Tobin vs Gattinoni: Infinity War💣
Get some more popcorn 🍿
Let's start back at the beginning...
🥊Round #1: Tobin's original editorial casts shade on P-SILI & recommends our usual, conservative approach to intubation (rather than pre-emptive intubation)
bit.ly/3h7wx3r
Round #2: Gattinoni replies
🥊3 citations to support existence of P-SILI
🥊claims COVID patients have unusually good compliance based on observing hundreds of patients (no data)
🥊recommends using esophageal pressure swings as a trigger for intubation 🤡
bit.ly/3aAHGaA
Round #3: Tobin strikes back
🥊Major flaws noted in three citations supporting the existence of P-SILI (still hasn't been clearly demonstrated, even in animal models 🐑)
🥊Lack of evidentiary support for esophageal pressure thresholds
bit.ly/3aEmUXB
Round #4: Gattinoni hits back weakly
🥊Cites pediatric study on asthma as evidence of P-SILI
Round #5: Tobin strikes back
🥊Pediatric asthma study widely believed to be fabricated data.
🥊Trends show improving mortality correlates with reduced intubation rates.
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