Saving Lives Podcast: Critical Care w/eddyjoemd: Recent Episodes
Eddy Joe Gutierrez, MD
Reviewing evidence based strategies to care for the Critically Ill patient in the Intensive Care Unit and other interesting topics in Medicine. This podcast is hosted by Eddy Joe Gutierrez, MD. Support this podcast: https://anchor.fm/eddyjoemd/support
In this episode of the Saving Lives Podcast, Eddy Joe breaks down a 2025 Journal of Critical Care study examining how the choice of the internal jugular vein for initial central line placement impacts outcomes when patients later need hemodialysis catheters. You'll learn why using the left IJV first may reduce the need for repeat procedures and complications. Essential insights for optimizing central line strategy in the ICU.
The Vasopressor & Inotrope Handbook
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My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Gharaibeh KA, Abdelhafez MO, Guedze KEB, Siddiqi H, Hamadah AM, Verceles AC. Impact of initial jugular vein insertion site selection for central venous catheter placement on hemodialysis catheter complications. J Crit Care. 2025 Jun;87:155011. doi: 10.1016/j.jcrc.2024.155011. Epub 2025 Jan 3. PMID: 39755012.
In this episode, we dive into a new pilot RCT exploring the addition of acetazolamide to furosemide in critically ill patients. We break down the study’s methods, findings, and practical implications for fluid management in the ICU. Could this inexpensive, decades-old drug be the key to sustaining diuresis and preventing metabolic alkalosis? Tune in to find out.
The Vasopressor & Inotrope Handbook
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation:
Maeda A, Brown A, Spano S, Chaba A, Phongphithakchai A, Hikasa Y, Pattamin N, Kitisin N, Nübel J, Nielsen B, Holmes J, Peck L, Young H, Eastwood G, Bellomo R, Neto AS. Furosemide with adjunctive acetazolamide vs furosemide only in critically ill patients: A pilot two-center randomized controlled trial. J Crit Care. 2025 Apr;86:155002. doi: 10.1016/j.jcrc.2024.155002. Epub 2024 Dec 16. PMID: 39689380.
In this episode of the Saving Lives Podcast, we review a July 2025 study from the Journal of Intensive Care comparing methylprednisolone and hydrocortisone for severe pneumonia treatment. The discussion focuses on how these findings may influence clinical decisions, particularly for patients with septic shock.
The Vasopressor & Inotrope Handbook
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Sato T, Sasabuchi Y, Inokuchi R, Aso S, Yasunaga H, Doi K. Mortality of severe pneumonia treated with methylprednisolone versus hydrocortisone: a propensity-matched analysis. J Intensive Care. 2025 Jul 15;13(1):39. doi: 10.1186/s40560-025-00810-1. PMID: 40665428; PMCID: PMC12261853.
In this episode of the Saving Lives Podcast, we break down a 2025 study from Intensive Care Medicine that emulates a target trial on the use of sodium bicarbonate in ICU patients with metabolic acidosis. With over 6,000 patients across 12 Australian ICUs, the study reveals a small but significant reduction in mortality and RRT use with bicarbonate therapy. Tune in to learn how this could transform our clinical approach to acidemia in the critically ill patients.
The Vasopressor & Inotrope Handbook
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Blank SP, Blank RM, Laupland KB, Tabah A, Gill D, Kumar A, White K, Attokaran A, Luke S, Whebell S, Garrett P, McCullough J, McIlroy P, Ramanan M; Queensland Critical Care Research Network (QCCRN). Sodium bicarbonate administration for metabolic acidosis in the intensive care unit: a target trial emulation. Intensive Care Med. 2025 Jun;51(6):1-9. doi: 10.1007/s00134-025-07979-x. Epub 2025 Jun 10. PMID: 40493225; PMCID: PMC12208957.
In this episode of the Saving Lives Podcast, we review a comprehensive 2025 meta-analysis on mortality risk factors in pulmonary embolism. Learn which clinical signs, biomarkers, and imaging findings most strongly predict outcomes — and how they can guide triage and therapy decisions in acute PE cases. A must-listen for anyone managing thromboembolic disease in the critically ill patients.
The Vasopressor & Inotrope Handbook
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: You W, Fan XY, Chen Y, Wang XL, Song J, Nie CC, Dong Q. Risk Factors for Mortality in Patients with Pulmonary Embolism-A Meta-Analysis. J Intensive Care Med. 2025 May 5:8850666251326539. doi: 10.1177/08850666251326539. Epub ahead of print. PMID: 40320917.
In this episode of the Saving Lives Podcast, we review a 2025 NEJM-Evidence study analyzing over 21,000 cases of severe hyponatremia to determine the safest and most effective correction rates. Learn why moderate correction (8–10 mmol/L/day) may actually reduce mortality, and how central pontine myelinolysis (CPM) remains rare even with faster correction.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy.
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Seethapathy H, Zhao S, Ouyang T, Passos C, Sarang A, Cheung PW, Waikar SS, Steele DJR, Kalim S, Allegretti AS, Ayus JC, Nigwekar SU. Severe Hyponatremia Correction, Mortality, and Central Pontine Myelinolysis. NEJM Evid. 2023 Oct;2(10):EVIDoa2300107. doi: 10.1056/EVIDoa2300107. Epub 2023 Sep 26. PMID: 38320180.
In this episode, we analyze a June 2025 study from the Journal of Intensive Care, which shows that lower hemoglobin levels at admission are strongly associated with worse outcomes in cardiogenic shock. We dive into the data from the FRENSHOCK registry, uncover key subgroup findings, and discuss implications for transfusion strategies. Could this shift how we manage anemia in shock? Tune in and find out.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy.
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Cherbi M, Levy B, Merdji H, Puymirat E, Bonnefoy E, Vardon F, Elbaz M, Morel O, Leurent G, Lamblin N, Gerbaud E, Gautier P, Roubille F, Delmas C. Hemoglobin in cardiogenic shock: the lower, the poorer survival. J Intensive Care. 2025 Jun 23;13(1):36. doi: 10.1186/s40560-025-00805-y. PMID: 40551259.
In this episode of the Saving Lives Podcast, we reviews a 2024 multicenter study on valproic acid for hyperactive delirium and agitation in ICU patients. The findings show that VPA may help reduce sedation needs, improve ventilator synchrony, and resolve delirium without major adverse effects. Tune in for practical insights into this emerging option for complex critical care cases.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy.
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Nuti O, Merchan C, Ahuja T, Arnouk S, Papadopoulos J, Katz A. Valproic Acid for Hyperactive Delirium and Agitation in Critically Ill Patients. J Intensive Care Med. 2025 May;40(5):519-527. doi: 10.1177/08850666241302760. Epub 2024 Dec 8. PMID: 39648603.
In this episode of the Saving Lives Podcast, we discuss a study from Intensive Care Medicine that explores whether baseline serum chloride and pH affect outcomes with balanced fluids versus saline. The findings from the PLUS trial show no significant interaction, but intriguing trends suggest that hyperchloremic patients may benefit more from balanced fluids.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy.
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Ramanan M, Hammond N, Billot L, Delaney A, Devaux A, Finfer S, Li Q, Micallef S, Venkatesh B, Young PJ, Myburgh J; PLUS Investigators. Serum chloride concentration and outcomes in adults receiving intravenous fluid therapy with a balanced crystalloid solution or 0.9% sodium chloride. Intensive Care Med. 2025 Feb;51(2):249-258. doi: 10.1007/s00134-024-07764-2. Epub 2025 Feb 10. PMID: 39928118.
In this episode of the Saving Lives Podcast, we break down a randomized trial from CHEST (2025) comparing Normosol-R vs. Lactated Ringer’s in critically ill adults. Learn whether acetate/gluconate-buffered fluids offer advantages over lactate-buffered solutions regarding acid-base balance, kidney function, and mortality. Tune in to hear how this study impacts critical care fluid management!
