RT @IM_Crit_: On a different note, I have to dedicate a post in saying how thankful I am for the graciousness and generosity of so many peo….

@MSharifpourMD @msiuba @siddharth_dugar @curromir @Thind888 @CriticalCareNow @edu_kattan @jonreismanMD @georgentou1 @MegriMohammed @UAlberta_Sono @phlegmfighter @siddharth_dugar . My apologies to everybody I missed. .

Join millions who have switched to Grok.

With the risk of forgetting many people, I am grateful to:.@ThinkingCC @eddyjoemd @jameshorowitzmd @MynephCC @icmteaching @ArielG_RRT @cliffreid @critconcepts @ross_prager @DrMiguelIbarra1 @PulmCrit @Askins_Razor @panagis21 @khaycock2 @nickmmark @RogerSeheult @NephroP.

On a different note, I have to dedicate a post in saying how thankful I am for the graciousness and generosity of so many people in #medtwitter #FOAMed . Colleagues I have never met in person have given me time, help, support & even study material (!) without me even asking. 🙏.

🤷‍♂️. Research posts on Bluesky are more original — and get better engagement .

RT @IM_Crit_: ICU Physiology Secrets:. If you've heard many "bad" things about the inferior vena cava (IVC), this is another one for you:….

RT @IM_Crit_: Decongestion Secrets ("ammo" for rounds):. In a multicenter study of 283 acute heart failure patients, changes in renal filtr….

RT @IM_Crit_: Just when I thought I had a decent understanding of ARDS, hemodynamic phenotypes and venous congestion, I will have to study….

Caught in the middle of a political battle, @BlackRock reaffirmed its focus is helping millions of Americans save for retirement. They warned that injecting politics from either side risks undermining financial performance.

Kudos to the researchers! .PMIDs: 27312050 and 29496502 . #foamed #foamcc #meded #MedTwitter #medstudent @icmteaching.

Interestingly enough, the same researchers found that in one of their patients, after bariatric surgery and weight loss of 65 kg, the pressure gradient between the thoracic and IVC disappeared (preoperative 9 mm Hg, postoperative 0-2 mm Hg)

Makes me wonder if some of the hemodynamic disturbances we see in obese patients are related to this phenomenon. In addition, should we take it into account when we perform CPR in obese patients? Should we displace the pannus to the left? Should we use mild reverse Trendelenburg?.

This phenomenon of "obesity-induced vena cava compression" has been described in late pregnancy, when IVC compression in the supine position of the parturient can lead to hypotension.

In 5/29 patients, a pressure difference between the right atrium and the IVC of 8 to 16 mm Hg was detected; this was twice as high as the average value. In one patient, the pressure gradient was 16 mm Hg.

After RA pressure measurement, the catheter was pulled back through the IVC, and the pressure gradient between the thoracic and abdominal vena cava was measured. A sharp pressure gradient developed proximately 10 cm below the diaphragm, resulting in a pressure ⬆️ of 3 to 12 mm Hg

ICU Physiology Secrets:. If you've heard many "bad" things about the inferior vena cava (IVC), this is another one for you:. Researchers performed L + R heart cath in 29 obese patients (BMI 33±18). A high BMI was associated with ⬆️ pressure gradient between the IVC & right atrium

RT @doctimcook: Avoiding unrecognised oesophageal intubation . The @RCoA & @dasairway have agreed to drop ‘no trace wrong place’ . The mess….

Just when I thought I had a decent understanding of ARDS, hemodynamic phenotypes and venous congestion, I will have to study about "mitochondrial challenges". #MedTwitter #nohope

RT @IM_Crit_: ICU Snapshots:. 60 yo pt, multiple medical problems (including morbid obesity; BMI 50), admitted to the ICU w ARDS in setting….

RT @IM_Crit_: Fantastic case in @journal_CHEST of an 18 yo who sustained a 40-ft fall leading to traumatic hemorrhagic pneumatoceles and r….

Kudos to the authors (PMID: 40784704) and hat tip to everybody who worked for this amazing save!. #foamed #foamcc #meded #medtwitter #medstudent.