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
Feih: also worked if given after CPB #CCC50 #PedsICU
Feih: side effects worse if given late #CCC50 #PedsICU
Feih: on to Hydroxycobalamine #CCC50 #PedsICU
Feih: most of the data is from case reports, and dosing and administration is greatly varied in the reports. most also got methylene blue. #CCC50 #PedsICU
Feih: one study compared Methylene Blue to B12 in cardiac surgery patients, but retrospective. Both drugs worked. No difference #CCC50 #PedsICU
Feih: our study, monotherapy vs. combo no difference for MAP goal #CCC50 #PedsICU
Feih: combo therapy may allow slight decrease in other vasopressor use #CCC50 #PedsICU
Feih: conclusions, bottom line is the data is limited. Be worried about G6PD and concomitant serotoninergic syndromes #CCC50 #PedsICU

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More from @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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Bembea presenting clinical arm of Year in Review, MIS-C, ARDS, here the PARDIE study #CCC50 #PedsICU
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
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The legend Ann Thompson, MD, MHCPM, MCCM talking about her career in #PedsICU, including offering herself up as chief at Pittsburgh 6 months out of fellowship. #CCC50 #PedsICU (her caveat was that the division was 2 people with one fellow, 7 nurses, 10 PICU beds)
Dr. Laura Evans, FCCM asking Dr. Thompson about that transition from fellowship to leadership, the growth of the program. Dr. Thompson relying back on her guidance from Drs Raphaelly and Downes at CHOP who mentored her. "Holding on by your fingertips" at times. #CCC50 #PedsICU
Dr. Thompson points out that having a strong team helped them persevere. (A team of course that she built over the years). #CCC50 #PedsICU
Read 15 tweets

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