Discover and read the best of Twitter Threads about #IVC

Most recents (6)

#POCUS con USPed Latinoamérica🌎

En #SabadosdePOCUS Roberth González Cardiólogo Pediatra de 🇵🇪 nos habló de #Ecocardiografía en el Paciente #Critico en #Pediatria.

¿Quieres saber un poco de qué trato?

Abrimos 🧵 👩‍⚕️👨‍⚕️
Comentarios iniciales #PedsICU:

No vemos internamente la interacción cardiopulmonar. El #POCUS ha cambiado eso.
Dicha interacción regularmente había sido estudiada por separado.
La integración ❤️-🫁Pulmón debe ser siempre en contexto.

🔄🔃
Algo que le sirvió mucho al Dr. Roberth: la #Fisiología, su funcionamiento.

Ojo, este dato se ha mencionado mucho en nuestras sesiones. El #POCUS en verdad te ayuda a mejorar tus conocimientos básicos, cuando ves lo que tanto estudiaste.
Read 21 tweets
En nuestros #SabadosdePOCUS tuvimos a @ACRP901 con el tema:

"Los Secretos Ecográficos de la Vena Cava Inferior (#VCI/#IVC)"

¿Quieres enterarte de alguna puntos claves?

Abrimos hilo... 🧵 #POCUS
Un punto clave del Dr. @ACRP901: "Los niños no son adultos pequeños"
La VCI sigue siendo esquiva.
Es #Fundamental conocer la fisiología y anatomía al tocar este tema.
Y recuerda: los secretos se encontrarán en la #Fisiología más que en la ecografía per se.
La #VCI se encuentra inmersa en varios protocolos y en las modificaciones de cada uno de estos dependiendo el contexto del paciente (#FOCUS, #RUSH, #EFAST).

Se habían utilizado a la #VCI regularmente para medir el estado de volemia y una posible respuesta (o no) a fluidos.
Read 25 tweets
As for substrate possibilities, here are a few papers that discuss all early Rgvedic loans from a different language.

citeseerx.ist.psu.edu/viewdoc/downlo…
hf.uio.no/ikos/forskning…
ideals.illinois.edu/handle/2142/26…

+
The emergence of retroflexes in Indo-Aryan languages and the lack of retroflexes in other Indo-European languages were discussed at lengths.

A few papers discussing the possibilities.

+

ideals.illinois.edu/handle/2142/26…
experts.illinois.edu/en/publication…
academia.edu/1306422/Genesi…
From an aDNA and genetic population studies, here are a few papers that discuss the migration into south Asia and Europe, positing there were migrations into South Asia during the late Bronze Age.

nature.com/articles/natur…
nature.com/articles/s4155…

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Read 8 tweets
Kicking off multidisciplinary Research Consensus Panel (RCP) to finally investigate the ❓: what is the optimal medical therapy (OMT) following venous recan? Follow #VenousRCP throughout the day to learn more and contribute! #SIRFoundation @SIRRFS @SIR_ECS @JVIRmedia
🔴 Pathophysiology of venous thromboembolism #VTE
🟠Venous recanalization & stenting
🟡The mystery of medical therapy following recanalization
🟢Patency & outcome measures
🔵Economics & cost-effectiveness of treatment
🟣Future directions
#VenousRCP
🔴 ✅#VTE affects ~100 of every 100,000 people yearly in the US
✅Incidence of VTE ⬆️⬆️ exponentially with age, especially after 40
#Endovascular recan is a common tx; post-tx algorithms vary widely
✅More #epidemiology info @CircAHA bit.ly/37IptZh
@Pertconsortium
Read 24 tweets
🧵 AKI and #COVID19

68 yo ♂️ PMH obesity, HTN, CAD w stent, OSA, T2DM
➡️ ED w SOB + fever 39.9°C. Poor oral intake

RR 40, Sat 94% Room Air, BP 157/74 HR 124. Alert. Bibasilar crackles

Labs: Cr 1.3 (baseline 0.8), WBC 10, K 5.4, HCO3 17, CK 184. UA and CXR👇 (case from @NEJM)
How would you manage this AKI initially? What is the likely cause of AKI in patients with #COVID19? (this last question discussed in thread 🧵)
No easy answer except to say that FENa is very unlikely to be useful. It is not unreasonable to try fluids for AKI in the setting of perceived hypovolemia. However, this gets complicated when the potential for worsening ARDS exists. I'll try to tackle the answers one by one 💪
Read 17 tweets
1/11
**Nuances of IVC assessment**

So I was asked by @msiuba and @NephroP to talk about about the various nuances of IVC assessment in mechanically ventilated patients. I thought I'd go over some basic concepts for both spontaneously breathing and vented patients

Thread/
2/11
Concept 1:
The core mechanism of respirophasic alterations of IVC diameter is its relationship with (actual, not transmural) CVP.
⬇️CVP -->⬆️venous return -->⬇️pressure within the IVC --> tendency to collapse (& vice versa).

Concept 2:
The IVC pressure-diameter relationship
3/11
Since ΔIVC pressure is related to changes in CVP (concept 1), a direct relationship between CVP and IVC diameter exists (image)

Note that as the IVC dilates, its compliance reduces (stiffens). Hence, any further increase in IVC pressure doesn't increase its diameter.
Read 11 tweets

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