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy.
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Qian ET, Brown RM, Jackson KE, Wang L, Stollings JL, Freundlich RE, Wanderer JP, Siew ED, Bernard GR, Self WH, Casey JD, Rice TW, Semler MW; Pragmatic Critical Care Research Group. Normosol-R versus Lactated Ringers in the Critically Ill: A Randomized Trial. Chest. 2025 Feb 17:S0012-3692(25)00165-5. doi: 10.1016/j.chest.2025.02.008. Epub ahead of print. PMID: 39971001.
In this episode of the Saving Lives Podcast, we review a 2025 study from Critical Care Medicine comparing lactated Ringer’s and normal saline for initial fluid resuscitation in sepsis-induced hypotension. The findings suggest that LR may improve survival and increase hospital-free days compared to NS, supporting current guidelines favoring balanced crystalloids. Tune in for a deep dive into the study’s results and clinical implications!
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy.
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Gelbenegger G, Shapiro NI, Zeitlinger M, Jilma B, Douglas IS, Jorda A. Lactated Ringer's or Normal Saline for Initial Fluid Resuscitation in Sepsis-Induced Hypotension. Crit Care Med. 2025 Feb 19. doi: 10.1097/CCM.0000000000006601. Epub ahead of print. PMID: 39969246.
In this episode of the Saving Lives Podcast, we review a nationwide study on cardiogenic shock in general ICUs, recently published in the European Heart Journal: Acute Cardiovascular Care. Discover why non-ischemic heart failure now leads cardiogenic shock admissions, which patient groups face the highest mortality, and how early ICU intervention can improve outcomes. Stay tuned for critical insights into managing this high-risk population.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy.
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Citation: Guido T, Giovanni T, Elena G, Anna Z, Michele Z, Stefano F. Cardiogenic shock in general intensive care unit: a nationwide prospective analysis of epidemiology and outcome. Eur Heart J Acute Cardiovasc Care. 2024 Dec 3;13(11):768-778. doi: 10.1093/ehjacc/zuae108. PMID: 39302432.
In this episode of the Saving Lives Podcast, we explore a systematic review and meta-analysis from the Journal of Critical Care on sleep interventions in ICU patients. We learn about the effectiveness of pharmacologic and non-pharmacologic strategies in reducing delirium and discover how improving sleep could transform critical care outcomes.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy.
Amazon: https://amzn.to/47qJZe1 (Affiliate Link)
My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Teng J, Qin H, Guo W, Liu J, Sun J, Zhang Z. Effectiveness of sleep interventions to reduce delirium in critically ill patients: A systematic review and meta-analysis. J Crit Care. 2023 Dec;78:154342. doi: 10.1016/j.jcrc.2023.154342. Epub 2023 Jun 9. PMID: 37302381.
In this episode of the Saving Lives Podcast, we dive into the latest research from CHEST, exploring how sepsis order sets can improve care value. Learn about the impact of these sets on reducing mortality, lowering hospital costs, and their role in streamlining sepsis management. Discover why order sets can be a game-changer for hospitals and society in addressing sepsis care.
The Vasopressor & Inotrope HandbookI have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: https://amzn.to/47qJZe1 (Affiliate Link)My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Dale CR, Chiu ST, Schoepflin Sanders S, Stowell CJ, Steel TL, Liao JM, Barnes JI. Sepsis Order Set Use Associated With Increased Care Value. Chest. 2024 Nov;166(5):1046-1055. doi: 10.1016/j.chest.2024.05.032. Epub 2024 Jun 19. PMID: 38906463; PMCID: PMC11638543.
In this episode of the Saving Lives Podcast, Eddy Joe breaks down a study comparing continuous glucose monitoring systems (CGMS) to conventional point-of-care monitoring in ICU patients. Learn how CGMS improves glycemic control, reduces variability, and eases nursing workloads, even without reducing mortality.
The Vasopressor & Inotrope HandbookI have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: https://amzn.to/47qJZe1 (Affiliate Link)My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Chu C, Li J, Yang X, Zhao H, Wu Z, Xu R, Gao J. Continuous glucose monitoring versus conventional glucose monitoring in the ICU: A randomized controlled trial. J Crit Care. 2024 Dec;84:154894. doi: 10.1016/j.jcrc.2024.154894. Epub 2024 Aug 5. PMID: 39106581.
In this episode of The Saving Lives Podcast, we explore Propofol Infusion Syndrome (PRIS), looking at this complication's incidence, laboratory, and clinical manifestations. Hat tip to the authors.The Vasopressor & Inotrope HandbookI have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. Amazon: https://amzn.to/47qJZe1 (Affiliate Link)My Store: https://eddyjoemd.myshopify.com/products/the-vasopressor-inotrope-handbook (Use "podcast" to save 10%)
Citation: Li WK, Chen XJC, Altshuler D, Islam S, Spiegler P, Emerson L, Bender M. The incidence of propofol infusion syndrome in critically-ill patients. J Crit Care. 2022 Oct;71:154098. doi: 10.1016/j.jcrc.2022.154098. Epub 2022 Jun 17. PMID: 35724444.@eddyjoemd is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.comAlthough great care has been taken to ensure that the information in this post is accurate, eddyjoemd, LLC shall not be held responsible or in any way liable for the continued accuracy of the information or for any errors, omissions, or inaccuracies or for any consequences arising therefrom.
In this episode of the Saving Lives Podcast, we discuss a recent randomized controlled trial exploring the use of minocycline to prevent delirium in critically ill patients. The study reveals that minocycline may significantly reduce delirium incidence and hospital mortality, offering a promising new pharmacologic approach.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. If you're in the US, you can order A SIGNED & PERSONALIZED COPY for $29.99 or via AMAZON for $32.99 (for orders in or outside the US). Ebook versions are available via AMAZON KINDLE for $9.99, APPLE BOOKS, and GOOGLE PLAY. ¡Excelentes noticias! Mi libro ha sido traducido al español y está disponible a traves de AMAZON. Las versiones electrónicas están disponibles para su compra for solo $9.99 en AMAZON KINDLE, APPLE BOOKS y GOOGLE PLAY.
Citation
Dal-Pizzol F, Coelho A, Simon CS, Michels M, Corneo E, Jeremias A, Damásio D, Ritter C. Prophylactic Minocycline for Delirium in Critically Ill Patients: A Randomized Controlled Trial. Chest. 2024 May;165(5):1129-1138. doi: 10.1016/j.chest.2023.11.041. Epub 2023 Dec 1. PMID: 38043911.
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In this episode of the Saving Lives Podcast, Eddy Joe delves into the latest research comparing balanced electrolyte solutions to 0.9% saline for treating diabetic ketoacidosis (DKA). Discover how BES could potentially revolutionize DKA management by speeding up recovery and reducing complications. Tune in for an in-depth analysis of the study and its implications for clinical practice.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy. If you're in the US, you can order A SIGNED & PERSONALIZED COPY for $29.99 or via AMAZON for $32.99 (for orders in or outside the US).
Ebook versions are available via AMAZON KINDLE for $9.99, APPLE BOOKS, and GOOGLE PLAY.
¡Excelentes noticias! Mi libro ha sido traducido al español y está disponible a traves de AMAZON. Las versiones electrónicas están disponibles para su compra for solo $9.99 en AMAZON KINDLE, APPLE BOOKS y GOOGLE PLAY.
