Podcasts about pulmcrit

Welcome to the origin story of PULMCRIT!    In this episode, we cover how best to practically monitor the balance between oxygenation, oxygen delivery and oxygen consumption. Controversial to say the least. Come take a listen, and learn about the pulsatility index, a space we should all be watching for in the future.

In this episode, we're joined by Dr. Haney Mallemat from @critcarenow to discuss the patient with a massive pulmonary embolism and how we need to manage these patients in the acute phase to keep them alive until we can get them to definitive care.Below are several resources Dr. Mallemat referenced in our talk, as well as links to Critical Care Now and the ResusX conference.Please do us a favor and check out Dr. Mallemat's site.  You'll be happy you did.Critical Care Now - https://criticalcarenow.com/ResusX Conference - https://www.resusx.com/PEAPETT Trial - https://pubmed.ncbi.nlm.nih.gov/27422214/RebelEM Post about PEAPETT - https://rebelem.com/peapett-trial-half-dose-tpa-pea-due-massive-pulmonary-embolism/PERT Teams - https://pertconsortium.org/about/PERT Teams - https://onlinelibrary.wiley.com/doi/10.1002/rth2.12216Nebulized Nitro from PulmCrit - https://emcrit.org/pulmcrit/ntg/Nebulized nitro from the American Academy of Emergency Physicians - https://www.aaem.org/UserFiles/file/CS21_MarAprCCMS.pdf Nebulized Nitro - https://rc.rcjournal.com/content/57/3/444Support the show

In deze aflevering heb ik Dr. Harm Jan de Grooth te gast.Harm Jan is intensivist en is gepromoveerd in doen van onderzoek naar het uitvoeren van onderzoek. Harm Jan vertelt erg gepassioneerd over de volgende onderwerpen:Wat is er op dit moment mis met de huidige manier van onderzoek uitvoeren in de acute zorg?Waarom hebben we nog steeds niet het wondermiddel gevonden voor ARDS of Sepsis?Wat is heterogeniteit en hoe voorkomen we dit in onderzoek?Waarom zijn de meeste onderzoeken niet te reproduceren?Wat is een p-waarde, en waarom is de grens vaak te arbitrair?Waarom is mortaliteit een slechte uitkomstmaat?Wat is wel een goede uitkomstmaat voor onderzoek op de IC?Wat is de toekomst van onderzoek op de IC?Welke tips kan je meegeven voor mensen die meer wetenschappelijke artikelen willen lezen?Waarom wordt veel onderzoek niet geïmplementeerd in de praktijk?Lees-tips:PulmCrit- .050 shades of grey in p-value cutoffsPulmCrit – It's insane to keep using mortality as a primary endpoint in critical care trialsThe Future of Critical Care Lies in Quality Improvement and EducationShould we rely on trials with disease- rather than patient-oriented endpoints?Bedankt voor het luisteren!Volg @intensiefdepodcast op InstagramVragen? intensiefdepodcast@gmail.com

Welcome to PedsCrit! We are a collaborative educational PICU podcast working with pediatric critical care educators around the world to create high-yield podcast episodes on core PICU topics. Find us at PedsCrit.com, or reach us via email at PedsCritPodcast@gmail.com. We hope you enjoy!How to support PedsCrit?Please share, like, rate and review on Apple Podcasts or Spotify!Donations appreciated @PedsCrit on Venmo --100% of all funds will go to supporting the show to keep this project going.

