👇 A really thoughtful article on the ethical responsibilities placed on physicians and healthcare systems when facing uncertainty about treatment effects. Very nicely illustrated with recent examples of unjustified confidence:

A wonderful (and continuously updated) compendium of publications and resources on ICU delirium, rehab, and more! Should be a permanent bookmark for anyone working in the ICU. Thank you Peter Nydahl Dale Needham, MD, PhD Cheryl Hickmann for maintaining this!

There was a totally overlooked trial in NEJM this week with jaw-dropping results. The question: how should we diagnose diabetes in pregnancy? 23,792 pregnant women randomized to receive either 1-step or 2-step screening for gestational diabetes. nejm.org/doi/full/10.10… /1

Very useful Nikhil Patel. These triage suggestions will be helpful for ED colleagues at community hospitals also JSCVD AINA Aarti Sarwal, FNCS, FAAN, FCCM, RPNI, Professor Vineeta Singh

Thank you to all my mentors at University of Maryland Neurocritical Care for supporting this work! As more health systems open satellite NCCUs, developing efficient triage systems becomes increasingly important. Our paper attempts to do so in patients presenting with ICH

Covid is an awful disease. But its disruption has delivered unexpected benefits. RECOVERY is one example. A cheap, quick mass-population clinical trial platform. A new ambition for scale. Is now setting up overseas. And a new standards for clinical trials. 🙏

2/2 Nice editorial on Annexa-4 ICH study by Drs. Armahizer and Badjatia from U Maryland Neurocritical care service. Maryland Neurology Residency Maryland Neurosurgery World Stroke Org European Stroke Org Stephan A Mayer AINA Aarti Sarwal, FNCS, FAAN, FCCM, RPNI, Professor Nicholas Morris Gunjan Parikh MD, FNCS ahajournals.org/doi/10.1161/ST…

1/ What is the most worthless electrolyte on the BMP, and why is it chloride? Agree? A #tweetorial 🧵 to change your mind… And if you’re thinking, why in the world is this a #neurotweetorial? Read on. #neurotwitter MedTweetorials

My own 2 cents: Don't let behavioral heuristics make the decision for you. Don't strictly dichotomize based on age 60. Love this study from NEJM: nejm.org/doi/full/10.10… showing CABG rates 2 weeks before vs. 2 weeks after 80th b-day. Think about your patients more deeply!

Thing worth discussing: I see lots of discussion of the body of evidence for/against some interventions that uses an unfortunately over-simplified heuristic of simply counting the number of positive trials done among the total number of trials.

Registration now LIVE for our free Zoom expert panel webinar to discuss TTM2 trial! Join Drs. Abella, Kurz, Perman, Gaeski and Balu for lively chat. (if it doesn't come out before the scheduled time, we'll reschedule) link: pennmedicine.zoom.us/webinar/regist… #TTM #postarrest

Tempting to look at vaccinations in US by states And it makes sense: states have a lot of control over vaccination sites, outreach, etc But there's ton of variation within states So let's talk Massachusetts, a super high vaccination state Its a tale of two cities Thread

Lady Glaucomflecken (she/her) Agree Lady Glaucomflecken (she/her). There’s a persistent negative view around cardiac arrest prognosis that can, worst case, become a self-fulfilling prophecy. We need better tools, and in the meantime, humility to acknowledge & communicate uncertainty.

We should have known the results after the first large trial. If 33 and 36 are equivalent no reason to think 36 and 38 would make a difference. This should end the TTM in CA trials!!! Let use our resources in finding new innovative therapeutics. #ttm2 nejm.org/doi/full/10.10…

4+ yrs from concept to publication. #SDM in critical care is now available in UK and on 8/5 in US/Can. cambridge.org/core/books/sha… Only possible through mentorship, guidance, and friendship of Dave Hwang! Cambridge University Press SCCM Neurocritical Care Society AAHPM International Neuropalliative Care Society #zentensivism

👇it wasn't the temperature that mattered as much as the hope and care that came along with it

Finally arrived! And on an opportune day when I used strategies from so many great authors!! Cambridge University Press - Academic Dave Hwang Melissa Motta Mitra Haeri S Muehlschlegel MD MPH, FNCS, FCCM, FAAN Jessica M McFarlin Michael Rubin @AuriemmaKatie @neurologyrules @NnekaPhD @EvieMarcolini Claire Creutzfeldt Vita incerta @addiegmd

1/ Results of our IMPACTS RCT out in Critical Care Medicine The multicomponent sepsis transition and recovery (STAR) program facilitated by nurse navigators reduced the composite of 30-day readmissions/mortality. An example of our impressive LHS team at work journals.lww.com/ccmjournal/abs…

Our dream comes true: the #WATERFALLtrial has been published in NEJM Aggressive fluid resuscitation in acute pancreatitis is not safe & does not improve outcomes #GItwitter #SomosAEG Aegastro What's behind this publication? It all started 21 years ago nejm.org/doi/full/10.10…