Discover and read the best of Twitter Threads about #ATS2023

Most recents (6)

Well it's finally here. New Global Definition of ARDS presented by Michael Matthay on behalf of a large diverse international panel.

More of a modification than a new definition. Berlin lives on but includes new patients under the ARDS umbrella

#ATS2023
@ATSCritCare Image
Consensus process:
100% agreement that Berlin definition need an update

100% agreement on recommendations (after many meetings)

Input without requirement for formal endorsement from 21 critical care societies. Image
Things have changed since 2012 Berlin definition.

More HFNC use, less ABG use, and less ultrasound use.

Our practice of respiratory failure patients has changed, our definitions need to evolve also Image
Read 7 tweets
C4: Making it Personal: Individualizing Resuscitation Targets - Pavan Bhatraju #ATS2023
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Can molecular phenotypes guide resuscitation? Image
Read 4 tweets
Next up: Dr Elizabeth Munroe, when do we add vasopressors in #sepsis ?

#ATS2023 @atscommunity

Early vasopressors will:
- control shock faster
- allow leas fluids

Look up the #CENSER and #CLOVERS trials
In #CLOVERS restrictive fluid groups show no difference in major outcomes compared to liberal group
How do we administer vasopressors?

Do we always need a CVC?

Check out the reviews 👇🏻 Image
Read 5 tweets
Dr Ivor Douglas discussing pathophysiology of IV fluids and vasopressors in #sepsis

#ATS2023

Follow below for highlights!

@atscommunity Image
Too much or too little fluids can have consequences.

What is the optimal range for fluids? Image
Excess fluid balance (> 5L in 1st day) is associated with increased mortality Image
Read 6 tweets
Here we go #ATS2023

Let’s talk about next generation trials.

First up is Mattew Semler discussing the ABCs of future trials.

@atscommunity Image
The equilibrium is being disrupted and new evolving trial designs are emerging

#ATS2023 @atscommunity Image
@MichelleNgGong discussing advantages of platform trials compared to traditional trials which be costly and ineffective

Frequent analyses, multiple interventions can be studied and ability to add additional arms are advantages of platform trials

#ATS2023 @atscommunity ImageImage
Read 6 tweets
NEJM:JAMA Critical Care Trials:
Now presenting - Corticosteroids for Severe CAP

#ATS2023
CAPE COD trial:
31 ICUs in France
Required MV, HFNC, or NRB
Randomized to Hydrocort 200mg x 4 days or placebo
At day 4, if still sick based on pre-specified criteria, re-randomized to receive steroids until day 8 or 14
Primary outcome:
Steroids: 6.2% mortality by day 28
Placebo: 11.9% mortality by day 28

Persisted through day 90
Read 9 tweets

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