Vitals & Useful Links: Learn about one important etiology of epigastric pain (see spoilers below if you want to know which one - hint: We've covered a type of it before!) PulmCrit has a great post about it here (spoilers) In this episode, Jordan (PGY1.5) takes Kyle (PGY0) and Arman (PGY0) through a case of epigastric abdominal pain. We quickly get to the diagnosis, but the etiology and management are fascinating! As per usual, Nurse Barb and Jordan lay down some wisdom on the way the real world of medicine works. How would you approach this case? As always, we learn a couple of very important points about the epigastric abdominal pain. If you have any questions, concerns, or comments, please email us at emjccast@gmail.com DISCLAIMER: The views/opinions expressed in this podcast are that of the hosts/guests and do not reflect their respective institutions. This is NOT a medical advice podcast, if you are having a medical emergency you should call 911 and get help. This is an educational podcast, and as such, sometimes we get things wrong - if you notice this, please email us at emjccast@gmail.com.

Hematologist Tom Deloughery gives a primer on COVID-19 cytokine storm, d-dimer, DIC that leans toward thrombus, why some clots break through heparin, utility of low molecular weight heparin, and using TPA for ARDS (don’t get too excited on that one quite yet).   We discuss: Great advice from Loren Rauch: we should reframe social distancing and instead think of it as physical distancing and social connectedness [0:00]; Cytokine storm and why it happens in COVID-19 [3:30}; How DIC and prothrombotic state are connected to cytokine storm [6:12]; Reasons why some COVID-19 patients have elevated D-dimer [8:43]; The association between elevated D-dimer and increased mortality [9:08]; The significance of an elevated LDH [14:47]; Why a standard approach to using unfractionated heparin might not work in COVID-19 thromboses [15:27]; Anti-Xa levels and why they might be more advantageous than following PTT [15:58] Tom’s preference for low molecular weight heparin  in COVID-related DVT and strategies for management if there are breakthrough clots [16:54]; When to change from therapeutic to prophylactic anticoagulation [22:32]; COVID-19 effects on lymphocytes and hemoglobin [23:20]; Elevated D-dimer summary [26;:47]; Case report of 3 patients given TPA for severe ARDS  [28:01] For a ton of other high yield info, check out the Hippo Education COVID-19 Resource Site Learn more about ERcast: https://www.hippoed.com/em/ercast/   References and other stuff mentioned in this episode: PulmCrit analysis of elevated D-dimer Link REBEL EM thrombosis page Link Cui S, et al. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haemost. April 2020. PMID: 32271988 Pulm crit wee on this paper Link Wang, J., et al. (2020), Tissue Plasminogen Activator (tPA) Treatment for COVID‐19 Associated Acute Respiratory Distress Syndrome (ARDS): A Case Series. J Thromb Haemost. Accepted Author Manuscript. PMID: 32267998. Zhou, Fei, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study." The Lancet (2020). PMID: 32171076

