Whisky is so apt

We talk about SDd every few years don’t we and my experience is that even in its heyday .. in my uk practice .. never get enough buy in from micro to do it and become a thing.

As in why mortality is such a high end point or whether it should be used as threshold?

I don’t understand why we are seeing a temporal effect with results. May be other things are changing ?!

Completely ! And the trial indication is purely for MAP. It’s important to not justify one trial to throw A line away or usher in bad practices which have taken decades of hard work to standardise etc.

PS. Also this is not just a rant about one specialty or one hospital. It was just my lived experiences rotating through various places in the uk

Have to be careful not to cite this paper as a cowboy practice and less optimal situations to provide critical care. As time and time again it’s never devices that make critical care .. the team and culture. I guess rant over. What do you think ? N/n @drfreeze.bsky.social

and over my years of practice, those places have been phased out to single provider icu model: FFICM and ICM has become stronger. I would argue rightly so and there is evidence to back up. So whilst this trial may show no need to rush to art line but this need to be done in a safe place 4/n

Those are the places where people with acute niv who have 2+ abg’s in a shift without artline , with low dose norad / metaraminol for extended periods with NIBP or art lines but transducer on the floor and no one really cares 🤷🏽‍♂️ or rather it is done if person so and so is on shift 3/n…

What I mean by properly .. is run by people who know and appreciate physiology. Art lines were not just sited but zeroed twice a day if not more and at proper height. Metaraminol is run only as until cvc goes in (don’t add me re low dose norad via pivc) and other non icu places …. 2/n

Anyone doing live tweets ?