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Jan 5, 2022 7 tweets 4 min read Read on X
1/ 🚨New Episode! 🚨

What is an “appropriate” Hgb bump?

Why do we usually say 1g/dL for 1 pRBC?

iTunes: bit.ly/coreimpodcast
Show Notes: bit.ly/3eUgyGw

First, let’s figure out how many grams of hemoglobin are donated?
2/ What is the patient’s PRE-transfusion #intravascular volume?

Usually 6.5% of body weight for women 👩
Usually 7.5% of body weight for men👨
3/ What is the patient’s POST-transfusion intravascular volume?
4/ What rise in hemoglobin can be expected after transfusion?

It's all division here to get the g per dL bump you expect and viola!

It works out nicely for a 13g/dL donor Hgb to a 70Kg male recipient !
5/ While the 1g/dL bump for 1 unit pRBC is a good rule of thumb, there are other factors that can affect hgb response to transfusion!
6/ Let’s apply two different scenarios with different:
(1) amount of g/dL of donor and
(2) body weight of the recipient

Takeaway: 1 unit pRBC can increase hgB response anywhere from 0.6g/dL to ~1.6g/dL!
7/ Thanks for following along, #MedTwitter!

And a huge thank you to our team:
Hosts: @FreedoBaggins, @ShreyaTrivediMD
Peer Review: Bentley Rodrigue, MD
Graphic: @Preeyal_P
Audio Editor: @onlysolon

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More from @COREIMpodcast

May 13
1/ 🚨 NEW #5Pearls episode on Cardiorenal Considerations 🫀🫘

So many diuretic options, so which to choose and why?

Use the toolkit ⤵️ for all your diuresis needs!

🖥️:
CME: 
Sponsor:  bit.ly/3wx8tnB
bit.ly/CIMCME
coreimpodcast.com/Freed
Image
2/ Not all AKI in heart failure is cardiorenal syndrome!

In pure cardiorenal, expect a “bland” UA with no:
🥩 Protein
🩸 Blood
🦠 Granular or other cell casts!

**Remember, keep a broad differential for AKI
3/ You suspect volume overload in a patient…what dose of diuretic do you start with?

2.5x their home dose of diuretic (in IV form)!

IV options include:
💉 Furosemide
💉 Bumetanide

**Bumetanide drip at higher doses is associated with myalgias
Read 9 tweets
Jun 8, 2023
1/ Time for #12LeadThursday!

What’s the axis and do you notice anything about the precordial leads? Image
2/ What do you see on ECG to identify extreme axis deviation?

Negative deflection in lead I + negative deflection in aVF = extreme axis deviation Image
3/ What about the precordial leads?

Do you notice dominant R waves, S waves, or T-wave inversions? Image
Read 5 tweets
Apr 13, 2023
1/ What better way to end off a week of pacemakers and ICDs than recapping and revisiting our #12LeadThursday series!

🧵 Image
2/ Which patients get pacemakers?

Think of 2 big buckets: conduction disease and heart failure Image
3/ Let’s start with conduction disease!

Refresh your memory with this past byte - 80 y/o M with hx of CABG…what's the rhythm?
bit.ly/40cAry0
Read 15 tweets
Jan 18, 2023
1/ Atrial Fibrillation: #GrayMatters Series

What do you do with that episode of #Afib when sick or post-op in the hospital?

What type of monitoring is best?

🎧: link.chtbl.com/Afib
🗒️: bit.ly/3QPiLFt
CME: bit.ly/CIMCME
Sponsor: go.amboss.com/CoreIM-E9
2/ When do you start AC for new Afib post-op?

We hope this infographic will be handy for the many times we may be in the gray zone!

From @accpchest guidelines

A few things to consider:
🤔 Patient specific risk
🤔 Blood thinner of choice
🤔 Bleeding risk of the surgery
3/ Credit to the team that worked tirelessly on this!

Hosts: Dr. Nick Villano, @Ali_Trainor, @FreedoBaggins
Off-air producer: @ShreyaTrivediMD
Experts: @jasonmatosmd, @PoojaJagadishMD, @gregorykatz
Graphic: Josie Levey

🎧:link.chtbl.com/Afib

coreimpodcast.com/2023/01/18/dia…
Read 5 tweets
Dec 15, 2022
1/🚨New Episode🚨
The Lipid Panel Reimagined: #MindtheGap Segment

How do you interpret the #lipidpanel to help inform patients' risk for #cardiovascular disease? Do you use #ApoB? 🧐

🎧: link.chtbl.com/Lipids
Sponsor: go.amboss.com/CoreIM-E8
2/ Unfortunately, our patient is stuck in "bumper-to-bumper" #cholesterol traffic 🚗!

See traffic analogy to understand why ApoB can give us information that LDL-C may not:

#Mindblown! 🤯
3/ Overall, LOWER ⬇️ is better for both #LDL-C and #ApoB in terms of reducing #CV disease risk!

But #discordance between LDL-C vs. ApoB is actually quite common!

Take a look at the orange line to see how ApoB confers a higher CVD risk over time 👇
Read 5 tweets
Nov 15, 2022
1/ November 14th is #WorldDiabetesDay

Let’s look back at one of the most influential #RCTs for

how we given insulin in #T2DM?

the #RABBIT2 trial🐰🧵

#Insulin #MedTwitter
2/ The #RABBIT2 study looked at the (1) efficacy and (2) safety of basal-bolus vs. sliding-scale #insulin in non-critical inpatients🏥.

Basal-bolus regimens consisted of a combo of #Glargine (basal) and #Glulisine (mealtime).

The primary outcome was average glucose🍬.
3/ See below for a graphical depiction of how the study was performed👇:
Read 6 tweets

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