Discover and read the best of Twitter Threads about #ATS2023
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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
More of a modification than a new definition. Berlin lives on but includes new patients under the ARDS umbrella
#ATS2023
@ATSCritCare
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.
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.
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
More HFNC use, less ABG use, and less ultrasound use.
Our practice of respiratory failure patients has changed, our definitions need to evolve also
C4: Making it Personal: Individualizing Resuscitation Targets - Pavan Bhatraju #ATS2023
Can molecular phenotypes guide resuscitation?
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
#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 👇🏻
Do we always need a CVC?
Check out the reviews 👇🏻
Dr Ivor Douglas discussing pathophysiology of IV fluids and vasopressors in #sepsis
#ATS2023
Follow below for highlights!
@atscommunity
#ATS2023
Follow below for highlights!
@atscommunity
Too much or too little fluids can have consequences.
What is the optimal range for fluids?
What is the optimal range for fluids?
Excess fluid balance (> 5L in 1st day) is associated with increased mortality
Here we go #ATS2023
Let’s talk about next generation trials.
First up is Mattew Semler discussing the ABCs of future trials.
@atscommunity
Let’s talk about next generation trials.
First up is Mattew Semler discussing the ABCs of future trials.
@atscommunity
The equilibrium is being disrupted and new evolving trial designs are emerging
#ATS2023 @atscommunity
#ATS2023 @atscommunity
@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
Frequent analyses, multiple interventions can be studied and ability to add additional arms are advantages of platform trials
#ATS2023 @atscommunity
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
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
Steroids: 6.2% mortality by day 28
Placebo: 11.9% mortality by day 28
Persisted through day 90
