Eddy Joe Gutierrez
@eddyjoemd.bsky.social
Intensivist
Author of “The Vasopressor & Inotrope Handbook.” Saving Lives Podcast Host.
Author of “The Vasopressor & Inotrope Handbook.” Saving Lives Podcast Host.
Setting the PEEP on patients who are on ventilators is something we cannot get wrong. Although the vast majority of patients are just fine with the baseline 5 we typically use, patients with severe ARDS need far more love. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 24, 2025 at 12:21 PM
Setting the PEEP on patients who are on ventilators is something we cannot get wrong. Although the vast majority of patients are just fine with the baseline 5 we typically use, patients with severe ARDS need far more love. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
The differential for cardiogenic shock is far broader than AMI. This image from the ELSO Guidelines for ECMO in cardiac patients highlights other etiologies that we need to consider in black and white. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 23, 2025 at 10:28 AM
The differential for cardiogenic shock is far broader than AMI. This image from the ELSO Guidelines for ECMO in cardiac patients highlights other etiologies that we need to consider in black and white. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
If you provide patients with blood transfusions in the ED or ICU, it's worth your while to check out these new guidelines from CHEST. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 22, 2025 at 10:16 AM
If you provide patients with blood transfusions in the ED or ICU, it's worth your while to check out these new guidelines from CHEST. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
We've all come across incidental findings of a renal mass in our patients. Right off the bat, renal cell carcinoma comes to mind. Here are the next steps in management. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 21, 2025 at 10:12 AM
We've all come across incidental findings of a renal mass in our patients. Right off the bat, renal cell carcinoma comes to mind. Here are the next steps in management. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
Need some strategies to manage a patient with an intermediate or high-risk pulmonary embolism? Here you go! 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 20, 2025 at 10:08 AM
Need some strategies to manage a patient with an intermediate or high-risk pulmonary embolism? Here you go! 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
In the effort to save the kidneys, different biomarkers have joined the party. After all, many illnesses that bring patients to the ICU, and many of our interventions, may provide a one-two punch to the beans. Are they worth it? 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 19, 2025 at 10:14 AM
In the effort to save the kidneys, different biomarkers have joined the party. After all, many illnesses that bring patients to the ICU, and many of our interventions, may provide a one-two punch to the beans. Are they worth it? 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
We've been learning about tumor necrosis factor for almost 50 years, but haven't quite sorted out if it's good or evil in sepsis. This paper attempted to answer that question, but we're all left with more questions. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 18, 2025 at 9:58 AM
We've been learning about tumor necrosis factor for almost 50 years, but haven't quite sorted out if it's good or evil in sepsis. This paper attempted to answer that question, but we're all left with more questions. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
We practice in a field of medicine where, despite our best efforts, outcomes are not always positive. In those cases, focusing on patient comfort & family support is the primary goal. Our palliative care teams can help us get there. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 17, 2025 at 10:05 AM
We practice in a field of medicine where, despite our best efforts, outcomes are not always positive. In those cases, focusing on patient comfort & family support is the primary goal. Our palliative care teams can help us get there. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
l've seen toxic shock syndrome a number of times in my career. Things can get ugly pretty quickly, especially in the desquamation phase. Don't forget to add an antitoxic agent to the mix. The jury is still out on IVIG. tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 16, 2025 at 10:17 AM
l've seen toxic shock syndrome a number of times in my career. Things can get ugly pretty quickly, especially in the desquamation phase. Don't forget to add an antitoxic agent to the mix. The jury is still out on IVIG. tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
Many patients who present to our hospitals after suffering a cardiac arrest develop acute lung injury. Although we may oversimplify and assume that the patient aspirated, there's more to it than that. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 15, 2025 at 10:02 AM
Many patients who present to our hospitals after suffering a cardiac arrest develop acute lung injury. Although we may oversimplify and assume that the patient aspirated, there's more to it than that. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
Do you make your patients NPO 6 hours before a cath lab procedure, such as PCI, which requires moderate sedation? Or even NPO after midnight for an AICD placement? Here's the data to show that fasting is not necessary for these procedures. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 14, 2025 at 12:46 PM
Do you make your patients NPO 6 hours before a cath lab procedure, such as PCI, which requires moderate sedation? Or even NPO after midnight for an AICD placement? Here's the data to show that fasting is not necessary for these procedures. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
When we care for patients with cardiogenic shock, we in the ICU oftentimes have no immediate tools other than vasopressors and inotropes. Although these temporarily make the numbers pretty, they likely do not address the etiology. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 12, 2025 at 10:11 AM
When we care for patients with cardiogenic shock, we in the ICU oftentimes have no immediate tools other than vasopressors and inotropes. Although these temporarily make the numbers pretty, they likely do not address the etiology. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
Arbitrary, overly-aggressive IV fluid resuscitation without a hemodynamic target outside of MAP has never sat well with me. This concise and to-the-point paper examines the data on why we shouldn't open the floodgates. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 11, 2025 at 12:11 PM