Citation: Szabó GV, Szigetváry C, Turan C, Engh MA, Terebessy T, Fazekas A, Farkas N, Hegyi P, Molnár Z. Fluid resuscitation with balanced electrolyte solutions results in faster resolution of diabetic ketoacidosis than with 0.9% saline in adults - A systematic review and meta-analysis. Diabetes Metab Res Rev. 2024 Jul;40(5):e3831. doi: 10.1002/dmrr.3831. PMID: 38925619.
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In this episode, Eddy Joe delves into the intensive care management of brain-dead donors, based on a recent article from Intensive Care Medicine. Learn about hemodynamic support, endocrine treatment, and respiratory management strategies to optimize organ procurement. Tune in for an in-depth discussion on improving donor organ viability while maintaining the dignity of the deceased.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy while supporting my endeavors. If you're in the US, you can order A SIGNED & PERSONALIZED COPY for $29.99 or via AMAZON (for orders outside the US). Ebook versions: AMAZON KINDLE for $9.99. APPLE BOOKS and GOOGLE PLAY.
¡Excelentes noticias! Mi libro ha sido traducido al español y las versiones electrónicas están disponibles para su compra for solo $9.99 en AMAZON KINDLE, APPLE BOOKS y GOOGLE PLAY. When you use these affiliate links, I earn an additional commission at no extra cost to you, which is a great way to support my work.
Citation: Gunst J, Souter MJ. Management of the brain-dead donor in the intensive care unit. Intensive Care Med. 2024 Jun;50(6):964-967. doi: 10.1007/s00134-024-07409-4. Epub 2024 Apr 10. PMID: 38598128.
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In this episode of the Saving Lives Podcast, we examine a groundbreaking 2017 study comparing vasopressin and norepinephrine for treating vasoplegic shock after cardiac surgery. We explore the study's compelling results, how vasopressin outperformed norepinephrine in reducing severe complications, and the potential implications for clinical practice.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy while supporting my endeavors. If you're in the US, you can order A SIGNED & PERSONALIZED COPY for $29.99 or via AMAZON (for orders outside the US). Ebook versions: AMAZON KINDLE for $9.99. APPLE BOOKS and GOOGLE PLAY.
¡Excelentes noticias! Mi libro ha sido traducido al español y las versiones electrónicas están disponibles para su compra for solo $9.99 en AMAZON KINDLE, APPLE BOOKS y GOOGLE PLAY. When you use these affiliate links, I earn an additional commission at no extra cost to you, which is a great way to support my work.
Citation: Hajjar LA, Vincent JL, Barbosa Gomes Galas FR, Rhodes A, Landoni G, Osawa EA, Melo RR, Sundin MR, Grande SM, Gaiotto FA, Pomerantzeff PM, Dallan LO, Franco RA, Nakamura RE, Lisboa LA, de Almeida JP, Gerent AM, Souza DH, Gaiane MA, Fukushima JT, Park CL, Zambolim C, Rocha Ferreira GS, Strabelli TM, Fernandes FL, Camara L, Zeferino S, Santos VG, Piccioni MA, Jatene FB, Costa Auler JO Jr, Filho RK. Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: The VANCS Randomized Controlled Trial. Anesthesiology. 2017 Jan;126(1):85-93. doi: 10.1097/ALN.0000000000001434. PMID: 27841822.
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In this episode of the Saving Lives Podcast, we discuss the comprehensive review of frailty assessment tools in critically ill older adults. Learn about the Clinical Frailty Scale and how these tools can influence clinical practice and patient outcomes. Tune in for insights on improving care for the elderly in ICU settings.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy while supporting my endeavors. If you're in the US, you can order A SIGNED & PERSONALIZED COPY for $29.99 or via AMAZON (for orders outside the US). Ebook versions: AMAZON KINDLE for $9.99. APPLE BOOKS and GOOGLE PLAY.
¡Excelentes noticias! Mi libro ha sido traducido al español y las versiones electrónicas están disponibles para su compra for solo $9.99 en AMAZON KINDLE, APPLE BOOKS y GOOGLE PLAY. When you use these affiliate links, I earn an additional commission at no extra cost to you, which is a great way to support my work.
CITATION:
Moïsi L, Mino JC, Guidet B, Vallet H. Frailty assessment in critically ill older adults: a narrative review. Ann Intensive Care. 2024 Jun 18;14(1):93. doi: 10.1186/s13613-024-01315-0. PMID: 38888743.
--- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy while supporting my endeavors. If you're in the US, you can order A SIGNED & PERSONALIZED COPY for $29.99 or via AMAZON (for orders outside the US). Ebook versions: AMAZON KINDLE for $9.99. APPLE BOOKS and GOOGLE PLAY.
¡Excelentes noticias! Mi libro ha sido traducido al español y las versiones electrónicas están disponibles para su compra for solo $9.99 en AMAZON KINDLE, APPLE BOOKS y GOOGLE PLAY. When you use these affiliate links, I earn an additional commission at no extra cost to you, which is a great way to support my work.
Citation: Choi HR, Ho MH, Lin CC. Navigating tensions when life-sustaining treatment is withdrawn: A thematic synthesis of nurses' and physicians' experiences. J Clin Nurs. 2024 Jun;33(6):2337-2356. doi: 10.1111/jocn.17059. Epub 2024 Feb 7. PMID: 38323726.
--- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support
What are the outcomes in patients who suffer in-hospital cardiac arrest based on the duration of the code? This podcast episode covers a retrospective cohort study that analyzed this.
The Vasopressor & Inotrope Handbook
I have written "The Vasopressor & Inotrope Handbook: A Practical Guide for Healthcare Professionals," a must-read for anyone caring for critically ill patients (check out the reviews)! You have several options to get a physical copy while supporting my endeavors. If you're in the US, you can order A SIGNED & PERSONALIZED COPY for $29.99 or via AMAZON (for orders outside the US).
Ebook versions: AMAZON KINDLE for $9.99. APPLE BOOKS and GOOGLE PLAY.
¡Excelentes noticias! Mi libro ha sido traducido al español y las versiones electrónicas están disponibles para su compra for solo $9.99 en AMAZON KINDLE, APPLE BOOKS y GOOGLE PLAY.
When you use these affiliate links, I earn an additional commission at no extra cost to you, which is a great way to support my work.
Citation: Okubo M, Komukai S, Andersen LW, Berg RA, Kurz MC, Morrison LJ, Callaway CW; American Heart Association’s Get With The Guidelines—Resuscitation Investigators. Duration of cardiopulmonary resuscitation and outcomes for adults with in-hospital cardiac arrest: retrospective cohort study. BMJ. 2024 Feb 7;384:e076019. doi: 10.1136/bmj-2023-076019. Erratum in: BMJ. 2024 Apr 18;385:q900. PMID: 38325874; PMCID: PMC10847985.
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In this episode, we explore a groundbreaking study on the cost-effectiveness of artificial intelligence (AI) in managing mechanically ventilated ICU patients. Discover how AI can improve patient outcomes, reduce hospital stays, and enhance decision-making in critical care settings. Tune in to learn about AI's potential to revolutionize ICU care and its practical implications for healthcare professionals.Citation: Zwerwer LR, van der Pol S, Zacharowski K, Postma MJ, Kloka J, Friedrichson B, van Asselt ADI. The value of artificial intelligence for the treatment of mechanically ventilated intensive care unit patients: An early health technology assessment. J Crit Care. 2024 Apr 6;82:154802. doi: 10.1016/j.jcrc.2024.154802. Epub ahead of print. PMID: 38583302.--- Support this podcast: https://podcasters.spotify.com/pod/show/eddyjoemd/support
In this episode of The Saving Lives Podcast, we delve into the intricate subject of advance directives in the intensive care setting. Titled "Deciphering the Complex World of Advance Directives in ICU Care: Challenges and Solutions," the episode explores the historical background, implementation challenges, and the impact of advance directives on patient care within ICUs. Let's highlight the practical difficulties healthcare professionals face in honoring patients' wishes and the varied effectiveness of advance directives across different regions. This episode aims to shed light on the importance of advance directives in ensuring patient autonomy and improving the quality of end-of-life care in critical settings.
