Here’s a fun medical puzzle: what does this antidote (Sugammadex) have in common with this cleaning product (Febreze)?
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The answer is the chemical structures for both are cyclodextrins!
2/ Sugammadex Febreze
Cyclodextrins are rings of glucose molecules linked together by α-1,4 glycosidic bonds.
Depending on the size, these ring can trap other molecules inside it.
For example, a 7 glucose (beta) cyclodextrin called Febreze can trap small odor molecules & neutralize smells. 3/
Sugammadex reverses neuromuscular blockers like rocuronium by trapping the medication inside the cyclodextrin ring, away from the acetylcholine receptor.
First, this finding was driven by OR mortality, particularly in cardiac surgery patients.
ICU mortality was non-significant. (p=0.5). Additionally this is an unadjusted p-value, so if we correct for multiple comparisons it’s even more insignificant.
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The OR and the ICU are different places & propofol is used differently: higher doses & boluses are frequent in the OR whereas low doses with daily interruptions are common in the ICU.
In short, I don’t think it’s reasonable to extrapolate an OR finding onto an ICU population.
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The usual anti-vax suspects are talking about a paper “proving masks raise CO2 to harmful levels.”
Well I read it and it’s a bunch of non clinical wackos who used the wrong equipment to accidentally measure end tidal CO2.
A debunking 🧵
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Before we get to the paper with it’s very flawed methods & conclusions, let’s talk about the authors.
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The lead author - Harald Wallach - a psychologist with no training in respiratory medicine or physiology, previously won a prize for “most astonishing pseudo-scientific nuisance of the year”
His prior pandemic publications were retracted within days.
Fact check: Marik was fired (he claims he resigned) from EVMS in late 2021. With no institution willing to hire him, he was *unable* to renew his university limited license. His license to practice medicine expired in 2022.