We've just presented and published a multicenter RCT at #CCR23 and in @JAMA_current!

Continuous vs Intermittent Meropenem Administration in Critically Ill Patients with Sepsis: The #MERCYtrial!

🔗 jamanetwork.com/journals/jama/…

This 🧵 will explain the study in detail /11

#FOAMcc 2/

β-lactams (e.g., #meropenem), are typically given intermittently, but continuous administration can provide constant serum levels and may improve outcomes.

In fact, several meta-analyses reported reduced mortality when administered continuously.

#Etomidate and mortality in critically ill patients

Etomidate is a common induction agent but controversy exists about its effects on outcomes

Our meta-analysis found a high probability that etomidate increases mortality (NNH 31)

🧵Thread 1/6 🔗sciencedirect.com/science/articl… #FOAMcc 2/

PICOS of this SR/MA

P: Critically ill patients
I: #Etomidate as an induction agent for intubation
C: Any comparator
O: Mortality at the main timepoint defined by authors
S: Randomized controlled trials

11 RCTs with 2704 patients were included

#FOAMcc

🚫 DON’T use glucocorticoids in oxygen-free #COVID19 pts

Just published @NEJMEvidence
 
Guidelines are against glucocorticoids in pts not on O2 but effect on survival remains unclear
 
Our meta-analysis found that glucocorticoids increase mortality

🔗eviden.cc/3MnrDSA 1/5 2/

📝 STUDY SELECTION
 
P: adults with #COVID19 not receiving oxygen
I: intravenous or oral #glucocorticoids
C: any
O: all-cause mortality at the longest follow-up available
S: RCTs, matched studies
 
➡️ 5 RCTs and 1 propensity-matched study (total 6634 pts) were included

Our @MarinaPieri4 now presenting at @EACTAIC webinar: native heart recovery is the first choice option! 2 RCTs are running on #levosimendan in VE #ECMO weaning @EACTAIC

Dieter Dauwe

Inoperable patients can now be offered a potentially curative surgery.

🔗 Read @annalsthorsurg: pubmed.ncbi.nlm.nih.gov/34111383/ and the thread 👇 #FOAMcc #FOAMecmo 2/

Here we report the 1st case of intraoperative use of VA-#ECMO in a patient with resectable lung cancer and bivasal critical coronary artery disease with prohibitive low EF (23%), and describe the benefits of this new indication.

🔗 pubmed.ncbi.nlm.nih.gov/34111383/ #FOAMcc #FOAMecmo

1/

In non-COVID-19 pneumonia/ARDS filling defects are found in pulmonary arteries branches vascularizing healthy lung segments. Instead, in #COVID19 there is an almost perfect topographical overlap of filling defects distribution & pneumonia extent.

🔗 jcvaonline.com/article/S1053-… 2/

We demonstrated that pulmonary vascular thrombosis in #COVID19 is due to local inflammatory endothelial damage with a superimposed thrombotic late complication and not to recurrent thromboembolism from peripheral deep vein thrombosis.

#MicroCLOTS

How we’ll we manage the first ten #COVID19 patients of 2021 (if any) hospitalized for #ARDS (compared to the first 10 patients we managed in February 2020). A multidisciplinary brain storming after managing approx 1000 such patients within the end of Apr 2020. A thread 1/ #FOAMed 2/
Not all our clinical impressions have already published evidence (but the majority was published), but our hospital #COVID19 mortality went close to zero in late April 2020 and we hope medical management accounts for at least part of these results.

https://twitter.com/giovannilandoni/status/1287743326620450818?s=20

[THREAD]

We just published the largest, most detailed case series of mechanically ventilated #COVID19 patients with ARDS in a western country and with the longest follow-up.

Read our infographic & the article on @CCRJournal bit.ly/2SiXYgD

#COVIDFOAM #FOAMed #FOAMcc 2/7
Mortality of ICU mechanically ventilated patients with #COVID19 ARDS is as high as 23% at the 20 days follow-up.

#COVIDFOAM #FOAMed #FOAMcc

How to administer oxygen worldwide in March 2020 to minimize viral dispersion: Tricks and Tips. #COVID19 #Coronavirus #COVID19foam #FOAMed #FOAMcc Thread 1/6 When using nasal cannula or High Flow Nasal Cannula consider adding a simple disconnected face mask as a shield to prevent viral spreading. #COVID19 #Coronavirus #COVID19foam #FOAMed #FOAMcc Thread 2/6