Thread: My plea for all #ICU staff: 1. Talk to intubated patients, no matter how old or young.Many of your patients are awake, even if their eyes are closed 2. Always tell them what you’re about to do to them and talk to them while you do it. (1/2) #PedsICU #medtwitter #meded

Low cost intervention to improve communication with patients. Place a chair at patient’s bedside and facing the bed:

#TipsForNewDocs Hospitalized patient hasn't walked in days. Wrong: call physical therapy Right: discuss w/bedside nurse if patient stable to mobilize w/nursing staff before calling PT Not every hosp patient needs a PT consult- use this resource wisely. #kittlesonrules

Left ventricular hemodynamics on VA #ECMO?? Physiology insights from catheterization & 3D echo 🫀 high flow VA #ECLS decompresses LV by significantly ⬇️ LV preload with minimal ⬆️ in afterload 🫀 this ⬇️ LVEDP, LVEDV, LV stroke work, LV PVA #FOAMcc 🔓 bit.ly/47U4Ip5

Novel off-pump direct apical #ECMO cannulation via mini-thoracotomy with dual-lumen cannula asaiojournal 🖇️ bit.ly/49Iabkf 🫀provides high flow #ECLS with LV decompression + (optional) biventricular + respiratory support 🫀allows ambulation + avoids peripheral artery

Direct apical #ECMO cannulation, large single (high-volume) center experience showing that technique could be safe & effective in a selected population at institutions with cardiac surgery support asaiojournal 🖇️ bit.ly/49Iabkf

Dr. Yerokun understands that medication for heart failure may not be an option for you. Take a listen as he shares his expertise on alternative treatments that may be right for you. #HeartMonth

🩸Modified 4Ts scoring system in patients on mechanical circulatory support?? 4TMCS probability score, considering type of #MCS (IABP, #ECMO, VAD) demonstrated improved diagnostic accuracy vs 4Ts, and higher sensitivity using the guideline-recommended cutoff.

26-year-old Sydney faced a near-death experience from an infection and kidney stones. Her doctors knew she needed ECMO treatment, so she was transferred to Ascension Saint Thomas Hospital West. This treatment gave her life again, and Sydney continues to praise her care team. 💜

Consider the prognostic importance of age in decisions surrounding initiation of VV #ECMO, even among relatively young patients! Analysis of ELSO Registry (2017-2022) among adults with acute respiratory failure #FOAMcc on Intensive Care Medicine 🔓 rdcu.be/dzcdZ Increasing age

Congrats to Danger team Christian Hassager! Impressive results, now after SHOCK and Culprit-Shock 3rd positive RCT. Nevertheless, multiple questions remain: 1) is it the device? 2) patient selection? 3) treatment bias? 4) longer follow-up? Sean van Diepen Johann Bauersachs Navin Kapur

Read the July Issue! loom.ly/Vuu8qGQ In the issue #ECMO #LVAD #RVAD #RespiratoryFailure #SystematicReview #PedsECMO #PedsVAD #LungTx #COVID19 + #FREE articles

Repeat after me: pressure is not flow.

Mixed cardiogenic shock (CS) -herein classified as CS with at least 1 additional contributing cause of shock state- is common (& usually quite challenging to treat...) 20% of all shock patients admitted to contemporary cardiac ICUs have mixed CS Besides this old-school approach

Transfer to Hub Hospitals and Outcomes in Cardiogenic Shock #AHAJournals Jiwon Kim, MD Kaz Negishi@Cardiologist/ Heart Mafia @navinkapur4 J Dawn Abbott Khue Ton Shubha Pawar Kannu Bansal Saraschandra Vallabhajosyula, MD MSc ahajournals.org/doi/10.1161/CI…

@jonathanemling #HSS25 Johnathan kicking off the last day of Houston shock with Why every program needs a shock coordinator.

The role of the shock coordinator… does your program have one? Houston Shock Symposium #HSS2025

Day 3 of Houston Shock Symposium talking about the importance of shock coordinators, maintaining the financial wellbeing of a shock center, and navigating the emotional wellbeing of the patient, caregivers, and providers. Jonathan Emling Stavros George Drakos Filio Billia CardioNerds