The Vasopressor & Inotrope Handbook: Amazon Affiliate Link (I will earn an extra small commission) and Signed/Personalized Copies.
Citation: Baumann SM, Kruse NJ, Kliem PSC, Amacher SA, Hunziker S, Dittrich TD, Renetseder F, Grzonka P, Sutter R. Translation of patients' advance directives in intensive care units: are we there yet? J Intensive Care. 2023 Nov 15;11(1):53. doi: 10.1186/s40560-023-00705-z. PMID: 37968692; PMCID: PMC10648602.
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In this episode of The Saving Lives Podcast, we explore the innovative MitraClip system, a less invasive treatment for mitral regurgitation. The discussion covers the device's evolution, its impact on patient outcomes, and the challenges and complications associated with its use.
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Citation: Schnitzler K, Hell M, Geyer M, Kreidel F, Münzel T, von Bardeleben RS. Complications Following MitraClip Implantation. Curr Cardiol Rep. 2021 Aug 13;23(9):131. doi: 10.1007/s11886-021-01553-9. PMID: 34387748; PMCID: PMC8363549.
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In this episode of The Saving Lives Podcast, we delve into the compelling findings of a recent review on the adverse effects of physical restraint use in ICUs. We discuss the paradoxical nature of restraints, designed for patient safety but linked to significant complications, including skin injuries, delirium, PTSD, and more. Understanding the limitations of our current system, we explore how this research urges a shift towards more compassionate, patient-centered care and the critical need for alternative practices.
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Citation: Sebastian Berger, Pascale Grzonka, Simon A. Amacher, Sabina Hunziker, Anja I. Frei, Raoul Sutter, Adverse events related to physical restraint use in intensive care units: A review of the literature, Journal of Intensive Medicine, 2023,ISSN 2667-100X,
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In this episode of The Saving Lives Podcast, we dive into a compelling study from the Annals of Intensive Care, exploring the prevalence and impact of hyperdynamic left ventricular systolic function in septic patients. Unpacking the findings, we discuss how this condition influences mortality rates and what it means for clinical practice in intensive care units.
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Citation: Sato R, Sanfilippo F, Hasegawa D, Prasitlumkum N, Duggal A, Dugar S. Prevalence and prognosis of hyperdynamic left ventricular systolic function in septic patients: a systematic review and meta-analysis. Ann Intensive Care. 2024 Feb 3;14(1):22. doi: 10.1186/s13613-024-01255-9. PMID: 38308701.
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This episode delves into the 2024 update on corticosteroid guidelines for critically ill patients with sepsis, ARDS, and community-acquired pneumonia. We break down the recommendations, evidence, and clinical implications of this crucial guidance for healthcare providers.
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Citation: Chaudhuri D, Nei AM, Rochwerg B, Balk RA, Asehnoune K, Cadena RS, Carcillo JA, Correa R, Drover K, Esper AM, Gershengorn HB, Hammond NE, Jayaprakash N, Menon K, Nazer L, Pitre T, Qasim ZA, Russell JA, Santos AP, Sarwal A, Spencer-Segal J, Tilouche N, Annane D, Pastores SM. Executive Summary: Guidelines on Use of Corticosteroids in Critically Ill Patients With Sepsis, Acute Respiratory Distress Syndrome, and Community-Acquired Pneumonia Focused Update 2024. Crit Care Med. 2024 Jan 19. doi: 10.1097/CCM.0000000000006171. Epub ahead of print. PMID: 38240490.
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In this episode, we delve into the groundbreaking study "Influence of therapeutic plasma exchange treatment on short-term mortality of critically ill adult patients with sepsis-induced organ dysfunction." We explore how Therapeutic Plasma Exchange (TPE) could revolutionize the treatment of sepsis, a condition notoriously difficult to manage. The episode breaks down the study's methods, results, and significant implications for future clinical practice, highlighting the urgent need for further research in this promising area.
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Citation: Kuklin V, Sovershaev M, Bjerner J, Keith P, Scott LK, Thomas OMT, Szpirt W, Rock G, Stegmayr B. Influence of therapeutic plasma exchange treatment on short-term mortality of critically ill adult patients with sepsis-induced organ dysfunction: a systematic review and meta-analysis. Crit Care. 2024 Jan 4;28(1):12. doi: 10.1186/s13054-023-04795-x. PMID: 38178170; PMCID: PMC10768220.
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In this episode of The Saving Lives Podcast, "Integrating Palliative Care in the ICU: Enhancing Quality of Life," host EddyJoe discusses the article 'Palliative Care in Intensive Care' from 'Intensive Care Medicine.' The episode examines how palliative care improves patient quality of life and reduces ICU stays, highlighting its role beyond end-of-life care. It emphasizes the need for training and changing perceptions among healthcare professionals. Essential for medical practitioners, this episode offers insights into incorporating palliative care into ICU practices for better patient outcomes.
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Citation: Neukirchen M, Metaxa V, Schaefer MS. Palliative care in intensive care. Intensive Care Med. 2023 Dec;49(12):1538-1540. doi: 10.1007/s00134-023-07260-z. Epub 2023 Nov 27. PMID: 38010381; PMCID: PMC10709230.
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In this episode, we delve into the groundbreaking DAMIS trial, exploring the impact of sublingual microcirculation assessment on treatment decisions for ICU patients with shock. We discuss the methodology, findings, and implications of this extensive multicenter study, offering insights into how real-time microcirculatory data influences clinical outcomes in critical care. Join us for an in-depth analysis and expert opinions on this pivotal topic in intensive care medicine.
Show Notes: https://eddyjoemd.com/damis-trial-microcirculation/
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Citation: Bruno RR, Wollborn J, Fengler K, Flick M, Wunder C, Allgäuer S, Thiele H, Schemmelmann M, Hornemann J, Moecke HME, Demirtas F, Palici L, Franz M, Saugel B, Kattan E, De Backer D, Bakker J, Hernandez G, Kelm M, Jung C. Direct assessment of microcirculation in shock: a randomized-controlled multicenter study. Intensive Care Med. 2023 Jun;49(6):645-655. doi: 10.1007/s00134-023-07098-5. Epub 2023 Jun 6. Erratum in: Intensive Care Med. 2023 Oct;49(10):1279. PMID: 37278760; PMCID: PMC10242221.
This Podcast was edited using Descript: https://www.descript.com?lmref=BGOxjQ
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Show Notes: eddyjoemd.com/asymptomatic-catheter-related-thrombosis/
Explore the often-overlooked issue of asymptomatic catheter-related thrombosis (CRT) in ICU patients on The Saving Lives Podcast. This episode delves into a revealing study published in the Annals of Intensive Care, uncovering the incidence, risk factors, and implications of asymptomatic CRT. Join us for a thought-provoking discussion that challenges traditional beliefs and sheds light on crucial aspects of catheter management in critical care.
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Citation: Abbruzzese C, Guzzardella A, Consonni D, Turconi G, Bonetti C, Brioni M, Panigada M, Grasselli G. Incidence of asymptomatic catheter-related thrombosis in intensive care unit patients: a prospective cohort study. Ann Intensive Care. 2023 Oct 19;13(1):106. doi: 10.1186/s13613-023-01206-w. PMID: 37858003; PMCID: PMC10587047. Link to Article
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This episode delves into the pivotal EuRIDICE randomized clinical trial published in Critical Care in 2023. This episode provides an in-depth analysis of the trial's findings on using haloperidol in managing delirium among critically ill adults in the ICU. We'll explore the implications of these results for clinicians and the broader healthcare community, discussing whether haloperidol truly impacts the duration of delirium and coma in ICU patients. This discussion is essential for medical professionals, from students to board-certified physicians, seeking to stay informed on the latest in critical care medicine. Tune in to gain valuable insights and broaden your understanding of ICU delirium management.
