Get ready for some tweet-ucation with "Critical Care Year in Review 1"! #CHEST2021 1/
First up is Dr. Robert Hyzy(@bhyzy) with "Update in ARDS". #CHEST2021 2/
We are seeing an increase in ARF and higher mortality in black, non-urban, and older patients. #CHEST2021 3/
This is the Berlin definition for ARDS. Note at the bottom that they specify these requirements can be met with NIV. #CHEST2021 4/
The Berlin definition may need to be modified to include HHFNC. #CHEST2021 5/
This study showed that awake proning in COVID-19 decreases intubation rates. #CHEST2021 6/
Low TiV with proning was better than low TiV with high PEEP, so consider proning early. #CHEST2021 7/
Low tidal volumes have the most benefit when there is low compliance. #CHEST2021 8/
Both driving pressure and mechanical power correlate with mortality when you re-analyze the data from old studies. #CHEST2021 9/
The change in driving pressure has more of an association with mortality than an increased PaO2/FiO2 ratio. #CHEST2021 10/
Driving pressure is at least 4 times as important as the RR in how much damage the vent inflicted. #CHEST2021 11/
Summary slide! #CHEST2021 12/
Next up is Dr. David Bowton (@David Bowton) with "Neuro Critical Care in Review". #CHEST2021 13/
This study analyzed thrombectomy >6 hours later for CVA and found improvements in mRS. #CHEST2021 14/
Thrombectomy up to 24 hours after last known normal can be effective in improving patient outcomes. #CHEST2021 15/
There are numerous studies comparing alteplase and teneteplace. #CHEST2021 16/
Why should you care? Tenecteplace is cheaper and easier to administer. #CHEST2021 17/
This meta-analysis has some potentially misleading conclusions in the article.35% of the patients >60yo in this study came from a trial that was withdrawn from publication. #CHEST2021 18/
This review looked at goal BP in ICH. No benefit to SBP goal <130. Optimal BP targets and timing remain somewhat uncertain. #CHEST2021 19/
The Divani article found that big BP changes were associated with worse outcomes. #CHEST2021 20/
This study looked at temperature management post-CPR for non-shockable rhythms. Targeting normothermia appears equivalent to cooling to 33 degrees C. #CHEST2021 21/
This study also agrees with the above conclusion. #CHEST2021 22/
TTM and expert assessment prior to consideration of withdrawal of life support leads to higher survival. #CHEST2021 23/
Last up is Dr. Steven Simpson (@sqsimp) with "Sepsis 2021" #CHEST2021 24/
The surviving sepsis campaign published 2021 guidelines. #CHEST2021 25/
These are the updates in the new surviving sepsis guidelines. #CHEST2021 26/
Infection Updates #CHEST2021 27/
Summary Chart #CHEST2021 28/
Updates in hemodynamic management. For septic shock resuscitation they suggest (weak recommendation) using balanced crystalloids instead of NS. #CHEST2021 29/
Updates in ventilation. #CHEST2021 30/
Updates in additional therapies. #CHEST2021 31/
New section on long-term outcomes and goals of care! #CHEST2021 32/
This study on SEP-1 found that there was an improvement in mortality if you did receive the bundle, regardless of the likelihood for compliance. #CHEST2021 33/
Thanks for joining us for this great review! #CHEST2021 34/34
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