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🧵Do clinicians think differently about withdrawal / withholding life supporting treatment (WLST) decisions in patients with acute brain injuries (ABI)? Our study investigating this question is now published in The Lancet Respiratory Medicine, with results shared ISICEM

#ISICEM25 | Giacomo Grasselli breaks down the differences between ATS & ESICM #ARDS guidelines – same problem, different recommendations. 🔍 Exploring the opinions, methods, and evidence shaping these major guidelines.

⏰ Just in time for #ISICEM25, a ⭐️ Special Feature ⭐️ out today in #journal_CHESTCritCare on “Lessons from Gattinoni”: chestcc.org/article/S2949-… Thanks, Andrea Castellví, T Pham, B Patel, & Eddy Fan for the educational, clinically valuable piece! #OpenAccess

Decisions to withdraw or withhold life-sustaining therapies in patients with and without acute brain injury: a secondary analysis of two prospective cohort studies - The Lancet Respiratory Medicine thelancet.com/journals/lanre…

👏 A new 1️⃣st for us at #journal_CHESTCritCare… just out a letter to the editor & author response: Letter: chestcc.org/article/S2949-… Response: chestcc.org/article/S2949-… Article: chestcc.org/article/S2949-… I ❤️ the reader engagement! CHEST® Journal CHEST

ARDSにおけるセボフルラン吸入とプロポフォール静注のRCTに対するエディトリアル この分野のこれまでの経緯▶今回のRCTの強み・弱み▶結果が将来の診療や研究に与える影響 の流れが小気味良いほど滑らかで読んでいて心地よい。こんな文献を書けるようになりたい。 jamanetwork.com/journals/jama/…

💉After multiple trials on Dexmedetomidine… #DEX Cruise Control: ✅ Part of multimodal sedation ✅ Sustained light sedation Yahya Shehabi at #ISICEM25

Another ISICEM is in the books - thank you Jean-Louis Vincent Fabio Taccone and team for a wonderful academic show! Wake Forest Critical Care Medicine Wake Forest Anesthesiology

#DEX 🔺Dexmedetomidine: current place Yahya Shehabi at #ISICEM25

Sedation Session #ISICEM25 Ary Serpa Neto 💉#Fentanyl 🆚 #Morphine?? ➡️ Fentanyl: - The majority of patients - Rapid titration - Younger patients - Patients with renal dysfunction ➡️ Morphine: - Longer analgesia - Non-ICU sedation

⛔️We use opiates too liberally… Jeremy Beitler at #ISICEM25 Why? 1️⃣ Dex is often insufficient for sedation 2️⃣ Hypotension from dex & propofol limit their up-titration 3️⃣ Conflate pain with non-pain 4️⃣ Use of opioids explicitly for goal of sedation 5️⃣ Attempted respirolysis

Episode 62! We talk about some of the articles from the ISICEM conference and talk in depth about SESAR published in JAMA with the conference last month! 🎧pod.link/1667336877 SESAR (pubmed): pubmed.ncbi.nlm.nih.gov/40098564/ SESAR (JAMA): jamanetwork.com/journals/jama/…

Inhaled sevoflurane - used more during the pandemic with shortages of other sedatives - but now we have an RCT evaluating its effects. Excellent study and great discussion.

Another highlight from #ISICEM25: Dr. Matthieu Jabaudon presented the #SESAR RCT on inhaled sedation in #ARDS—published same day in JAMA. Key insights into sedation strategies. Read: jamanetwork.com/journals/jama/… or watch it on ISICEM YouTube channel Matthieu Jabaudon JAMA Network Open

Thank you 🙏 for covering the SESAR trial, great discussions as always! 👏 I can only recommend following this wonderful podcast 🏥🥼📊💡🤩

Our next Journal Club will be livestreamed! 📆 Wednesday, April 16 | 07:00 AM CEST 📣 Inhaled Sedation in Acute Respiratory Distress Syndrome - The #SESARTrial Featuring special guest Matthieu Jabaudon Matthieu Jabaudon. Don't miss out, join the discussion here: teams.microsoft.com/l/meetup-join/…

San Raffaele Anesthesia and Intensive Care Matthieu Jabaudon It was an exceptional journal club interacting with the PI of this great trial! Thank you Giovanni Landoni, MD Giacomo Monti for organizing this opportunity and Matthieu Jabaudon for sharing your own thoughts on the unexpected results!

Thanks a million to Giovanni Landoni, MD Giacomo Monti 小谷祐樹 Yuki Kotani｜集中治療医 Intensivist and all teams San Raffaele Anesthesia and Intensive Care for the invitation, the wonderful presentation, and inspiring discussions! Keep up the great work, you all rock! 🙏👏🤩

Where do you perform tracheal extubation - theatre or the post-operative care unit? Extubation in the OT is associated with an increase in theatre occupancy of < 8 min and a lower incidence of postoperative respiratory & cardiovascular complications. #MedTwitter Thomas Godet MD PhD

More data suggesting there might not be a single best sedative for all critically ill (mech vent) pts. Ongoing study should look at phenotypes and use of different sedatives and whether the sedative agent should be dynamic across a patient's critical care course. Edward Qian