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@IM_Crit_

@imcrit.bsky.social

3.2K followers 520 following 6.8K posts

Intensivist I Internal Medicine | ☕️, 🍩, 🥐, 🍫 addict | #emimcc

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@IM_Crit_ @imcrit.bsky.social · 15h

@IM_Crit_ @imcrit.bsky.social · 15h

@IM_Crit_ @imcrit.bsky.social · 15h

@IM_Crit_ @imcrit.bsky.social · 15h

Six surgeons general warn about RFK Jr.

#medsky

@IM_Crit_ @imcrit.bsky.social · 1d

ICU Snapshots:

Assessment/Plan (ICU Edition):
Day #1: Start Colace qd
Day #2: Change to Colace bid
Day #3: Add Senna
Day #4: Add Miralax
Day #5: The next intensivist comes on service

#medsky #foamed #foamcc #meded #emimcc

@IM_Crit_ @imcrit.bsky.social · 1d

Amazon is trying to get a piece of the pie, aka the multi-trillion dollar US health care industry

#Medsky #Healthcare

@IM_Crit_ @imcrit.bsky.social · 2d

🤔😳🫣

@IM_Crit_ @imcrit.bsky.social · 3d

Friendly reminder:

Science does not progress by popular vote

#meded #foamed #foamcc #Medsky

Reposted by @IM_Crit_

@IM_Crit_ @imcrit.bsky.social · 5d

Nice review on the role of right-sided heart dysfunction (#RHD) on acute respiratory distress syndrome (#ARDS). The review is covering RHD's pathophysiology, diagnosis & potential treatments:

@IM_Crit_ @imcrit.bsky.social · 5d

Hat tip to the authors!

#foamed #foamcc #meded #Medsky #emimcc #cccsky #hemodynamics

@IM_Crit_ @imcrit.bsky.social · 5d

This will hopefully challenge our belief that prone positioning is universally beneficial in ARDS-associated RHD. As usually happens in any hemodynamic maneuver/intervention, we have to measure/study the physiology at the bedside and see if the experiment actually confirms our theory!

@IM_Crit_ @imcrit.bsky.social · 5d

I am biased here (😊) but probably the most interesting part of the review is the reference #69, in which a patient with COVID-19 & ARDS-associated RHD was proned & pressure-volume loop analysis showed ⬆️ RV end-diastolic pressure & ⬇️ stroke volume & RVEF:

@IM_Crit_ @imcrit.bsky.social · 5d

Several strategies are employed for the management of RHD in ARDS:

@IM_Crit_ @imcrit.bsky.social · 5d

A failing heart in ARDS might behave like this:

@IM_Crit_ @imcrit.bsky.social · 5d

Several pathophysiological mechanisms contribute to ⬆️ pulmonary vascular tone & RV afterload in ARDS, including hypoxic vasoconstriction (Euler-Liljestrand mechanism), hypercapnia, acidosis, in situ thrombosis & an imbalance between pulmonary vasoconstrictors & vasodilators:

@IM_Crit_ @imcrit.bsky.social · 5d

Nice review on the role of right-sided heart dysfunction (#RHD) on acute respiratory distress syndrome (#ARDS). The review is covering RHD's pathophysiology, diagnosis & potential treatments:

Reposted by @IM_Crit_

@IM_Crit_ @imcrit.bsky.social · 5d

Refresher on Spectral Doppler assessment of the hepatic veins in tricuspid valve disease:

Reposted by @IM_Crit_

@IM_Crit_ @imcrit.bsky.social · 6d

This systematic review included 65 studies & 17,008 patients with #sepsis. The occurence rate of each one of the three #echocardiographic phenotypes, namely left ventricular systolic dysfunction (LVSD), LV diastolic dysfunction (LVDD), & RV dysfunction (RVD) peaked at 48h:

@IM_Crit_ @imcrit.bsky.social · 5d

Hat tip to the authors!

#foamed #foamcc #meded #Medsky #pocus #emimcc

@IM_Crit_ @imcrit.bsky.social · 5d

Take-home message:
Blunting of the S-wave and SR are not specific
markers of moderate and severe TR, respectively

@IM_Crit_ @imcrit.bsky.social · 5d

Various hepatic vein (HV) Doppler patterns can be observed in the setting of TR:

@IM_Crit_ @imcrit.bsky.social · 5d

Severe TR mimic:

@IM_Crit_ @imcrit.bsky.social · 5d

Severe TR masquerading as moderate TR:

@IM_Crit_ @imcrit.bsky.social · 5d

Severe TR during atrial fibrillation:

@IM_Crit_ @imcrit.bsky.social · 5d

Severe TR in sinus rhythm: