I’m so excited to be at #SCCM2024 to talk about @PICU_Up and listen to the amazing work presented by @JessLaRosaMD @SapnaKmd and the @HopkinsKids and @HopkinsACCM group! What better way to celebrate my 5th @SCCM congress!

To the extent people haven’t already seen this:

Pathophysiology of anaphylactic shock captured on CT
- early vs late-phase images comparison with marked intestinal edema, IVC collapse, volume-reduced spleen

rdcu.be/dnTpJ

Interesting study! No difference in RRT, AKI or mortality, but more ICU-free days in thiamine group. At baseline, the placebo patients look slightly sicker. In thiamine-deficient patients mortality difference is striking (29% vs 69%), but not enough power to make inferences. https://t.co/wdO80D29He

The search strategy for this study is why we need people like @KatieLobner and @carrieprice78. Somehow they also excluded 60,000(!) results before screening. https://twitter.com/RecoveryDoctor/status/1679161920098828288

Librarians are authors. If you're doing a systematic review and a librarian did not write the search strategy, odds are your search strategy is not that great. Don't believe me? See for yourself. The second strategy is just for MEDLINE. https://twitter.com/carrieprice78/status/1658537328133148672

This is your friendly PSA that: 1. antipsychotics are not interchangeable 2. atypical antipsychotics are not better than typical ones
3. antipsychotics can cause delirium You wouldn't randomly choose a vasopressor, so don't randomly choose an antipsychotic.

Does IFN-γ-1b prevent HAP in ICU patients? Resoundingly, no! Trial stopped early after interim analysis showed possible harm (HR 1.76 [95%CI 0.94–3.29] for HAP or death at 28d). The immune system is smarter than us which is why haphazard "immunomodulation" is harmful.

#Medtwitter is talking about neuromuscular blockade. The perfect time to bring up one of my favorite papers. Q: What happens to the bispectral index when you give (just) paralytics to awake volunteers? A: It drops. In some, down to the 50s. Please sedate your patients.

Thanks to @SapnaKmd, I now have the traditional mug! Love it!!!

Another argument for why TEG should be considered the standard of care for hemostatic management. Platelet use: RR 0.17 vs usual care
7-day mortality: RR 0.52
Decreased blood product usage
No difference in bleeding rates https://t.co/OcLdbtTKKb