Thread by @cianmcdermott

Session IV ft @ThinkingCC @aron_jonny @drhazemlashin
➡️ Hemodynamics, RV and #VEXUS #covid19pocus

Early phase = predicted fluid responsive state

RV struggles at an early stage as result of hyperinflammatory lung condition - moderate dilation, increase in TRVmax, worsening RV strain pattern

RV thrombus in COVID19 - consider early TPA

But the LV is also susceptible to stress cardiomyopathy (adrenergic, metabolic, sepsis, high dose sedation). Look for RWMA

Don't forget the lungs as cause of obstructive shock

Bottom line - Echo is vital for diagnosis, treatment initiation and monitoring

Next up - RV failure in COVID19 @drhazemlashin
*hypoxia *pulmonary vasoconstriction *high PEEP *excess fluids or diuresis are the culprits

Look for acute cor pulmonale using FUSIC techniques bit.ly/3eQihuI

Here's how....

Who is assessing RV systolic function? annalsofintensivecare.springeropen.com/articles/10.11…

OK - last leg is @ThinkingCC with #VExUS - quick review ⬇️ theultrasoundjournal.springeropen.com/articles/10.11…

My #VEXUS resources ➡️ acep.org/how-we-serve/s…

These guys also ➡️ @iceman_ex @Wilkinsonjonny criticalcarenorthampton.com/vexus-score/#m…

Could delirium result from venous congestion? pubmed.ncbi.nlm.nih.gov/31395469/

This is how @ThinkingCC does it thinkingcriticalcare.com/2020/02/28/a-v… #covid19pocus

#VExUS and AKI in COVID19 @khaycock2 #covid19pocus thinkingcriticalcare.com/2020/06/25/bed…

@threadreaderapp unroll #covid19pocus

threadreaderapp.com/thread/1276898… #covid19pocus