Tobin vs Gattinoni: Infinity Warπ£
Get some more popcorn πΏ
Let's start back at the beginning...
π₯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
π₯3 citations to support existence of P-SILI
π₯claims COVID patients have unusually good compliance based on observing hundreds of patients (no data)
π₯recommends using esophageal pressure swings as a trigger for intubation π€‘ bit.ly/3aAHGaA
Round #3: Tobin strikes back
π₯Major flaws noted in three citations supporting the existence of P-SILI (still hasn't been clearly demonstrated, even in animal models π)
π₯Lack of evidentiary support for esophageal pressure thresholds bit.ly/3aEmUXB
Round #4: Gattinoni hits back weakly
π₯Cites pediatric study on asthma as evidence of P-SILI
Round #5: Tobin strikes back
π₯Pediatric asthma study widely believed to be fabricated data.
π₯Trends show improving mortality correlates with reduced intubation rates.
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how to place a consult: you MUST understand the five stages of consultant grief.
once you can understand this painful and natural process, requesting consults will make a LOT more sense
buckle up, it can be a little roughβ¦
𧡠1/6β¦
stage 1: denial
- You dont need a consult.
- You called the wrong service.
- 18 years old? consult pediatrics
- Iβm not actually on call now
- Everythingβs fine, just walk it offβ¦
stage 2: anger
- you should have consulted us earlier/later
- you should have checked this test before calling us
- youβre a terrible doctor/student/human being