A polite discussion about a controversial post

Joel TopfJennie LinMatt SparksSwapnil HiremathShow Notes: IgA Nephropathy ScoreLevi Strauss: https://www.biography.com/fashion-designer/levi-straussLevey MDRD study: https://www.ncbi.nlm.nih.gov/pubmed/10075613ADPKD Total Kidney Volume: https://www.nejm.org/doi/10.1056/NEJMoa054341Halt PKD: https://www.nejm.org/doi/full/10.1056/nejmoa1402685Tempo 3:4 Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1205511Description description of IgA nephropathy by Berger and Hiunglais: https://www.ncbi.nlm.nih.gov/pubmed/4180586The reprint in JASN in 2000 with commentary as part of the Milestones in Nephrology series: https://jasn.asnjournals.org/content/jnephrol/11/10/1957.full.pdf JASN supplies an English translation from the original French.Nice reference from JASN backing up Matt’s assertion that preeclampsia and not IgA nephropathy is the most common glomerular disease in the world: https://jasn.asnjournals.org/content/18/8/2281Description of the Singapore Army screening recruits from the Oxford Textbook of Clinical Nephrology: https://books.google.com/books?id=fVItBQAAQBAJ&lpg=PA485&ots=JRoOnUnleT&dq=singapore%20kidney%20biopsy%20army&pg=PA485#v=onepage&q&f=falseDescription of the Japanese glomerulonephritis screening program: https://cjasn.asnjournals.org/content/2/6/1360Swapnil’s studies on autopsy studies:Finland: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC501386/Japan: https://www.ncbi.nlm.nih.gov/pubmed/12753320/Nephrology Secrets, either one of the best or the best nephrology textbooks ever: https://www.amazon.com/Nephrology-Secrets-Book-Edgar-Lerma-ebook/dp/B079TSYNQW/ref=sr_1_1TESTING Trial on NephJC: http://www.nephjc.com/news/2017/8/28/testingStop-Iga Trial on NephJC: http://www.nephjc.com/iga-nephropathyTesting Trial two: Therapeutic Evaluation of Steroids in IgA Nephropathy Global Study Low Dose Study: https://clinicaltrials.gov/ct2/show/NCT01560052MEST Score versus MEST-C in NephJC: http://www.nephjc.com/news/2016/10/16/do-crescents-matter-for-iga-nephropathyNice discussion of the statistical tests during the Tweet Chat by people who know their stats (I.e. not Joel): https://twitter.com/NephJC/status/1133546750814367746Tweet-length description of IDI: https://twitter.com/kiwiskiNZ/status/1133595698929098752Assessing the performance of prediction models: a framework for traditional and novel measures. https://www.ncbi.nlm.nih.gov/pubmed/20010215/Net Reclassification Indices for Evaluating Risk-Prediction Instruments: A Critical Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3918180/Predicting Progression in CKD: Perspectives and Precautions https://www.ajkd.org/article/S0272-6386(15)01413-4/abstractThe Article by Nancy Cook in Circulation that Jennie was talking about: Use and misuse of the receiver operating characteristic curve in risk prediction. https://www.ncbi.nlm.nih.gov/pubmed/17309939Discovery of new risk loci for IgA nephropathy implicates genes involved in immunity against intestinal pathogens https://www.nature.com/articles/ng.3118Genome-wide polygenic risk predictors for kidney disease https://www.nature.com/articles/s41581-018-0067-6Where does Matt find minutia like the grams of IgA produced a day? Here: https://www.annualreviews.org/doi/abs/10.1146/annurev-pathol-011110-130216Animal models of IgA nephropathy: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4337240/Matt’s Book Originals: https://www.amazon.com/gp/product/014312885X/ref=dbs_a_def_rwt_bibl_vppi_i1Eric Neilson, Dean of Northwestern University https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=23239Brussels sprout Insta-famous dog and future dean of the medical school: https://www.instagram.com/brussels.sprout/?hl=enJosh Farkas Rantorial about Contrast Nephropathy: https://twitter.com/PulmCrit/status/1134922050794139648Swapnil’s Tweetorial about Contrast Nephropathy: https://twitter.com/hswapnil/status/1133906398096609280Tukaram’s pic of NEJM’s progression from Contrast Induced Nephropathy to Contrast Associated Nephropathy: https://twitter.com/tukaramj/status/1135214980985266178Zero sodium dialysate for heart failure? https://twitter.com/i/moments/1134811009217155072

In this episode, episode 98, I discuss the BICAR-ICU trial and what it tells us about using sodium bicarbonate to treat metabolic acidosis. References: BICAR-ICU Trial: https://www.ncbi.nlm.nih.gov/pubmed/29910040 BICAR-ICU Editorial: https://www.ncbi.nlm.nih.gov/pubmed/29910039 Forsythe: https://www.ncbi.nlm.nih.gov/pubmed/10631227 Sabatini: https://www.ncbi.nlm.nih.gov/pubmed/18322160 Pulmcrit post: https://emcrit.org/pulmcrit/bicar-icu/  

This podcast is going to dive into the hot topic of ARDS or lack there of. I’ve been so excited to review this article and was blown away by its depth and science based discussion. In this amazing article by Pulmcrit and Josh Farkas, the topic of ARDS is examined with the focus on the Berlin Definition of ARDS, pathophysiology, iatrogenic injury and the new theory called “pseudoARDS”. In this episode, we explore the old thought process in ARDS, with a focus on diagnosis, physiology, theory, and overall treatment approach. We then examine the science and take a look at the newer thoughts on “pseudoARDS”. We couldn’t make this podcast without. Please rate, and review wherever you download the podcast. Thanks for listening!

