There is always an XKCD

Hard lessons re cardiogenic shock at #SoA25 - refusal of ICU admission because of lack of organ support needs at that point always irks me. In a sick patient with multi organ dysfunction we clearly ought to intervene early to mitigate the need to organ support - are we too reactive as a specialty?

Conservative oxygen therapy with a target SpO2 of 90% did not reduce 90-day all-cause mortality compared to usual oxygen therapy in mechanically ventilated adult patients. #CCR25 @criticalcarereviews.com https://ja.ma/4kG5gWK

Donald Trump’s gargantuan self-dealing | Opinion https://www.ft.com/content/f1cf9453-8fc4-49d5-9781-e117f744c3c7

Everyone should ideally leave twitter and come to bluesky for several reasons. - Unify the discussion - Safe space for everyone (eg LGBTQ) - Stop supporting twitter (which is now a vehicle of misinformation & political manipulation) - Twitter is currently NSFW (eg frankly pornographic content)

Scary what’s going on in the US right now - but also clearly legally highly dubious?

Time to dump my shares in Sedaconda! Inhaled Sevoflurane led to increased 90d mortality compared to propofol (52.9% v 44.3%) in pts with ARDS (Also median duration of NMB use of 5 days in both groups seems wild 🫤) jamanetwork.com/journals/jam... #MedSky #EMIMCC

Highly recommended for anyone with even a fleeting interest in cardiothoracic anaesthesia!

vasopressin challenge: this group evaluated 1U bolus of vasopressin to evaluate patient responsiveness I love this for a few reasons: [1] allows vaso to have rapid onset (rather than taking 30-60 min to build up) [2] we can get a sense of whether the vaso is helping 🧵 1/5 #EMIMCC

Speaking about my own patch… Wales has the lowest number of ICU beds per head of population in the world - and you can’t do that in the community. These conversations shouldn’t be an either/or between primary and secondary care. It needs to be asking what are hospitals *for*?

The last days of Walter Benjamin https://www.ft.com/content/fe8d0d96-ccbf-4410-8955-306987aea3b5

Wrote a little piece for the @ficm.bsky.social Resident’s Eye Newsletter on our forays into tabletop simulation on the ICU - have a read!