Polyuria : The Perfect Storm -Nephrology is consulted for Urine output of 9L in one day -Pt. with AML, T2DM has been in the hospital for > 2 weeks for pneumonia, sepsis & subsequently developed Sweet Syndrome & was started on steroids 1/

Each year, Acute Decompensated Heart Failure (ADHF) leads to over 1,000,000 hospitalizations in the U.S. Here's my approach to admitting a patient with ADHF, along with some key clinical pearls. IM Interns - bookmark this! #MedEd #MedTwitter #tipsfornewdocs 1/20

Excellent paper 👇regarding the role of lung US in acute and chronic heart failure. I have a minor comment, so please keep reading!

🚨Mechanisms of hypoxemia in #COPD patients w severe #PulmonaryHypertension is finally out! A long, long work but worth the effort 😅 We wondered: why is it that COPD patients with severe PH often have less airflow obstruction and yet more hypoxemia? 🌐bit.ly/3Wnzpik

CRRT in inborn error of metabolism in #PEDSICU Hyperammonaemia acute management: Indications for dialysis at #CCNCLondon2023 Critical Care Nephrology in Children

ET tube confirmation by POCUS: - Bullet sign: reverberation artifact in trachea, single air-mucosal interface = tracheal intubation - Double tract sign: two air mucosal interfaces with posterior shadowing = esophageal intubation

1/🧵 Hypovolemia➡️hyperdynamic LV. Maybe not! Take home: Hypovolemia➡️reduced LV function; Hyperdynamic LV is mainly due to low afterload, not hypovolemia. #POCUS #EchoFirst #FOAMed #FOAMcc #POCUS

INPATIENT WORKUP OF STROKE To many, stroke admissions are not very exciting: it’s formulaic with the same tests ordered every time. But if you understand the reason behind the tests, it becomes much more interesting! Let’s explore together. #neurology #meded #stroke #FOAMed

Congestive nephropathy has been documented more than 100 years ago but still patients with with AKI reflexively receive intravenous fluids 🤔 #POCUS

The RVOT or PA Doppler has a lot of underutilized potential for hemodynamic monitoring of the RV #ThePeoplesVentricle 🧵On the physiology of the RVOT/PA Doppler. Simplified understandings. Corrections are welcome!😃 #FOAMcc #EchoFirst #Cardiotwitter #FOAMed #Medtwitter #POCUS

Review of recent advances in management of ascites and AKI #livertwitter onlinelibrary.wiley.com/doi/10.1111/ap…

Guidelines are unanimous; For look risk procedures like paracentesis we need not check INR and should not give FFP Liver, gastroenterology, hematology, and interventional radiology societies agree So why the variation in managing “the cirrhotic coagulopathy”? 🧵

Some myths regarding use of Lactated Ringers (LR) from BeanQueen Gaddy Sudha Mannemuddhu, MD, FAAP, FASN, FNKF Dr Priti MD,FASN🇮🇳 (प्रिति) Joel M. Topf, MD FACP #Nephpearls #AKIinICU 👉 shop.lww.com/Handbook-of-Cr…

ELAN trial post-hoc analysis: Early DOAC treatment after ischemic strokes was not associated with a higher rate of adverse events, especially sICH, regardless of infarct size group. Persons with major stroke seem to benefit most (OR 0.52 (0.21 to 1.18)). ja.ma/3wHuMr2

Noninvasive ventilation (NIV) has been standard of care treatment for acute exacerbation of COPD (AECOPD) for > 30 years. In this article, the authors describe an evidence-based algorithm of the initiation, titration, monitoring, and weaning of NIV in AECOPD

ICU Physiology (and Mechanical Ventilation) Secrets: Reminder: The lowest pulmonary vascular resistance occurs when the patient is breathing close to functional residual capacity (FRC) Diagram from: derangedphysiology.com/main/cicm-prim…

Drug dosing optimization across the antimicrobial course in critically ill patients doi.org/10.1016/j.join…

URINALYSIS 👉Leukocyte esterase: Enzymes released by lysed WBCs. Surrogate marker for pyuria. 👉Nitrite: Metabolic byproduct of nitrate produced by bacteria. Produced by E Coli & Enterobacteriaceae family. Not produced by pseudomonas, enterococci, & S saprophyticus.

ESGE guidelines on the management of lower GI bleeding 🩸 📸: thieme-connect.de/products/ejour…

I love these two slides on the evidence for combination therapy in persistent MRSA and MSSA bacteremia. References in footer of each slide. #IDWeek2024