Get ready for some tweet-ucation with "Critical Care Year in Review 1"! #CHEST2021 1/
First up is Dr. Robert Hyzy(@bhyzy) with "Update in ARDS". #CHEST2021 2/
We are seeing an increase in ARF and higher mortality in black, non-urban, and older patients. #CHEST2021 3/ Image
This is the Berlin definition for ARDS. Note at the bottom that they specify these requirements can be met with NIV. #CHEST2021 4/ Image
The Berlin definition may need to be modified to include HHFNC. #CHEST2021 5/ Image
This study showed that awake proning in COVID-19 decreases intubation rates. #CHEST2021 6/ ImageImage
Low TiV with proning was better than low TiV with high PEEP, so consider proning early. #CHEST2021 7/ Image
Low tidal volumes have the most benefit when there is low compliance. #CHEST2021 8/ Image
Both driving pressure and mechanical power correlate with mortality when you re-analyze the data from old studies. #CHEST2021 9/ Image
The change in driving pressure has more of an association with mortality than an increased PaO2/FiO2 ratio. #CHEST2021 10/ Image
Driving pressure is at least 4 times as important as the RR in how much damage the vent inflicted. #CHEST2021 11/ Image
Summary slide! #CHEST2021 12/ Image
Next up is Dr. David Bowton (@David Bowton) with "Neuro Critical Care in Review". #CHEST2021 13/
This study analyzed thrombectomy >6 hours later for CVA and found improvements in mRS. #CHEST2021 14/ ImageImageImageImage
Thrombectomy up to 24 hours after last known normal can be effective in improving patient outcomes. #CHEST2021 15/ Image
There are numerous studies comparing alteplase and teneteplace. #CHEST2021 16/ Image
Why should you care? Tenecteplace is cheaper and easier to administer. #CHEST2021 17/ Image
This meta-analysis has some potentially misleading conclusions in the article.35% of the patients >60yo in this study came from a trial that was withdrawn from publication. #CHEST2021 18/ ImageImageImageImage
This review looked at goal BP in ICH. No benefit to SBP goal <130. Optimal BP targets and timing remain somewhat uncertain. #CHEST2021 19/ ImageImage
The Divani article found that big BP changes were associated with worse outcomes. #CHEST2021 20/ ImageImage
This study looked at temperature management post-CPR for non-shockable rhythms. Targeting normothermia appears equivalent to cooling to 33 degrees C. #CHEST2021 21/ ImageImageImage
This study also agrees with the above conclusion. #CHEST2021 22/ Image
TTM and expert assessment prior to consideration of withdrawal of life support leads to higher survival. #CHEST2021 23/ Image
Last up is Dr. Steven Simpson (@sqsimp) with "Sepsis 2021" #CHEST2021 24/
The surviving sepsis campaign published 2021 guidelines. #CHEST2021 25/ Image
These are the updates in the new surviving sepsis guidelines. #CHEST2021 26/ ImageImage
Infection Updates #CHEST2021 27/ ImageImageImage
Summary Chart #CHEST2021 28/ Image
Updates in hemodynamic management. For septic shock resuscitation they suggest (weak recommendation) using balanced crystalloids instead of NS. #CHEST2021 29/ ImageImage
Updates in ventilation. #CHEST2021 30/ Image
Updates in additional therapies. #CHEST2021 31/ Image
New section on long-term outcomes and goals of care! #CHEST2021 32/ Image
This study on SEP-1 found that there was an improvement in mortality if you did receive the bundle, regardless of the likelihood for compliance. #CHEST2021 33/ ImageImage
Thanks for joining us for this great review! #CHEST2021 34/34

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More from @gretchemaben

20 Oct
Next up for some tweet-ucation is "Inhaled Medications in COPD: Contemporary Strategies to Manage an Old Disease"! #CHEST2021 1/
Dr. Arzu Ari speaks on "Aerosol Drug Delivery in Patients with COPD." #CHEST2021 2/
There are many devices available and the goal is to choose the most appropriate device to meet the patient's needs. #CHEST2021 3/ Image
Read 23 tweets
20 Oct
I'm excited to jump into the Wellness Zone next with Dahlia El Gazzar (@DahliaElGazzar) speaking on "Practicing Gratitude for the Present: The Power of Gratitude." #CHEST2021 1/
Learning objective and key takeaway #CHEST2021 2/ Image
We want to optimize our energy. Block out time to replenish your energy. #CHEST2021 3/ Image
Read 15 tweets
20 Oct
Next up for #CHEST2021 is "Controversies for Diagnosis and Management of Acute Pulmonary Embolism"! 1/
Dr. Bhavin Dalal (@Bhavinddalal) will speak on "Patient with intermediate risk PE should go for thrombolysis: True/False". #CHEST2021 2/
Risk stratification of PEs #CHEST2021 3/ Image
Read 45 tweets
20 Oct
First up for tweet-ucation on this final day of live #CHEST2021 is “The Wave of the Future: Beyond the Ultrasound Basics"! 1/
Dr. Orlando Garner (@ogarnerccm) will discuss "Brain Drain: Neuro-Ultrasound for the non-Neurointensivist." #CHEST2021 2/
Transcranial US anatomy and probe positioning. #CHEST2021 3/
Read 39 tweets
19 Oct
Last for tweet-ucation in day 3 of #CHEST2021 - "Controversies in Septic Shock: Vasopressors and Corticosteroids"! #CHEST2021 1/
First up is Dr. Angel Coz Yataco will discuss "Adding Vasopressin Early" #CHEST2021 2/
Improved urine output and creatinine clearance with Vasopressin vs Levophed. #CHEST2021 3/ Image
Read 39 tweets
19 Oct
The next #CHEST2021 session for tweet-ucation is "COVID-19: Other Considerations in Management"! 1/
Derlis Fleitas Sosa talks on "Significant dyspnea in post-acute COVID-19 is associated with abnormal pulmonary vasculature on CT during the acute phase." #CHEST2021 2/
Their hypothesis #CHEST2021 3/ Image
Read 41 tweets

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