This podcast is going to dive into the hot topic of ARDS or lack there of. I've been so excited to review this article and was blown away by its depth and science based discussion. In this amazing article by Pulmcrit and Josh Farkas, the topic of ARDS is examined with the focus on the Berlin Definition of ARDS, pathophysiology, iatrogenic injury and the new theory called “pseudoARDS”. In this episode, we explore the old thought process in ARDS, with a focus on diagnosis, physiology, theory, and overall treatment approach. We then examine the science and take a look at the newer thoughts on “pseudoARDS”. We couldn't make this podcast without. Please rate, and review wherever you download the podcast. Thanks for listening!See omnystudio.com/listener for privacy information.

This week we review pearls from the EEMCrit conference back in January 2018. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_138_0_Final_Cut.m4a Download Leave a Comment Tags: BRASH, Hyperkalemia, TTP, Ventricular Tachycardia, VTach Show Notes Show Notes Core EM: Procainamide vs Amiodarone in Stable Wide QRS Tachydysrhythmias (PROCAMIO) PulmCrit: Myth-Buesting: Lactated Ringers is Safe in Hyperkalemia, and Is Superior to NS PulmCrit: BRASH Syndrome Read More

This week we review pearls from the EEMCrit conference back in January 2018. https://media.blubrry.com/coreem/content.blubrry.com/coreem/Podcast_Episode_138_0_Final_Cut.m4a Download Leave a Comment Tags: BRASH, Hyperkalemia, TTP, Ventricular Tachycardia, VTach Show Notes Show Notes Core EM: Procainamide vs Amiodarone in Stable Wide QRS Tachydysrhythmias (PROCAMIO) PulmCrit: Myth-Buesting: Lactated Ringers is Safe in Hyperkalemia, and Is Superior to NS PulmCrit: BRASH Syndrome Read More

Over at the Pulmcrit blog, Dr. Josh Farkas has proposed the use of phenobarbital monotherapy for the treatment of ethanol withdrawal and we cover this protocol. We then dive into core content alcohol withdrawal using Rosen’s Emergency Medicine (9th ed) Chapter 142 , Tintinalli’s Emergency Medicine (8th ed) Chapter 292, and Goldfrank's Toxicologic Emergencies (10th ed) Chapter 81  as guides. Thanks for listening, Lauren Westafer and Jeremy Faust

Ämnet för dagen är trombolys (eller inte) av lungemboli. Inspirationen är hämtad från en serie fantastiska inlägg av Josh Farkas från PulmCrit (numera en del av EMCrit). Kolla in originalen här och här. Det finns ännu mer på sajten – Emcrit/PulmCrit. Referenser Konstantinides, S. V., Vicaut, E., Danays, T., Becattini, C., Bertoletti, L., Beyer-Westendorf, J., […]

The Free Open Access Medical Education (FOAM)  We cover a post from Dr. Josh Farkas on PULMcrit on lithium toxicity. The key message from the post is: a single serum lithium level doesn't necessitate dialysis, despite a recommendation from the EXTRIP working group  to initiate dialysis in patients with a lithium level > 5 mEq/L [1].  Dr. Farkas advocates for aggressive management in asymptomatic patients with chronic lithium toxicity and patients without impaired renal function. Core Content We review rhabdomyolysis using Rosen's Emergency Medicine (8e)  Chapter 160 and Tintinalli's Emergency Medicine (8e), Chapter 181.   Show notes at FOAMcast.org Thanks for listening! Jeremy Faust & Lauren Westafer