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Adrian Wong Profile picture
@avkwong
Apr 8, 2021 • 14 tweets • 7 min read • Read on X
Scrolly
Afternoon learning #esicmtv
Revisiting some basic physiology on vasoactive drugs...

Vasopressor and Inotrope Therapy in Cardiac Critical Care
journals.sagepub.com/doi/abs/10.117…
Outcomes Associated With Norepinephrine Use Among Cardiac Intensive Care Unit Patients With Severe Shock

journals.lww.com/shockjournal/A…
Here we go again... Comparison of Dopamine and Norepinephrine in the Treatment of Shock

nejm.org/doi/full/10.10…
Onto Vasopressin - VASST/VANISH

jamanetwork.com/journals/jama/…

@agordonICU
SO when would you add in a second vasopressor??
I use vasopressin as my add on vasopressor...
Clinical pearls - tips and tricks..

Have you got the diagnosis? Have you got source control?
Management of Refractory Vasodilatory Shock
@accpchest
journal.chestnet.org/article/S0012-…
FOllowing nicely on from Dr Jentzen, @ArthurvanZanten
Terlipressin versus norepinephrine as infusion in patients with septic shock: a multicentre, randomised, double-blinded trial

@yourICM
pubmed.ncbi.nlm.nih.gov/29971593/
Probably good to take a step back and look at what colleagues from across the globe do....

A global perspective on vasoactive agents in shock
in @yourICM
@Glenn04716918 @agordonICU

link.springer.com/article/10.100…
An argipressin protocol anyone??
Wow - the netherlands have a vasopressin registry

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More from @avkwong

Adrian Wong Profile picture
Dec 3, 2022
First session post lunch - reseach and #POCUS.

And Prof Atkinson of SHOC-ED - a landmark #POCUS trial

pubmed.ncbi.nlm.nih.gov/29866583/

#WINFOCUS22
A summary from @WICSBottomLine #SHOCED
Does Point-of-Care Ultrasonography Improve Clinical Outcomes in Emergency Department Patients With Undifferentiated Hypotension?

thebottomline.org.uk/summaries/em/s…
#WINFOCUS22
@WICSBottomLine Do combined ultrasound and electrocardiogram-rhythm findings predict survival in emergency department cardiac arrest patients? The Second Sonography in Hypotension and Cardiac Arrest in the Emergency Department (SHoC-ED2) study

pubmed.ncbi.nlm.nih.gov/31566175/
#WINFOCUS22 #EACEM22
Read 4 tweets
Adrian Wong Profile picture
Dec 3, 2022
Teleproctoring - mentoring with @POCUSClub

#WINFOCUS22
A very poignant question - with so much online learning/recordings/presentations, do we invest in the TIME and tech for these? Or do we just try to replicate the face-to-face version?

lighting, mics, etc

#WINFOCUS22
Your mobile phone probably has a better camera than your intergrated laptop #WINFOCUS22
Read 7 tweets
Adrian Wong Profile picture
Dec 3, 2022
AI and ultrasound - @arntfield
Are you AI bilingual? I am definitely not.

ping @teddyhla @AriErcole @drPaulElbers @tomlincr

#WINFOCUS22 #EACEM22
A recurring theme for this session is could machines do it better?

#WINFOCUS22
Read 6 tweets
Adrian Wong Profile picture
Dec 3, 2022
Next up @heart_lung talking about wearable technology and ultrasound #WINFOCUS22 #EACEM22
Wearable ultrasound and provocative hemodynamics: a view of the future
#WINFOCUS22 #EACEM22
ccforum.biomedcentral.com/articles/10.11…
I must admit, it is rather clever device

#WINFOCUS22 #EACEM22
Read 8 tweets
Adrian Wong Profile picture
Dec 3, 2022
Next - optic nerve sheath diameter - AUTOMATED #WINFOCUS22 #EACEM22

ping @LauretaPereta @chiara_robba
A summary of the sensitivity and specificity of ONSD
BUT.....
#WINFOCUS22
There is the issue of heterogeneity in operator measurement #WINFOCUS22

@icmteaching has an excelleng video on how to do this properly
Read 5 tweets
Adrian Wong Profile picture
Dec 3, 2022
Technology changing the ultrasound game #WINFOCUS22 #EACEM22
First up - machine learning and artificial intelligence - the use of automation
There are a number of manufacturers now with automated tools
- B lines
- VTI
- IVC

Do colleagues use them routinely??

#WINFOCUS22 #EACEM22
It is not just measurements though - can the software/machine help make POCUS more accessible. Act as a teacher?

I think so.

#WINFOCUS22 #EACEM22
Read 7 tweets

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