What haemodynamic / fluid physiology do you want me to post about? #FOAMed #physiology #haemodynamics #MedX
11
2
17
Replies
@Ostratrzustka There’s a couple here
IV fluids save lives — but misprescribing causes harm. Turning the Tide exists to improve fluid safety through education & physiology. Our hub of threads: Foundations – Fluids as life-saving therapy (cholera & beyond) https://t.co/f3fII5wyoB – Maintenance fluids
0
0
1
@icmteaching Another one, resuscitation (fluids & pressers) in Septic cardiomyopathy, when there is a profound vasoplegic & cardiogenic shock, please 🙏
1
0
2
@TaquaDahab Should be covered here but ask if you have further questions.
1/ Shock isn’t “give fluids, then pressors, then inotropes.” That recipe misses the physiology. Here’s how to manage shock properly: 🧵 #MedX #haemodynamics
1
0
6
@icmteaching Can you be very oedematous but also intravascular depleted? And how to resuscitate?
1
0
2
@TaquaDahab Just done that one.
🧵 Why you cannot be oedematous and hypovolaemic at steady state “Puffy but intravascularly dry”? ⚠️The most persistent myth in IV fluid therapy #FOAMed #physiology #MedX
0
0
2
@Stephan12230233 Anything specific that wasn’t covered here?
1️⃣ We can remove fluid at rates up to 12 mL/kg/h and blood pressure often holds. That limit isn’t arbitrary – it comes from dialysis data showing steep rises in hypotension and mortality above it. It marks the upper boundary of how fast plasma can be refilled from the
0
0
2
@icmteaching Mechanism of peripheral edema without elevated cvp in cirrhosis. These patients often hyperdynamic. Is this related to hypoalbuminemia, decreased arteriolar tone leading to increased peripheral pressure/capillary pressure, lymphatic failure…
1
0
1
@shanearish Corrected from a typo earlier. Oedema in cirrhosis doesn’t need a high CVP because the venous hypertension is regional, not global. Portal hypertension raises venous pressure upstream of the liver (splanchnic + abdominal wall beds). That pushes local Pv → Pc up, so filtration
0
0
1
@icmteaching @icmteaching thank you for your work! Are your articles/summaries collected in one file/pdf?
1
0
1
@DowntownFork No but you can find links in my pinned post (needs updating). Glad you’re enjoying the content!
0
0
0
@icmteaching The challenges of diuresing in severe nephrotic syndrome. What alterations in the capillary and lymphatic return haemodynamics does one need to bear in mind? Are they reflected in any observable (and useable) clinical signs?
0
0
1
@icmteaching Which patients with volume overload are at risk of going into shock/hypotension with diuresis? I think it's a pretty rare situation, outside some scenarios with high preload-dependency (tamponade, some restrictive cardiomiopathies), but would love to know your opinion on it
0
0
1
@icmteaching This pls…. Albumin leaks, adds solute to an already sodium-overloaded patient, and can worsen oedema and ascites over hours. Vasopressors + careful sodium removal match the physiology better, but we still lack the RCTs comparing them. Maybe I'll do a whole thread on this....
1
0
1
Greatness belongs to the relentless. The Code Chronicles II: The Course of Code
3
5
65