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
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
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.
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...
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…
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
@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
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?
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" #ESICMphysioacademic.oup.com/bja/article/10…
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