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Show Notes: https://eddyjoemd.com/book/
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In this podcast I break down the DEVICE trial looking at using video laryngoscopy (VL) or direct laryngoscopy (DL) for intubation.
Show Notes: https://eddyjoemd.com/vl-dl-intubation/ This Video was Editing Using Descript: https://www.descript.com?lmref=BGOxjQ
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Citation: Prekker ME, Driver BE, Trent SA, Resnick-Ault D, Seitz KP, Russell DW, Gaillard JP, Latimer AJ, Ghamande SA, Gibbs KW, Vonderhaar DJ, Whitson MR, Barnes CR, Walco JP, Douglas IS, Krishnamoorthy V, Dagan A, Bastman JJ, Lloyd BD, Gandotra S, Goranson JK, Mitchell SH, White HD, Palakshappa JA, Espinera A, Page DB, Joffe A, Hansen SJ, Hughes CG, George T, Herbert JT, Shapiro NI, Schauer SG, Long BJ, Imhoff B, Wang L, Rhoads JP, Womack KN, Janz DR, Self WH, Rice TW, Ginde AA, Casey JD, Semler MW; DEVICE Investigators and the Pragmatic Critical Care Research Group. Video versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2023 Jun 16. doi: 10.1056/NEJMoa2301601. Epub ahead of print. PMID: 37326325.
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First of all, I apologize for the bad audio. This episode was lost until my buddy Haney Mallemat (@criticalcarenow) saved it.
Aortic pulsatility index (API) is a hemodynamic measurement being studied to predict clinical outcomes in heart failure & cardiogenic shock.
Show Notes: https://eddyjoemd.com/aortic-pulsatility-index/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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IV Thiamine may be helpful to improve the outcomes of critically ill (ICU) patients who have sepsis or septic shock.
Show Notes: https://eddyjoemd.com/iv-thiamine
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Show Notes: https://eddyjoemd.com/hydrocortisone-cap/
Citation:
Dequin PF, Meziani F, Quenot JP, Kamel T, Ricard JD, Badie J, Reignier J, Heming N, Plantefève G, Souweine B, Voiriot G, Colin G, Frat JP, Mira JP, Barbarot N, François B, Louis G, Gibot S, Guitton C, Giacardi C, Hraiech S, Vimeux S, L'Her E, Faure H, Herbrecht JE, Bouisse C, Joret A, Terzi N, Gacouin A, Quentin C, Jourdain M, Leclerc M, Coffre C, Bourgoin H, Lengellé C, Caille-Fénérol C, Giraudeau B, Le Gouge A; CRICS-TriGGERSep Network. Hydrocortisone in Severe Community-Acquired Pneumonia. N Engl J Med. 2023 Mar 21. doi: 10.1056/NEJMoa2215145. Epub ahead of print. PMID: 36942789.
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My Amazon store for resources you may find helpful: www.amazon.com/shop/eddyjoemd
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Show Notes: https://eddyjoemd.com/methylene-blue-septic-shock/
Link to Lactic Acid Post: https://eddyjoemd.com/lactic-acid-sepsis/
Citation: Ibarra-Estrada M, Kattan E, Aguilera-González P, Sandoval-Plascencia L, Rico-Jauregui U, Gómez-Partida CA, Ortiz-Macías IX, López-Pulgarín JA, Chávez-Peña Q, Mijangos-Méndez JC, Aguirre-Avalos G, Hernández G. Early adjunctive methylene blue in patients with septic shock: a randomized controlled trial. Crit Care. 2023 Mar 13;27(1):110. doi: 10.1186/s13054-023-04397-7. PMID: 36915146; PMCID: PMC10010212.
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
My website: www.eddyjoemd.com
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odcast: https://anchor.fm/eddyjoemd
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Show Notes: https://eddyjoemd.com/b12-septic-shock/
Citation:
Patel JJ, Willoughby R, Peterson J, Carver T, Zelten J, Markiewicz A, Spiegelhoff K, Hipp LA, Canales B, Szabo A, Heyland DK, Stoppe C, Zielonka J, Freed JK. High-Dose IV Hydroxocobalamin (Vitamin B12) in Septic Shock: A Double-Blind, Allocation-Concealed, Placebo-Controlled Single-Center Pilot Randomized Controlled Trial (The Intravenous Hydroxocobalamin in Septic Shock Trial). Chest. 2023 Feb;163(2):303-312. doi: 10.1016/j.chest.2022.09.021. Epub 2022 Sep 26. PMID: 36174744.
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Show Notes: eddyjoemd.com/appreciating-nurses/
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Citation:Vincent JL, Boulanger C, van Mol MMC, Hawryluck L, Azoulay E. Ten areas for ICU clinicians to be aware of to help retain nurses in the ICU. Crit Care. 2022 Oct 13;26(1):310. doi: 10.1186/s13054-022-04182-y. PMID: 36229859.
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Show Notes: Coming Soon!
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Citation:
National Heart, Lung, and Blood Institute Prevention and Early Treatment of Acute Lung Injury Clinical Trials Network; Shapiro NI, Douglas IS, Brower RG, Brown SM, Exline MC, Ginde AA, Gong MN, Grissom CK, Hayden D, Hough CL, Huang W, Iwashyna TJ, Jones AE, Khan A, Lai P, Liu KD, Miller CD, Oldmixon K, Park PK, Rice TW, Ringwood N, Semler MW, Steingrub JS, Talmor D, Thompson BT, Yealy DM, Self WH. Early Restrictive or Liberal Fluid Management for Sepsis-Induced Hypotension. N Engl J Med. 2023 Jan 21. doi: 10.1056/NEJMoa2212663. Epub ahead of print. PMID: 36688507.
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Show Notes: eddyjoemd.com/hello-2023/
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Evaluation of patients with Cardiogenic Shock. Why do we need a swan, introduction to CPO, PAPi and survival rates in these critically ill patients
Show Notes: https://eddyjoemd.com/cardiogenic-shock-mcs/
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Evaluation of patients with Cardiogenic Shock. Part two of who knows how many episodes I will create on this topic. In this episode I discuss the stages and prognosis based on the staging.
Show Notes: https://eddyjoemd.com/cardiogenic-shock-mcs/
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Evaluation of patients with Cardiogenic Shock. Part one of who knows how many episodes I will create on this topic. Definition, Clinical Manifestations, Phenotypes and an Introduction to Management Strategies
Show Notes: https://eddyjoemd.com/cardiogenic-shock-mcs/
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How should we provide IV fluids to patient with acute pancreatitis? Let's look at a recent paper in the NEJM that helps with rate & duration.
Show Notes: http://eddyjoemd.com/fluids-pancreatitis/
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Citation:
de-Madaria E, Buxbaum JL, Maisonneuve P, García García de Paredes A, Zapater P, Guilabert L, Vaillo-Rocamora A, Rodríguez-Gandía MÁ, Donate-Ortega J, Lozada-Hernández EE, Collazo Moreno AJR, Lira-Aguilar A, Llovet LP, Mehta R, Tandel R, Navarro P, Sánchez-Pardo AM, Sánchez-Marin C, Cobreros M, Fernández-Cabrera I, Casals-Seoane F, Casas Deza D, Lauret-Braña E, Martí-Marqués E, Camacho-Montaño LM, Ubieto V, Ganuza M, Bolado F; ERICA Consortium. Aggressive or Moderate Fluid Resuscitation in Acute Pancreatitis. N Engl J Med. 2022 Sep 15;387(11):989-1000. doi: 10.1056/NEJMoa2202884. PMID: 36103415.
