Discover and read the best of Twitter Threads about #HFNC

Most recents (5)

This just out: Physicians do not logically/correctly estimate the probability of outcomes resulting from sequences of events - a thread. #conjunctionfallacy #probability #medicaldecisionmaking #clinicalreasoning #innumeracy #numeracy… @JAMANetworkOpen
In this article, we showed that physicians estimated the probability of two events both occurring as *more* likely than one or both of the individual events. This is logically impossible and consistent with the #conjunctionfallacy. This #bias can lead to catastrophic outcomes
The impetus for the study was an #OBGYN catastrophe that resulted, in part, from this bias. A woman presented in labor w brow presentation. For successful vaginal delivery, 2 events must happen: reversion to deliverable position, and vaginal delivery w/o #caesareansection
Read 20 tweets
#CCCF2020 Brian Kavanaugh Controversies - #COVID19: #ARDS or not? What we really addressed - not so much "is it ARDS?" but rather, "does it matter?" So happy to have been a part of this, but man, I still have so much to say! My take on the ? – yes, it matters - to an extent 🧵 1/ Image
Pre-intubation management: YES, but not because it substantially changes methods of support, or the criteria used for #intubation. It matters because categorizing patients as having #ARDS has value. 2/
If we use the Berlin definition, patients on Venturi masks or arguably #HFNC don’t actually meet criteria for #ARDS because they’re not on PEEP >/= 5. The natural history of ARDS though almost certainly begins prior to the use of mechanical ventilation (invasive or not). 3/
Read 13 tweets
Starting a series on clinical Pearls I am gathering in #COVID19 patients based on experiences of many experts

Will add as we go along

Feel free to add your own observations/experiences

#covidclinicalpearls /1
Anosmia is likely the most specific #COVID19 related symptom
30% of patients have anosmia as their 1st symptom
#covidclinicalpearls /2
Around 90% of patients have fever.
50% maybe afebrile at the time of presentation
Fever tends to be very resistant to routine measures in hospitalized patients
There is no consensus that NSAIDs are to be avoided in #COVID2019 patients

#covidclinicalpearls /3
Read 66 tweets
1/ [ 5th AMIB-ESICM Symposium]:
I talked about the physiological rationale of the #HFNC for hypercapnic ARF.
So not all hypercapnic ARF are the same. There are those due to Central hypoventilation / neuromuscular disorders & those due to V/Q mismatch
@israelmaia16 @RENOVATEtrial
2/ In the V/Q mismatch category, airway diseases such as #COPD commonly presents a mismatch due to ⬆️Vd/Vt. And how that happens can be easily appreciated in these two slides:
3/ Dead space (Vd) is composed by:
- anatomical dead space (fixed)
- alveolar dead space (which can vary)

When we think on the potential effect of the HFNC for hypercapnic ARF, it´s probable that the greatest benefits will b seen on hypercapnia due to ⬆️Vd/Vt, and the reason is:
Read 8 tweets
Short #Tweetorial

How did we started with heated humified high flow nasal cannula in 🇺🇾 ?

Easy explanation of 3 #HHHFNC homemade models #HFNC devices?

(No COI to declare)

#PedsICU #SoMe4MV #historyofmedicine @WFPICCS
It is really easy.
You can get information of its uses and applications in this nice review in @respcare ▶️

This is basically the diagram 👇
So back in 2012 in our country we wanted to try some kind of respiratory support for the youngest infants in which interfases for #NIV was difficult.

SO we came up with an idea: What if we dismantle the old ventilators we do not use any more?

Like this ones 👇
Read 13 tweets

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