CritCareDoc

Ich bin bei Ihnen, was die Irritation gegenüber dem Hype angeht. Wir werden zu den NW noch sehr viel lernen in den nächsten Jahrzehnten.

Semaglutid oder Gesellschaft? 🧐

Semaglutid hat es schon jetzt in eine Menge Leitlinien hinein geschafft. Alles wird besser: Adipositas, Diabetes, RR, Herz, Niere, Kognition… Ozempic geht steil, aber aus Gründen.

Dem möchte ich in größter Gelassenheit widersprechen.

I went down a bit of a rabbit hole looking at Alzheimer's disease (AD) the last few days (because I was curious) and I found out about a really interesting antibody that is in trials and I think the approach used here is super cool so I wanted to share a bit about it🧵

Vaccination prior to SARS-CoV-2 infection does not affect the neurologic manifestations of long COVID Mukherjee et al. report that vaccination prior to SARS-CoV-2 infection does not affect the neurological manifestations of Long COVID. Minor symptom differe

Achtung: Irreführende Wissenschaftskommunikation zu LongCovid und Impfung. Gestern wurde jetzt ein Artikel dazu offiziell veröffentlicht, der schon vor einem Monat mit der Interpretation durch Social Media ging, dass Impfungen nicht vor Long Covid schützen würden. Das ist aber falsch! (1/14)

Das klingt nach Diabetes insipidus. Dafür gibt es in Europa ➡️ Desmopressin, ein weiteres ADH-Analogon mit etwas erhöhter Affinität zu V2-Rezeptoren. Fast gleiches Präparat, ganz andere Indikation.

Falls es darum geht: Endokrinologen sind Ansprechpartner. ✅

Die Produkte auf dem europäischen Markt sind Empressin & Argipressin: beides = Vasopressin, gemäß SSC-Leitlinien indiziert im katecheolaminrefraktären septischen Schock.

Nach dem, was ich im Netz finde, ist Vasostrict nur der Handelsname der ersten FDA-zugelassenen synthetischen Version.

(S+) Dry January: Was bringt ein Monat ohne Alkohol – und wie hält man ihn durch? Nach den Festen im Dezember legen viele einen alkoholfreien Januar ein: Doch hat ein Monat ohne Alkohol überhaupt einen Effekt? Und wie hält man durch? Fragen an einen Internisten.

@spiegel.de: Sie sehen in der Auswahl der Überschrift www.spiegel.de/gesundheit/e... nicht das Problem, daß Sie Alkoholkonsum verharmlosen und normalisieren?

„Durchhalten“ muss einen solchen Monat nur ein Alkoholkranker, alle anderen sind vollkommen unbeeinträchtigt.

Liebe Menschen, die glauben, dass es falsch ist, dass niedergelassene Ärzte sich über die Bezahlung beschweren.
Bitte fragt doch alle mal eure eigenen Ärzte, was ein Regress ist, wie oft diese kommen und wofür und wer das dann bezahlt.
Vielleicht versteht ihr dann…!

Nice case series. Did anybody changed its SOPs already?
#Pocusky
pocusjournal.com/article/17700/

Early Restrictive vs Liberal Oxygen for Trauma Patients This randomized controlled trial investigates whether an early 8-hour restrictive oxygen strategy compared with a liberal oxygen strategy lowers the incidence of death and/or major respiratory complic...

How much Oxygen do you give to patients after major trauma in your 🚁🏨🚑?
15l/min or FiO2=1, as ATLS recommends?

Turns out this may not be necessary or even harmful.

What did we do & find?
A short 🧵

jamanetwork.com/journals/jam...

Are you up-to-date with the latest evidence on airway management in patients with suspected or confirmed cervical spine injury?

@sthjournalclub.bsky.social @iliff-helen.bsky.social
@elboghdadly.bsky.social

#AnSky #MedSky 🧪

https://buff.ly/3UXJweg

@medsky.social <Figures things out>

💯

Graphic shows dramatic reduction in polio, rubella, mumps, measles, and hepatitis A cases after the introduction of vaccines for each disease.

Disease prevalence in US states before & after vaccine introduction

Graphic from Edward Tufte
More graphics.wsj.com/infectious-d... 🧪

a picture of deadpool and wolverine with the words deadpool & wolverine Alt: a picture of deadpool and wolverine with the words deadpool & wolverine

Anaesthetics: Deadpool

has a healing factor like wolverine but without the aggro. In fact quite humourous despite being paired with ITU.

Loves Sudoku and coffee. Much better looking with their masks on

a group of avengers are fighting each other in a scene from the movie avengers Alt: a group of avengers are fighting each other in a scene from the movie avengers

Specialties as super heroes - this is gonna span Marvel and DC. Inspired by medtwitter posts of old

a man in a captain america costume is standing in the snow . ALT: a man in a captain america costume is standing in the snow .

(You actually just solved an ancient riddle for me. For years I was wondering why the „normal“ infusion in American Crit Care studies is always obsolete NaCl, of all things.

Turns out you still use it as your standard drip. 🫣 I don’t envy you all the extra electrolyte work…)

And we have THAM… 🥲

bsky.app/profile/simp...

I am relieved beyond measure. Believe me.

Oh! Ok.
I‘m SO sorry. (And I was shocked!)

European here. We don’t use NaCl at all. All our infusions are buffered. 😅

It really doesn’t do that.
What you do is to help the intercellular acidosis enter the cells. Bicarbonate is CO2 in waiting.
PLEASE don’t give a buffer that transforms acid to CO2 in respiratory acidosis.
Read up on how this „buffer“ (it isn’t a buffer at all) actually works.
Consider THAM instead.

While I have nothing but respect for your obviously goodish intent - what on gods great earth do you expect the bicarbonate to do in a case of respiratory acidosis? 🤔

‎Quick Reference Handbook ‎The Quick Reference Handbook for Obstetric Emergencies (Obs QRH) is a collection of action card guides for medical and resuscitation emergencies in hospitals. These guides are intended to help the mu...

If you haven’t already we would massively recommend downloading the *FREE* OAA Quick Reference Handbook App! An amazing resource covering all the essential management for anaesthetists in obstetric emergencies in an easy-to-read format #obsanaes #obsanes

apps.apple.com/gb/app/quick...

🩻❗️👍🏻

SGLT2 inhibitors - Key points

• hold for 72 h before elective surgery (5 half-lives)

• multidisciplinary input for procedures w dietary alterations and in poorly controlled DM or cardiac/renal disease

• ketone monitoring in emergency surgery

#AnSky #MedSky 🧪

https://buff.ly/3O6qa2C

kermit the frog is covering his face with his hand and says your liver be like Alt: kermit the frog is covering his face with his hand and says your liver be like

Derangements in hemostasis can affect any organ system.

But no other organ system has more effects on hemostasis than the liver.

Liver dysfunction (LD) can result in deranged hemostasis with wide ranging implications.

A #skeetorial. #liversky #hemesky
1/n

I never wanted to live in interesting times.

There are dozens of us now!

DOZENS!!

#medsky