Here’s another pulmonary physiology question that *everyone* who gives O2 to patients ought to know: What is the primary mechanism by which supplemental oxygen can increase PaCO2 in someone with severe COPD? 1/

The iGel is a great supraglottic airway device But like other supraglottic airway devices (SAD) it's not foolproof Here's how to maximise your success with the iGel - a thread 🧵

1. Optimise patient position Ear-to-sternal notch horizontal alignment with neck flexion never lets you down. Also called 'flextension' this is identical to the optimal direct laryngoscopy position

And what was the consequence of all that hyponatremia? All that rapid correction? 12 of osmotic demyelinating syndrome. 12 out of 22,858. 0.05% If you divide by starting Na they found an incidence of: 0.3% with a Na < 120 0.015% with a Na > 120 **2.5% with a Na < 110** 7/10

Off to DC for American Thoracic Society (ATS) for my first conference since 🦠 — and first time as a grown up (aka attending). Who else is going? Catch me on Tuesday afternoon talking about abdominal infections in the ICU as part of ATS Crit Care education series! 🤓👨‍🏫🫃🏻ATS Early Career

We love a mini BIDMC IM Residency BIDMC Department of Medicine BIDMC reunion in the CCU at Weill Cornell Medicine NewYork-Presbyterian! We’ve come a long way in the last decade — from intern night float to attending in the ICU!

“this bronchoscopy could have been an induced sputum” “this A-line could have been a cuff pressure” “this intubation for ‘airway protection’ could have been a sternal rub” “this swan could have been a POCUS” “this consult could have been a google search”

🚀Na over-correction (Na📈) as THE (only) cause of ODS/CPM: An absurd over-simplification. Since 1980s, Na📈 has been portrayed as the main cause of CPM (so far as now the terms ODS and CPM are used synonymously). However, finding the truth (if it exists) is more complicated.

It’s my favorite time of the year — time to teach pulmonary physiology (and patho-) to the MS1s Weill Cornell Medicine with my partner in learning Meredith Turetz. Had the opportunity to teach a new lecture today on gas transport — and had so much fun! 🥸🫁💨

ICU snapshots: What do you think?

I’m still going to say free healthcare, but… like a good neighbor, State Farm is there. Anyway, thanks for the chuckle, Alexa Klorman 😂

Best way to wrap up the pulmonary unit for Weill Cornell Medicine MS1s with Lindsay Lief interviewing Dr Chris Belardi — one of our ED physicians, medical educators and COVID ARDS survivor. An inspiration and a privilege!

My favorite airway rescue device! One thing I always have at the head of the bed with me when I’m intubating.

Excited to share our JAMA CGS on SCCM’s 2024 guidelines on use of corticosteroids in sepsis, ARDS, and CAP! 📣learn about the nuanced evidence behind the rec for corticosteroid use. As always it’s great to work with @AndyDavis Joshua Davis (he/him)! General Internal Medicine Weill Cornell Internal Medicine Chief Residents

As the tragic #CaliforniaWildfires continue, those with respiratory disease will be most impacted as exposure continues. Learn more about treatment protocols from the Chest Infection and Disaster Response Network: hubs.la/Q031VgTn0 #WildfireSmoke

Excited to be talking about steroids in sepsis, ARDS and CAP this Tuesday morning on Doctor Radio!

Had a blast talking with Frank Adams about updated guidelines on steroid use in ARDS, sepsis and CAP on Doctor Radio — though at 6a, my face is only for radio! 😂 Thanks for having me!

Pulmonary medicine is everywhere you look 🙃