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Should we use milrinone or dobutamine in patients in cardiogenic shock? NEJM published data providing us with the answer.
Show Notes: https://eddyjoemd.com/milrinone-dobutamine/
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Citation: Mathew R, Di Santo P, Jung RG, Marbach JA, Hutson J, Simard T, Ramirez FD, Harnett DT, Merdad A, Almufleh A, Weng W, Abdel-Razek O, Fernando SM, Kyeremanteng K, Bernick J, Wells GA, Chan V, Froeschl M, Labinaz M, Le May MR, Russo JJ, Hibbert B. Milrinone as Compared with Dobutamine in the Treatment of Cardiogenic Shock. N Engl J Med. 2021 Aug 5;385(6):516-525. doi: 10.1056/NEJMoa2026845. PMID: 34347952.
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Do Cardiogenic Shock Pts Need a Swan-Ganz/Pulmonary Artery Catheter? Let's look at the data. Let's also look at the devices such as pulse-contour analysis and bioreactance to see if they could replace the PA catheter in the management of cardiogenic shock.
Show Notes: https://eddyjoemd.com/cardiogenic-shock-swan/
Mechanical Circulatory Support Notes: https://eddyjoemd.com/cardiogenic-shock-mcs/
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Pulmonary Artery Pulsatility Index (PAPi) is a hemodynamic parameter with prognostic value in pts w/right heart failure & cardiogenic shock.
Show Notes: https://eddyjoemd.com/papi/
Citations:
Lim HS, Gustafsson F. Pulmonary artery pulsatility index: physiological basis and clinical application. Eur J Heart Fail. 2020 Jan;22(1):32-38. doi: 10.1002/ejhf.1679. Epub 2019 Nov 28. PMID: 31782244.
Škulec R, Parizek T, Stadlerova B, Bilska M, Cerny V. Subcostal TAPSE measured by anatomical M-mode: prospective reliability clinical study in critically ill patients. Minerva Anestesiol. 2021 Nov;87(11):1200-1208. doi: 10.23736/S0375-9393.21.15464-1. Epub 2021 May 13. PMID: 33982987.
Modin D, Møgelvang R, Andersen DM, Biering-Sørensen T. Right Ventricular Function Evaluated by Tricuspid Annular Plane Systolic Excursion Predicts Cardiovascular Death in the General Population. J Am Heart Assoc. 2019 May 21;8(10):e012197. doi: 10.1161/JAHA.119.012197. PMID: 31088196; PMCID: PMC6585329.
Korabathina R, Heffernan KS, Paruchuri V, Patel AR, Mudd JO, Prutkin JM, Orr NM, Weintraub A, Kimmelstiel CD, Kapur NK. The pulmonary artery pulsatility index identifies severe right ventricular dysfunction in acute inferior myocardial infarction. Catheter Cardiovasc Interv. 2012 Oct 1;80(4):593-600. doi: 10.1002/ccd.23309. Epub 2012 Jan 10. PMID: 21954053.
Morine KJ, Kiernan MS, Pham DT, Paruchuri V, Denofrio D, Kapur NK. Pulmonary Artery Pulsatility Index Is Associated With Right Ventricular Failure After Left Ventricular Assist Device Surgery. J Card Fail. 2016 Feb;22(2):110-6. doi: 10.1016/j.cardfail.2015.10.019. Epub 2015 Nov 10. PMID: 26564619.
Kang G, Ha R, Banerjee D. Pulmonary artery pulsatility index predicts right ventricular failure after left ventricular assist device implantation. J Heart Lung Transplant. 2016 Jan;35(1):67-73. doi: 10.1016/j.healun.2015.06.009. Epub 2015 Jun 17. Erratum in: J Heart Lung Transplant. 2017 Nov;36(11):1272. PMID: 26212656.
Kapur NK, Esposito ML, Bader Y, Morine KJ, Kiernan MS, Pham DT, Burkhoff D. Mechanical Circulatory Support Devices for Acute Right Ventricular Failure. Circulation. 2017 Jul 18;136(3):314-326. doi: 10.1161/CIRCULATIONAHA.116.025290. PMID: 28716832.
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Should we provide our DKA patients with sodium bicarbonate (bicarb) pushes or drips to improve their pH? Let's look at the data.
Show Notes: https://eddyjoemd.com/bicarb-dka/
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When you're taking one of those automated blood pressure measurements on an oscillometric device, you should trust the MAP.
Show Notes: https://eddyjoemd.com/oscillometric-map/
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The European Respiratory Society has provided 8 conditional recommendations for the use of nasal high flow/high flow nasal cannula/high flow oxygen/whatever you want to call it. Here, I review the 8 recommendations and add some commentary on them.
Show Notes: https://eddyjoemd.com/high-flow/
Citation:
Oczkowski S, Ergan B, Bos L, Chatwin M, Ferrer M, Gregoretti C, Heunks L, Frat JP, Longhini F, Nava S, Navalesi P, Ozsancak Uğurlu A, Pisani L, Renda T, Thille AW, Winck JC, Windisch W, Tonia T, Boyd J, Sotgiu G, Scala R. ERS clinical practice guidelines: high-flow nasal cannula in acute respiratory failure. Eur Respir J. 2022 Apr 14;59(4):2101574. doi: 10.1183/13993003.01574-2021. PMID: 34649974.
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Is intermittent fasting (time-restricted-eating) with a calorie restriction better than just a calorie restriction?
Show Notes: https://eddyjoemd.com/intermittent-fasting/
Citation:
Liu D, Huang Y, Huang C, Yang S, Wei X, Zhang P, Guo D, Lin J, Xu B, Li C, He H, He J, Liu S, Shi L, Xue Y, Zhang H. Calorie Restriction with or without Time-Restricted Eating in Weight Loss. N Engl J Med. 2022 Apr 21;386(16):1495-1504. doi: 10.1056/NEJMoa2114833. PMID: 35443107.
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Aspirin has been thoroughly studied for patients with COVID-19. This study is a positive trial suggesting benefits to using it. But should we? Let's interpret the data given recent advancements.
Show Notes: https://eddyjoemd.com/aspirin-covid/
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
Citation:
Hawkins K, Jackson AM, Quintana MT, Lankford AS, Keneally RJ, Al-Mashat M, Fisher D, Williams J, Berger JS, Mazzeffi MA, Crandall KA; N3C Consortium and ANCHOR Investigators. Association of Early Aspirin Use With In-Hospital Mortality in Patients With Moderate COVID-19. JAMA Netw Open. 2022 Mar 1;5(3):e223890. doi: 10.1001/jamanetworkopen.2022.3890. PMID: 35323950; PMCID: PMC8948531.
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In patients who are immunocompromised, we must determine whether using high flow oxygen (HFNC/NHF/HFO) or NIV would better serve our patients
Show Notes: https://eddyjoemd.com/high-flow-immunocompromised/
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Citation:
Bourenne J, Girault C, Vinsonneau C, Dellamonica J, Labro G, Jochmans S, Herbland A, Quenot JP, Devaquet J, Benzekri D, Vivier E, Nseir S, Colin G, Thevenin D, Grasselli G, Bougon D, Assefi M, Guérin C, Lherm T, Kouatchet A, Ragot S, Thille AW; FLORALI-IM study group and the REVA Research Network. High-flow nasal oxygen alone or alternating with non-invasive ventilation in critically ill immunocompromised patients with acute respiratory failure: a randomised controlled trial. Lancet Respir Med. 2022 Mar 21:S2213-2600(22)00096-0. doi: 10.1016/S2213-2600(22)00096-0. Epub ahead of print. PMID: 35325620.