Arbitrary, overly-aggressive IV fluid resuscitation without a hemodynamic target outside of MAP has never sat well with me. This concise and to-the-point paper examines the data on why we shouldn't open the floodgates. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
When patients with chronic liver disease decompensate and end up in our ICUs, they tend to shut down other organs in the process. Here's how to try to fix those other organs. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 10, 2025 at 10:22 AM
When patients with chronic liver disease decompensate and end up in our ICUs, they tend to shut down other organs in the process. Here's how to try to fix those other organs. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
Does it ever seem that the way fresh frozen plasma (FFP) and platelet transfusion takes place is a bit more arbitrary than you'd like? CHEST published this guideline to tidy up practice. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 9, 2025 at 10:12 AM
Does it ever seem that the way fresh frozen plasma (FFP) and platelet transfusion takes place is a bit more arbitrary than you'd like? CHEST published this guideline to tidy up practice. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
If you've ever wondered why we spend incredible resources on septic shock, at the expense of cardiogenic, look no further. It becomes a distribution game (pun intended), with distributive accounting for 66% of shock cases. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 8, 2025 at 10:07 AM
If you've ever wondered why we spend incredible resources on septic shock, at the expense of cardiogenic, look no further. It becomes a distribution game (pun intended), with distributive accounting for 66% of shock cases. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
Knowing the significant potential adverse effects of using paralytics, it is crucial to optimize management of patients w/ARDS before administering them. However, if the patient needs them, then they need them. Have an exit strategy. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 7, 2025 at 10:11 AM
Knowing the significant potential adverse effects of using paralytics, it is crucial to optimize management of patients w/ARDS before administering them. However, if the patient needs them, then they need them. Have an exit strategy. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
It becomes unfortunately inevitable that our patients are going to become incredibly weak during their ICU stay. Being aware of the factors that lead to ICU-acquired weakness could help us improve outcomes. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 6, 2025 at 9:43 AM
It becomes unfortunately inevitable that our patients are going to become incredibly weak during their ICU stay. Being aware of the factors that lead to ICU-acquired weakness could help us improve outcomes. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
A variety of cells are invited to the party in critically ill patients. Unfortunately, not all behave as they should. Some party too hard and trash the place. This paper tackles the innate immune response in critically ill patients. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 5, 2025 at 9:48 AM
A variety of cells are invited to the party in critically ill patients. Unfortunately, not all behave as they should. Some party too hard and trash the place. This paper tackles the innate immune response in critically ill patients. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
Using the eyeball test when performing bedside POCUS for heart failure can be helpful, but taking our skills up a notch can prove to be worthwhile for our patients. Here are some key points to consider. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 4, 2025 at 10:09 AM
Using the eyeball test when performing bedside POCUS for heart failure can be helpful, but taking our skills up a notch can prove to be worthwhile for our patients. Here are some key points to consider. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
I would like to poll the audience to gauge the prevalence of indirect calorimetry in the real world, as I don't have access to this technology. I've been reading about it for years, and the data suggest that benefits exist. 🎩 tip to the authors.
eddyjoemd.com/foamed/
eddyjoemd.com/foamed/
September 3, 2025 at 9:43 AM
I would like to poll the audience to gauge the prevalence of indirect calorimetry in the real world, as I don't have access to this technology. I've been reading about it for years, and the data suggest that benefits exist. 🎩 tip to the authors.
eddyjoemd.com/foamed/
eddyjoemd.com/foamed/
Delirium is amongst the most frustrating things our patients and their families experience in their ICU stay. This table could prove helpful in demonstrating to them why their behavior is as it is. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 2, 2025 at 10:28 AM
Delirium is amongst the most frustrating things our patients and their families experience in their ICU stay. This table could prove helpful in demonstrating to them why their behavior is as it is. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
If we are going to keep giving empiric antibiotics at the current rate, we might as well do it properly. The biomarkers are not yet where they need to be. This paper discusses antimicrobial management in sepsis. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
September 1, 2025 at 11:48 AM
If we are going to keep giving empiric antibiotics at the current rate, we might as well do it properly. The biomarkers are not yet where they need to be. This paper discusses antimicrobial management in sepsis. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
It is safe to assume that days spent with us in the ICU are among the worst days in the lives of our patients and their families. Coping with the rollercoaster of emotions is no easy task, especially when there's no recovery. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
August 31, 2025 at 11:33 AM
It is safe to assume that days spent with us in the ICU are among the worst days in the lives of our patients and their families. Coping with the rollercoaster of emotions is no easy task, especially when there's no recovery. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
Numerous patients are transferred to our ICU for management of the pericardial effusions. Patients ask me about the etiology of the effusion. I print this out and hand it to them. Kidding, of course. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed
August 30, 2025 at 11:17 AM
Numerous patients are transferred to our ICU for management of the pericardial effusions. Patients ask me about the etiology of the effusion. I print this out and hand it to them. Kidding, of course. 🎩 tip to the authors.
eddyjoemd.com/foamed
eddyjoemd.com/foamed