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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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

Need some strategies to manage a patient with an intermediate or high-risk pulmonary embolism? Here you go! 🎩 tip to the authors. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed

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. eddyjoemd.com/foamed/

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. eddyjoemd.com/foamed

The 20th monthly Saving Lives Newsletter has just been sent out. Here's the link to view it and consider subscribing. mailchi.mp/9c77787867a2...

If we are going to keep giving empiric antibiotics at the current rate, we might as well do it properly. The biomarkers are not yet where they need to be. This paper discusses antimicrobial management in sepsis. 🎩 tip to the authors. eddyjoemd.com/foamed

It is safe to assume that days spent with us in the ICU are among the worst days in the lives of our patients and their families. Coping with the rollercoaster of emotions is no easy task, especially when there's no recovery. 🎩 tip to the authors. eddyjoemd.com/foamed

Numerous patients are transferred to our ICU for management of the pericardial effusions. Patients ask me about the etiology of the effusion. I print this out and hand it to them. Kidding, of course. 🎩 tip to the authors. eddyjoemd.com/foamed

As we advance in our expertise in managing critically ill patients, we must question some long-standing practices. In this case, the MAP target of >65 mmHg is an oversimplification that overlooks others. 🎩 tip to the authors. eddyjoemd.com/foamed

Once the acute myocardial infarction-related cardiogenic shock starts knocking out other organs, mortality skyrockets. This is why it's imperative to restore function and perfusion as early as possible. 🎩 tip to the authors. eddyjoemd.com/foamed

Your patient has severe aortic stenosis. We bring our structural heart and CT surgery buddies on board to help decide whether they'd benefit from a SAVR or TAVR. Here are some insights as to how they decide which is better for them. 🎩 tip to the authors. eddyjoemd.com/foamed

With every decision we make while caring for ICU patients, we weigh the risks and benefits. Providing platelets to patients is no exception. This paper breaks down what we need to know about this process in 10 elegant points. 🎩 tip to the authors. eddyjoemd.com/foamed

When patients go into ARDS, their right ventricle often takes a nap in the process. Here's why it frequently turns into a deleterious spiral, compromising other organs in its slumber. 🎩 tip to the authors. eddyjoemd.com/foamed

The management of ascites in patients with cirrhosis can get tricky. When they're hospitalized, whether in the wards or the ICU, striking a balance is a delicate one. This article details an algorithm for this. 🎩 tip to the authors. eddyjoemd.com/foamed

Vasopressin is extremely powerful and not only meant to be used as a "backup dancer" as I refer to in my book, The Vasopressor & Inotrope Handbook. This paper provides a free deep dive into the data. 🎩 tip to the authors. eddyjoemd.com/foamed

Depending on the etiology, different LFT patterns exist in patients who are suffering from acute liver failure. This table addresses some, and this paper breaks down the picture. 🎩 tip to the authors. eddyjoemd.com/foamed

Are you using 0.9% NaCl or balanced salt solutions such as Lactated Ringer's or Plasmalyte to resuscitate your patients with DKA? This paper suggests that we should be using the latter. 🎩 tip to the authors. eddyjoemd.com/foamed

There might be a new vasopressor coming to town: Centhaquine. I'm looking forward to the research that will add it to our armamentarium. I hope to include it in the second edition of The Vasopressor & Inotrope Handbook. 🎩 tip to the author. eddyjoemd.com/foamed

There are numerous pharmacological options to manage patients with an acute pulmonary embolism. This paper explores each of these and the data supporting them. The said data gets sparse pretty quickly. 🎩 tip to the authors. eddyjoemd.com/foamed

There's more to resuscitation than hitting a MAP goal in a hemodynamically unstable patient. There are numerous other parameters that we should be working on learning and optimizing to achieve the best outcomes. 🎩 tip to the authors. eddyjoemd.com/foamed

Should You Avoid the Right IJ for Central Lines in Critically Ill Patients? New episode of The Saving Lives Podcast. 🎩 tip to the authors. open.spotify.com/episode/06nP...

When treating patients w/acute heart failure, we witness the renal function fluctuate during their hospitalization. This paper explains when we should stay the course with decongesting them versus worrying. Some AKI may be ok. 🎩 tip to the authors. eddyjoemd.com/foamed

There are many areas for improvement in how patients sleep in the ICU. Many of our interventions trash their ability to get the rest they need. This paper tackles how light is just another piece of the puzzle. 🎩 tip to the authors. eddyjoemd.com/foamed

Pts who present w/ "toxic metabolic encephalopathy" present unique challenges going down the diagnostic rabbit hole. As much as there is a societal aversion to LPs, getting it done early is helpful before empirically treating them. 🎩 tip to the authors. eddyjoemd.com/foamed

Approximately a third of patients who undergo cardiac surgery develop atrial fibrillation. This paper tackles the mechanisms, adverse clinical events, and treatment strategies. 🎩 tip to the authors. eddyjoemd.com/foamed

Approximately 30% of patients who undergo cardiac surgery develop acute kidney injury. Here are some mechanisms as to why it happens and why it's silly to put the blame solely on fluid status. 🎩 tip to the authors. eddyjoemd.com/foamed

New podcast episode: Acetazolamide + Furosemide: Boosting Diuretic Response & Fighting Alkalosis in the ICU open.spotify.com/episode/5jEQ...

Albumin continues to be a controversial fluid we provide to our critically ill patients. These guidelines attempt to clear things up, but we need to be frank that the data is not as robust as we'd like for various indications. 🎩 tip to the authors. eddyjoemd.com/foamed

One will never forget the first time they saw a patient with a variceal hemorrhage. It is not a moment to panic at what your eyes are seeing. Here's how to take charge and save a life. 🎩 tip to the authors. eddyjoemd.com/foamed

Anyone who cares for critically ill patients should have a deep understanding of the heart-lung interaction. I'll admit that it's not easy, as there is nuance and numerous variables to account for. It's worth the effort, though. 🎩 tip to the authors. eddyjoemd.com/foamed/

At first, it can seem overwhelming for healthcare professionals learning how to use point-of-care ultrasound to know where to start. Here's a table demonstrating what we could or should be looking for. 🎩 tip to the authors. eddyjoemd.com/foamed