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The tagline of the @CuringComa Campaign is #AwakeningHope

So now it’s time to start a conversation. What does #CuringComa mean to you?

Please tell us…
@caseyalbin @almuftifawaz @drdangayach @aartisarwal @WesElyMD @ClaudeHemphill @Menon_Cambridge @fabio_taccone @Dr_Cit
To me, #AwakeningHope means this: I explain The diagnosis And proposed treatment plan. I then explain the range of possible outcomes. I explain the most likely scenario, the worst case scenario, and the best case scenario.
I then explain that MY APPROACH is to take the best case scenario and never let it go. I explain that visualization goes all long way in making things come true. I encourage my families to work with us to create every opportunity to for the best case scenario to come true.
Read 5 tweets
1/ So now it's the cataclysmic TTM -2 trial, just published in @NEJM. How can a world changing trial like HACA published in 2002 now be effectively reversed almost 20 years later? I will explain.

nejm.org/doi/full/10.10…
2/ Lots of head scratching. Hard to understand. But I am not surprised. It's a pattern that we have seen before with goal directed therapy for sepsis and intensive insulin therapy for hyperglycemia. The answer is that a trial's results depend very much on the clinical milieu
3/ When Manny Rivers published his EGDT classic in the @nejm in 2001, the milieu was bad sepsis therapy. The control group was neglected, under-resuscitated, anemic nursing home patients. I remember these shocky patients in the in ER those days, waiting for hours for an ICU bed.
Read 12 tweets

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