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Should we be considering tPA (alteplase) as a last-ditch effort to try to improve oxygenation in our COVID-19 patients?
Show Notes: https://eddyjoemd.com/tpa-covid/
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Citation:
Barrett CD, Moore HB, Moore EE, Wang J, Hajizadeh N, Biffl WL, Lottenberg L, Patel PR, Truitt MS, McIntyre RC Jr, Bull TM, Ammons LA, Ghasabyan A, Chandler J, Douglas IS, Schmidt EP, Moore PK, Wright FL, Ramdeo R, Borrego R, Rueda M, Dhupa A, McCaul DS, Dandan T, Sarkar PK, Khan B, Sreevidya C, McDaniel C, Grossman Verner HM, Pearcy C, Anez-Bustillos L, Baedorf-Kassis EN, Jhunjhunwala R, Shaefi S, Capers K, Banner-Goodspeed V, Talmor DS, Sauaia A, Yaffe MB. Study of Alteplase for Respiratory Failure in SARS-CoV-2 COVID-19: A Vanguard Multicenter, Rapidly Adaptive, Pragmatic, Randomized Controlled Trial. Chest. 2022 Mar;161(3):710-727. doi: 10.1016/j.chest.2021.09.024. Epub 2021 Sep 27. PMID: 34592318; PMCID: PMC8474873.
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Should we use rapid shallow breathing index (RSBI) in isolation or in conjunction with other parameters to predict extubation success?
Show Notes: https://eddyjoemd.com/rsbi/
GoodRx Link: https://goodrx.onelink.me/1153955910/x52sjptq
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Citations:
Trivedi V, Chaudhuri D, Jinah R, Piticaru J, Agarwal A, Liu K, McArthur E, Sklar MC, Friedrich JO, Rochwerg B, Burns KEA. The Usefulness of the Rapid Shallow Breathing Index in Predicting Successful Extubation: A Systematic Review and Meta-analysis. Chest. 2022 Jan;161(1):97-111. doi: 10.1016/j.chest.2021.06.030. Epub 2021 Jun 26. PMID: 34181953.
Ouellette DR. The Decision to Liberate From the Ventilator: More Than Just a Number. Chest. 2022 Jan;161(1):6-7. doi: 10.1016/j.chest.2021.07.016. PMID: 35000708.
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Reviewing the data and guidelines to provide anticoagulation or VTE prophylaxis to our patients with COVID-19.
Show Notes: https://eddyjoemd.com/anticoagulation-covid/
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Moores LK, Tritschler T, Brosnahan S, Carrier M, Collen JF, Doerschug K, Holley AB, Iaccarino J, Jimenez D, LeGal G, Rali P, Wells P, Thromboprophylaxis in Patients with COVID-19. A Brief Update to the CHEST Guideline and Expert Panel Report, CHEST (2022), doi:https://doi.org/10.1016/j.chest.2022.02.006.
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Show Notes: https://eddyjoemd.com/expectations/
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Ji Y, Fang Y, Cheng B, Li L, Fang X. Tracheostomy timing and clinical outcomes in ventilated COVID-19 patients: a systematic review and meta-analysis. Crit Care. 2022 Feb 8;26(1):40. doi: 10.1186/s13054-022-03904-6. PMID: 35135597; PMCID: PMC8822732.
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Are you annoyed when the clinician orders two sets of blood cultures for your patient? Let's look at why you have to do two and 20ml's.
Show Notes: https://eddyjoemd.com/blood-cultures/
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In this podcast I cover lactate levels (aka lactic acid levels) sorting out the original data as to why we check it on every patient with sepsis or septic shock upon arrival to the ED, how it is associated with mortality, and how trending it could provide insight to the prognosis of our patients.
Show Notes: https://eddyjoemd.com/lactic-acid-sepsis/
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Citations:
Spiegel R, Gordon D, Marik PE. The origins of the Lacto-Bolo reflex: the mythology of lactate in sepsis. J Thorac Dis. 2020 Feb;12(Suppl 1):S48-S53. doi: 10.21037/jtd.2019.11.48. PMID: 32148925; PMCID: PMC7024759.
Mikkelsen ME, Miltiades AN, Gaieski DF, Goyal M, Fuchs BD, Shah CV, Bellamy SL, Christie JD. Serum lactate is associated with mortality in severe sepsis independent of organ failure and shock. Crit Care Med. 2009 May;37(5):1670-7. doi: 10.1097/CCM.0b013e31819fcf68. PMID: 19325467.
Nguyen HB, Rivers EP, Knoblich BP, Jacobsen G, Muzzin A, Ressler JA, Tomlanovich MC. Early lactate clearance is associated with improved outcome in severe sepsis and septic shock. Crit Care Med. 2004 Aug;32(8):1637-42. doi: 10.1097/01.ccm.0000132904.35713.a7. PMID: 15286537.
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Are the vaccine mandates that are seen around the world today evidence based? Based on these data, it appears that they are not.
Show Notes: https://eddyjoemd.com/vaccine-mandate/
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Reviewing a recently published article on Cardiac Injury in COVID-19 that was published in the Intensive Care Medicine Journal by Julie Helms, Alain Combes and Nadia Aissaoui.
Show Notes: https://eddyjoemd.com/foamed
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Citation: Helms J, Combes A, Aissaoui N. Cardiac injury in COVID-19. Intensive Care Med. 2022 Jan;48(1):111-113. doi: 10.1007/s00134-021-06555-3. Epub 2021 Nov 2. PMID: 34727214; PMCID: PMC8562019.
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Many people often ask me how I stay up to date with the most recent literature in Critical Care Medicine. This podcast will hopefully explain this.
Show Notes: https://eddyjoemd.com/up-to-date-critical-care/
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The PLUS Trial compared plasma-lyte to 0.9% NaCl (aka normal saline) in patients who were critically ill and needed IV fluids.
Show Notes: https://eddyjoemd.com/plus-trial/
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Citation: Finfer S, Micallef S, Hammond N, Navarra L, Bellomo R, Billot L, Delaney A, Gallagher M, Gattas D, Li Q, Mackle D, Mysore J, Saxena M, Taylor C, Young P, Myburgh J; PLUS Study Investigators and the Australian and New Zealand Intensive Care Society Clinical Trials Group. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. N Engl J Med. 2022 Jan 18. doi: 10.1056/NEJMoa2114464. Epub ahead of print. PMID: 35041780.
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A new study is showing that we should add vasopressin and methylprednisolone to our ACLS protocols as it helps patients achieve ROSC faster. Should they be standard of care?
Show Notes: https://eddyjoemd.com/vasopressin-methylprednisolone/
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Citations:
Andersen LW, Isbye D, Kjærgaard J, Kristensen CM, Darling S, Zwisler ST, Fisker S, Schmidt JC, Kirkegaard H, Grejs AM, Rossau JRG, Larsen JM, Rasmussen BS, Riddersholm S, Iversen K, Schultz M, Nielsen JL, Løfgren B, Lauridsen KG, Sølling C, Pælestik K, Kjærgaard AG, Due-Rasmussen D, Folke F, Charlot MG, Jepsen RMHG, Wiberg S, Donnino M, Kurth T, Høybye M, Sindberg B, Holmberg MJ, Granfeldt A. Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA. 2021 Oct 26;326(16):1586-1594. doi: 10.1001/jama.2021.16628. PMID: 34587236; PMCID: PMC8482303.
Haukoos J, Douglas IS, Sasson C. Vasopressin and Steroids as Adjunctive Treatment for In-Hospital Cardiac Arrest. JAMA. 2021 Oct 26;326(16):1583-1585. doi: 10.1001/jama.2021.15460. Erratum in: JAMA. 2021 Nov 9;326(18):1874. PMID: 34587235.
