Acute hypoxemic respiratory failure in #ICU in 🇦🇺🇳🇿: disease burden may be higher than expected! 🪦mortality ⬆️ with ⬇️ P/F, particularly <200: need to reconsider how we stratify AHRF severity? 🪦mortality ⬇️ over time: improvements in critical care? 🔓 bit.ly/3Xrdh8E

I believe that #ECMO is a life-saving temporising intervention. Yet, there are ethical dilemmas when it appears "futile". In The Lancet Respiratory Medicine, Kiran Shekar Ramanathan KR and I envision a future where ECMO can be reliably used as a long-term device. thelancet.com/journals/lanre…

🌊 When #ECMO-dependent patients are no longer candidates for destination therapy, should #ECLS be continued indefinitely? It would eventually serve only as a bridge to fatal complication. Complications might prolong suffering and affect quality of life. Beyond ethical

Why are haemodynamics so complicated and why have critical care physicians made such a mess of haemodynamic management over the years (eg aiming for high CVP)? A circular system means that a change at 1 point affects all the other points...

My ARDS patient deteriorates and is now haemodynamically unstable, what do we do? With Prof Luigi Camporota @Luigi_ICM Oliver Hunsicker Jean-Louis Teboul and Lise Piquilloud ESICM #LIVES2024

I struggle a lot conceptually with the fact that in some countries we give CAR-T, give 5th line expensive treatments, dialysis in 80 y, but find a bridge to decision LVAD in a 40 year old a too big investment if eg, egfr 30 ml/min or only 1.5 years after curative cancer treatment

(1/x) Here are the top things I think of when a patient with sepsis is worsening despite 'appropriate therapy'. (note: it rarely is that the bug developed resistance..) A 🧵 #medtwitter #foamed

ICU Resuscitation Thoughts: Every 2 y this time of the year I have to provide my hospital-employer w proof of ACLS recertification. I usually take an on-line course which I finish in a few hours. Sadly, this biennial ritual is also a reminder that we keep following the same #CPR

pEEG and ketamine If youve spent any time around TIVA and EEG You'll know that ketamine can increase the BIS number - Perhaps you never use ketamine because every time you do your processed EEG keeps telling you the patient's 'awake' 1/12

Five predictions for critical care research in the next 5 years. 🧵(1/6)

(1/x) High quality CPR, early defibrillation, and treating the underlying cause saves lives in cardiac arrest, but what else can we do? Here are 7 advanced therapies for cardiac arrest👇 A🧵 Caution: Bleeding edge - evidence 'light' zone.

Excited to share our tool Resub that automatically formats your manuscript for any journal. We designed Resub for clinical researchers who: 1) Hate wasting time formatting papers 2) Want to save hours per manuscript 3) Are committed to productivity and impact You can trial it

🩸 Preoperative anemia and anemia treatment in cardiac surgery 📃: buff.ly/4cTBmcY #anemia

This 🧵 is inspired by a conversation that Raghav Sundar and I recently had. This is for all of the trainees who will sign their first offer letter. As one that is almost 3 years to the date from the day I signed here are my tips 🧵1/6

Last year, I had the privilege of spending 2 months in Australia at Monash Health and anzicrc under A/Prof Ashwin Subramaniam and David Pilcher. One of the studies that we came up with was just published! Critical Care Medicine journals.lww.com/ccmjournal/abs… #intensivecare #FOAMcc #ICU

Takeaways from #ACC2025. Late breaking trials - take home points American College of Cardiology   1. WARRIOR Trial : Intensive medical therapy did not significantly impact the rate of serious cardiovascular events at five years in women with suspected ischemia with nonobstructive coronary arteries

What is the impact of #LV #unloading during #ECPR? Target trial emulation using #ELSO registry: 🏥 300 centres, 621 matched pairs ❌ LV unloading NOT a/w survival benefits 💘 More CNS, CVS, and metabolic complications, and longer #ECMO durations! link.springer.com/article/10.118…

Left ventricular unloading in #ECPR 🔎 > 3.2K pts from ELSO Registry, 2020-2023 ⚖️ 621 pairs (LV unloading +/-) matched 🚧 LV unloading associated with higher complications 🫀not associated with improved survival/functional outcomes in context of #ECMO assisted CPR regardless of