdwards @maura_healey ? Trying to figure out how best to get to work tomorrow...

Current Service: mbta.com/schedules 🚇Subway: Regular schedule, GLX Medford Branch open, new winter schedules 🚌Bus: Regular weekday, new winter schedules 🚄@MBTA_CR: Regular weekday ⛴️Ferry: Regular weekday 🚐RIDE: Full service 💳CharlieCard Store: Open Tues-Fri 8:30am–5pm

Flight attendants also talking about how dispatch wouldn't let the gate agent clear the 18 standbys, even though this is a half empty flight. This isn't weather related. This is the poor infrastructure of @SouthwestAir

Between @triciaepeck and me, we have spent about 12 hrs on hold with @SouthwestAir this holiday weekend. Being stuck at the gate with a fully boarded plane and a full crew, just because of a software issue, is really par for the course for Southwest at this point.

Stuck at the MDW gate on @SouthwestAir flight 1435, not because of weather or passenger delays... we are stuck because the staffing software isn't counting one of the flight attendants, and we can't leave until it does. This is after 2 canceled flights, website/phone issues...

Waiting on my year-end "hours spent on prior authorization issues" summary like so many services like Pocket and Duolingo have... as I'm on the phone with an insurance company re: a denied prior auth 🤬

@ChloDubs theverge.com/2021/10/8/2271…

Yep, already marked my calendar to cancel before annual renewal -- have stopped using them anyway because service has gotten so bad, @Target and local stores are MUCH better than @amazon

@davidhuey The "old / vulnerable" are no longer who we are seeing in the ICUs because they are mostly vaccinated -- now only people under age 65 who opted not to get vaccinated, some of whom "have had COVID". The safest path is to get the vaccine until more effective treatments available.

@tpeck_86 I support this for the old / vulnerable - not for those that have had covid seems like the data on the long term efficacy is about the same for antibodies/vaxxed

@davidhuey "MAY elude vaccines" -- best protection is still to get a vaccine (or booster if eligible). Hospitals need all the help we can get right now.

Are we rejecting the science by telling people to vaxx up?

@PGeorgeMD Such a great way to measure real-world activity compared to the snapshot of the 6MWD. Would be interested to know whether there is good correlation between the two, since I'm assuming this new method is not fully validated.

@JoshDavisMD @MHayes_MD @critical_med @BIDMC_Medicine @HarvardPulm Such an overgeneralization! A dilated and overloaded RV is more likely to benefit from volume offloading through diuresis than from volume administration to "increase RV preload."

@MHayes_MD @critical_med @tpeck_86 @BIDMC_Medicine @HarvardPulm Yes to all of this but especially the “preload dependence”

“Hypotension should not be considered a reason to hold diuretics in overtly volume overloaded patients with heart failure” - @tpeck_86 #criticalmedboston @BIDMC_Medicine @HarvardPulm