theoretically yes.

but if the patient is really diuretic resistant you'll never be able to achieve an effective diuretic concentration using an infusion

my experience is there's is a LOT of practice variation regarding how people do MacVL (how the stylette is curved, whether intubation is truly direct or partly direct or fully indirect)

most of the time MacVL is largely performed with indirect vision via the videoscope, which is not intended & hard

some cardiologists here have a weird fixation on caffeine-free, low-salt diets. it’s not evidence based.

💯 fair

the only time I see people reaching for an infusion is for diuretic resistance which has colored my opinion (diuretic infusions are reliably worthless for that)

TBH diuretic infusions are dumb

for diureric-resistant patients, you need high-dose bolus diuretics to achieve concentrations high enough to cause diuresis

for diuretic-sensitive patients, it doesnt matter (either strategy will work fine)

more discussion here:

emcrit.org/ibcc/diurese...

meropenem has a uniquely tiny R-side chain, so it barely causes any allergic reactions

cases of anaphylaxis due to meropenem are incredibly rare

you can give meropenem to nearly any patient

more discussion on carbapenem x-reactions here
emcrit.org/ibcc/penicil...

some hospitals have terlipressin in USA but not here

agree 💯💯

#EMIMCC

well let’s just be happy it was a negative trial 🤣

can you imagine how catastrophic it would be if the trial were positive?

there would be a ton of pressure to ram A-lines into every septic patient emergently

Zarbock is a strange guy - he’s done a lot of positive kidney trials which others have not been able to replicate

I don’t believe any work if it only comes from that group

And the amino acid story is so implausible 🤷🏽‍♂️