Dr. David Lyness Profile picture
ICU Doctor 🏳️‍🌈#FOAMed Founder of https://t.co/AGRx4RNPHw Faculty for: #IFAD, @ISICEM , @ICS_updates, #RAUK & @ESICM Editorial and Publ. Committee. LLB Grad Student.
Dr. David Lyness Profile picture Priya Nair Profile picture 2 added to My Authors
20 Apr
Thank you @NSWOC who have produced a great powerpoint, summarised below, on Prevention and Management of Skin Damage Related to Personal Protective Equipment (PPE) 👇👇nswoc.ca/ppe/ #FOAMed #FOAMcc #COVID19 #PPE
Read 5 tweets
18 Apr
Thank you to @ICNARC who have published data on the first 5578 critically ill patients in the NHS. I've summarised some of their publication in this thread below: #covid19 #covid19foam #foamed #FOAMcc Original here: icnarc.org/Our-Audit/Audi…
The data does not include Scottish ICUs - but does for Eng, Wales and NI. To date (yday) there have been 6664 ICU admissions due to COVID19. The largest cohort being in London. There is also cumulative data of numbers by date. #covid19 #covid19foam #foamed #FOAMcc
You can see the *current* distributions of cases across England, Wales and NI #covid19 #covid19foam #foamed #FOAMcc
Read 9 tweets
16 Apr
Welcome to the @esicm webinar on renal issues in #COVID19 including AKI & CRRT esicm-tv.org #COVID19foam #foamed #FOAMcc
Low rates of AKI and CRRT initially thought. Does this marry up with the current picture?
AKI and CRRT data in #COVID19 currently. Real world data. #foamed #foamcc
Read 13 tweets
28 Mar
Welcome to #COVIDMarathon from @ESICM - follow this thread for the content coming up over the next 7 hours. #FOAMed #FOAMcc #COVID19 #COVIDfoam
A general update #covidmarathon
Evolving insights into increasing cases over time, globally. Very few reported cases in Africa over time. #covidmarathon
Read 43 tweets
11 Feb
What is CORONAVIRUS? How might it affect ICU? Let's go back to basics and look at the emerging evidence bases, protocols and risks. #FOAMed #FOAMcc #WuhanCoronavirus #CoronavirusWho
Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). #FOAMcc #FOAMed
A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.... which is what the virus that is widely reported on the media, and via the WHO and CDC etc are talking about. #FOAMed #FOAMcc
Read 52 tweets
9 Feb
What is going on with VITAMIN C in Critical Care? From basics to current day conundrums. #FOAMed #FOAMcc #VitaminC You can use the @threadreaderapp to read this Tweetorial!
First - let's look at what Vitamin C is. Unlike most mammals, we can't actually synthesise it! It's a water-soluble vitamin: lpi.oregonstate.edu/mic/vitamins/v…
Which is why it needs ingested, or... supplemented.
It's most important function (from a critical care perspective) likely comes from its function as an anti-oxidant. #FOAMed #FOAMcc intechopen.com/books/vitamin-…
Read 34 tweets
8 Feb
Thematic talk today about the ROLE of RCTs in Intensive Care Medicine. **TWEETORIAL** #ESICMphysio #FOAMed #FOAMcc
Randomised controlled trials (RCTs) are the most rigorous way of determining whether a cause-effect relation exists between treatment and outcome and are an integral component in the hierarchy of evidence which guide current clinical practice. #ESICMphysio ... but...
There are some problems... ncbi.nlm.nih.gov/pubmed/20413119
Read 14 tweets
8 Feb
Today we're going to take a look at BIOENERGETICS in ICU in this quick Tweetorial :-) #ESICMphysio #FOAMed #FOAMcc
Bioenergetics = biochemistry concerned with the energy involved in making and breaking of chemical bonds in the molecules found in biological organisms. It can also be defined as the study of energy relationships and energy transformations and transductions. #ESICMphysio
Mitochondrial functions incl production of energy, activation of programmed cell death, and a number of cell specific tasks, e.g., cell signaling, control of Ca2+ metabolism, and synthesis of a number of important biomolecules. ncbi.nlm.nih.gov/pmc/articles/P…
Read 37 tweets
7 Feb
So - the candidates from #ESICMphysio are off to engage in their workshops - so I thought... let's hold a virtual workshop here on MECHANICAL VENTILATION! #FOAMed @ESICM
Let's start off at the very beginning. This is a HUGE topic... obviously not going to cover everything. But let's start off at the very beginning and look at my Tweetorial from yday from Prof Barnes talk on the physics of ventilation... #ESICMphysio
@MedCramVideos do a REALLY good series for beginners - for free - on YouTube - 5+ videos on Ventilators and how they work: youtube.com/results?search…
Read 30 tweets
7 Feb
The amazing @icu_nivare gives a talk on HOMEOSTASIS in ICM! Here is my Tweetorial on his brilliant talk. #FOAMed #ESICMphysio IT'S ALL ABOUT BALANCE.
Three main topics of this Tweetorial and @icu_nivare's lecture. All about the salt! #ESICMphysio
A brilliant overview of OSMOREGULATION and VOLUME REGULATION. #ESICMphysio
Read 20 tweets
6 Feb
@susannaprice gives us a whirlwind tour of VENOUS RETURN. Going back to basics is vitally important. This is her talk in the form of a Tweetorial at #ESICMphysio #FOAMed - don't forget to get involved in the conversation! #POCUS
"When asking about the RIGHT heart... Which RIGHT heart do you mean?" Normal? Pathological? It's complicated... #FOAMed #ESICMphysio
Starling = what goes in 'must' (hopefully) come out. Although venous return leads to COutput; COutput must dictate venous return! BOTH must be equal.... or it can't quite 'flow'.... #ESICMphysio
Read 15 tweets
6 Feb
The fantastic Prof Tom Barnes gave us a talk today on the PHYSICS of mechanical ventilation. This is his material via @ESICM #ESICMphysio in the form of a Tweetorial :) #FOAMed THREAD BELOW --> (continued...)
and so we start... Physics can tell us an awful lot about the way our bodies work - but it's SO different from clean 'physics' - this is applied physics. All patients lungs are different. These concepts however are vital to understanding key issues in ventilation.
Lung damage can amplify from the smallest of initial injuries. Positive feedback ++. Damage begets damage. This is why we try to mitigate pressures in our vent settings. #ESICMphysio Question is tho... how can we do it better?
Read 18 tweets
6 Feb
Before our LUNG sessions today... a quick look at what we already know about PPV and PEEP in ICU... #ESICMphysio #FOAMed
We've been looking at MV for decades. In 1986 - a good summary was published about its deleterious effects... Life saving yes, but nurses and doctors agreed it came with profound sequelae... #FOAMed #ESICMphysio ncbi.nlm.nih.gov/pubmed/9564354 and ncbi.nlm.nih.gov/pubmed/3530039
In 2008 a great reflection was published in BJA - which did summarise that "Ventilation with PEEP is a proven, effective modality in both anaesthesia and ICU, despite the immense physiological derangement it causes" #ESICMphysio academic.oup.com/bja/article/10…
Read 10 tweets
28 Sep 19
Let's decode APRV.... don't trust the labels. At the baseline, you have CPAP for insp pressure, inspiratory time, expir time and pressure... and the slope... 1/2 #LIVES2019
SO...Thigh in APRV - when shorter = no spont breathing and when longer, allows for potential spontaneous breathing. We should aim for higher Thighs due to better alveolar stability with longer exp times... 2/2 #LIVES2019
1/2 - APRV cont... better alveolar stability when expir time is extended. #LIVES2019
Read 8 tweets