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Ken Tegtmeyer, MD, FCCM, FAAP 🇺🇸

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1 Feb, 11 tweets, 9 min read

DeVita: Rapid Response System 20 Years Later #CCC50 #PedsICU

DeVita: critical illness is common, and it's a system issue #CCC50 #PedsICU

DeVita: early model of Rapid Response System structures #CCC50 #PedsICU Developed triggers for special teams, but the other piece was to collect the data for improvement

DeVita: chain of prevention, different limbs of response
#CCC50 #PedsICU

DeVita: administrative limb to help change the culture #CCC50 #PedsICU

DeVita: response to obstetrical emergencies led to improvement in responses to other issues #CCC50 #PedsICU

DeVita: there will be events that are unpredictable, suggesting that intermittent monitoring wont help. IF you increasing monitoring diurnal variation of RRS goes away #CCC50 #PedsICU (briefly touches on nuisance alarms)

DeVita: gap in monitoring exists on the floor, more monitoring now at home #CCC50 #PedsICU

DeVita: quality limb rapid response and the "sick hospital" #CCC50 #PedsICU

DeVita: UPMC has numerous rapid responses #CCC50 #PedsICU

DeVita: with COVID have had some specific extra needs/resources #CCC50 #PedsICU

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Ken Tegtmeyer, MD, FCCM, FAAP 🇺🇸

@pccm_doc

2 Feb

Sevransky: rationale for Vitamin C in sepsis and shock #CCC50 #PedsICU

Sevransky: CITRIS-ALI #CCC50 #PedsICU 167 patients with Sepsis AND ARDS for < 24 hours.

Sevransky: it did raise Vitamin C levels but didn't modify SOFA or other scores. But interventional group had a lower mortality (not a primary outcome measure of the study though, one of 46 secondary measures) #CCC50 #PedsICU Billiard analogy of calling your shot -

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Ken Tegtmeyer, MD, FCCM, FAAP 🇺🇸

@pccm_doc

2 Feb

Next up Joel Feih, PharmD from Froedtert Hospital at MCW in Milwaukee on B12 and Methylene Blue in refractory vasodilatory shock #CCC50 #PedsICU

Feih: Methylene Blue #CCC50 #PedsICU

Feih: Methylene Blue has been studied for prophylaxis in high risk vasoplegic syndrome following CPB #CCC50 #PedsICU

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Ken Tegtmeyer, MD, FCCM, FAAP 🇺🇸

@pccm_doc

2 Feb

@KhannaAshishCCM

@KhannaAshishCCM reviewing stuff that I knew once upon a time... #CCC50 #PedsICU RAAS

Khanna: Is renin the new lactate? #CCC50 #PedsICU

Khana: case report of high renin vasodilatory shock in a COVID patient on VV ECMO aaa #CCC50

Read 5 tweets

Ken Tegtmeyer, MD, FCCM, FAAP 🇺🇸

@pccm_doc

2 Feb

Douglas White (UPMC): ICU triaging both on saving most lives and those with longest life expectancy, even based on SOFA scores invariably will bias against patients of color, or lower SES #CCC50 #PedsICU

White: 4 strategies for ICU triage that promote equity

White: Arizona as an example, some hospitals were overburdened, others had empty beds. Arizona surgeline addressed this to coordinate and facilitate transfer 5000 patient transfer so they didn't need to triage. #CCC50 #PedsICU

Read 10 tweets

Ken Tegtmeyer, MD, FCCM, FAAP 🇺🇸

@pccm_doc

2 Feb

Katri Typpo presenting the basic science arm of the Peds Year in Review (it's not all SARS-CoV2) #CCC50 #PedsICU

Typpo: looking at mechanism of Cytokine Release Syndrome in CAR-T therapy #CCC50 #PedsICU by Liu at al Blocking GSDME may prevent CRS

Typpo: an animal model of Inhaled Vitame E Acetate and EVALI-like Lung injury #CCC50 #PedsICU

Read 8 tweets

Ken Tegtmeyer, MD, FCCM, FAAP 🇺🇸

@pccm_doc

2 Feb

Bembea presenting clinical arm of Year in Review, MIS-C, ARDS, here the PARDIE study #CCC50 #PedsICU

@SapnaKmd

Bembea: PARK-PICU study looking at physical rehab point prevalence in the US from @SapnaKmd et al #CCC50 #PedsICU

Bembea: Canadian and European versions of PARK-PICU showed some similarities but some noticiable differences #CCC50 #PedsICU

Read 8 tweets

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