Holmberg MJ, Granfeldt A, Mentzelopoulos SD, Andersen LW. Vasopressin and glucocorticoids for in-hospital cardiac arrest: A systematic review and meta-analysis of individual participant data. Resuscitation. 2022 Jan 3;171:48-56. doi: 10.1016/j.resuscitation.2021.12.030. Epub ahead of print. PMID: 34990764.
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Could atorvastatin (lipitor) help improve outcomes in our COVID patients who are in the ICU? Let's review the evidence from this trial.
Show Notes: https://eddyjoemd.com/atorvastatin-covid/
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Citation: MJ. 2022 Jan 7;376:e068407. doi: 10.1136/bmj-2021-068407. PMID: 34996756.
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Traditionally, we do not cannulate patients for VV-ECMO if they've been on invasive mechanical ventilation for more than 7 days. These new data say we should allow for a bit more grace.
Show Notes: https://eddyjoemd.com/ecmo/
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Citation: Hermann M, Laxar D, Krall C, Hafner C, Herzog O, Kimberger O, Koenig S, Kraft F, Maleczek M, Markstaller K, Robak O, Rössler B, Schaden E, Schellongowski P, Schneeweiss-Gleixner M, Staudinger T, Ullrich R, Wiegele M, Willschke H, Zauner C, Hermann A. Duration of invasive mechanical ventilation prior to extracorporeal membrane oxygenation is not associated with survival in acute respiratory distress syndrome caused by coronavirus disease 2019. Ann Intensive Care. 2022 Jan 13;12(1):6. doi: 10.1186/s13613-022-00980-3. PMID: 35024972; PMCID: PMC8755897.
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The following are my resolutions for the year 2022 with regards to my educational and social media endeavors to bring you all the best.
Show Notes: https://eddyjoemd.com/2022-resolutions/
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Obesity is a risk factor for COVID that we are not hearing enough about. It is a modifiable risk factor that should be addressed.
Show Notes: https://eddyjoemd.com/obesity-covid/
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Anderson MR, Shashaty MGS. Impact of Obesity in Critical Illness. Chest. 2021 Aug 5;160(6):2135–45. doi: 10.1016/j.chest.2021.08.001. Epub ahead of print. PMID: 34364868; PMCID: PMC8340548.
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When a patient has an acidosis which is respiratory in nature, the right answer should not include using sodium bicarbonate.
Show Notes: https://eddyjoemd.com/bicarbonate-respiratory-acidosis/
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Patient is hypotensive and in need of a fluid bolus resuscitation. Do you place the fluids in a pressure bag or IV Pump?
Show Notes: https://eddyjoemd.com/fluid-bolus/
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Pfizer has a new therapeutic Paxlovid (PF-07321332/ritonavir) to help patients stay out of the hospital. Is the cost worth the potential benefit?
Show Notes: https://eddyjoemd.com/paxlovid
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Fluvoxamine was shown in the RCT to decrease the risk of hospitalization in high-risk patients.
Show Notes: https://eddyjoemd.com/fluvoxamine/
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People tend to think that 1L of intravenous fluids (IVF) provided means that the patient retains that amount of fluid intravascularly. This is false. Here's some data to prove this.
Show Notes: https://eddyjoemd.com/fluid-resuscitation/
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
Citation: Lobo DN, Stanga Z, Aloysius MM, Wicks C, Nunes QM, Ingram KL, Risch L, Allison SP. Effect of volume loading with 1 liter intravenous infusions of 0.9% saline, 4% succinylated gelatine (Gelofusine) and 6% hydroxyethyl starch (Voluven) on blood volume and endocrine responses: a randomized, three-way crossover study in healthy volunteers. Crit Care Med. 2010 Feb;38(2):464-70. doi: 10.1097/CCM.0b013e3181bc80f1. PMID: 19789444.
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There are various means that we can use to determine fluid/volume responsiveness in our critically ill patients. These include PLR with SV changes, SVV, PPV, VTI, etc. End-expiratory occlusion testing can be performed on patients who are on mechanical ventilation.
Show Notes:https://eddyjoemd.com/end-expiratory-occlusion/
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Cardiac arrest with no IV access: Should we place a peripheral IV or place an intraosseous (IO) access? Let's examine the data. #shorts
Show Notes: https://eddyjoemd.com/io-or-iv
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Citation: Schwalbach KT, Yong SS, Chad Wade R, Barney J. Impact of intraosseous versus intravenous resuscitation during in-hospital cardiac arrest: A retrospective study. Resuscitation. 2021 Sep;166:7-13. doi: 10.1016/j.resuscitation.2021.07.005. Epub 2021 Jul 14. PMID: 34273470.
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Molnupiravir is a potent ribonucleoside analog that inhibits the replication of SARS-CoV-2 made by Merck that helps COVID patients.
Show Notes:https://eddyjoemd.com/molnupiravir/
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Why is pregnancy associated with more severe forms of COVID-19? Looking at the data to learn why we need to protect our pregnant loved ones.
Show Notes:https://eddyjoemd.com/pregnancy-covid/
Link to CDC report: https://emergency.cdc.gov/han/2021/han00453.asp
Link to 70% Increase Source Material: https://www.cdc.gov/mmwr/volumes/69/wr/pdfs/mm6944e3-H.pdf
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Why is pregnancy associated with more severe forms of COVID-19? Looking at the data to learn why we need to protect our pregnant loved ones.
Show Notes:https://eddyjoemd.com/pregnancy-covid/
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Baricitinib is a Janus kinase 1/2 inhibitor the has been shown to decrease mortality in COVID-19 patients who are on HFNC or NIV.
Show Notes:https://eddyjoemd.com/baricitinib-covid/
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Citation: RECOVERY Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial. Lancet. 2021 May 1;397(10285):1637-1645. doi: 10.1016/S0140-6736(21)00676-0. PMID: 33933206; PMCID: PMC8084355.
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Should we be proning COVID patients who are not intubated/spontaneously breathing? The short answer is yes. Prone positioning works. A hat tip to the authors!
Show Notes: https://eddyjoemd.com/proning-covid/
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Citation: Aguirre-Avalos G, Trump MW, Nay MA, Dellamonica J, Nseir S, Mogri I, Cosgrave D, Jayaraman D, Masclans JR, Laffey JG, Tavernier E; Awake Prone Positioning Meta-Trial Group. Awake prone positioning for COVID-19 acute hypoxaemic respiratory failure: a randomised, controlled, multinational, open-label meta-trial. Lancet Respir Med. 2021 Aug 20:S2213-2600(21)00356-8. doi: 10.1016/S2213-2600(21)00356-8. Epub ahead of print. PMID: 34425070; PMCID: PMC8378833.
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Do Proton Pump Inhibitors (PPI) help or harm patients with COVID-19? Let's take an evidence-based approach to evaluate the best approach.
Show Notes: https://eddyjoemd.com/ppi-covid/
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As an Intensivist taking care of critically ill COVID-19 patients on mechanical ventilation, I frequently set expectations for families. In this podcast, I review the third 5 of 15 things I usually discuss with the family members of patients who are the ventilator because of COVID-19.
Show Notes: https://eddyjoemd.com/expectations/
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As an Intensivist taking care of critically ill COVID-19 patients on mechanical ventilation, I frequently set expectations for families. In this podcast, I review the second 5 of 15 things I usually discuss with the family members of patients who are the ventilator because of COVID-19.
Show Notes: https://eddyjoemd.com/expectations/
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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As an Intensivist taking care of critically ill COVID-19 patients on mechanical ventilation, I frequently set expectations for families. In this podcast, I review the first 5 of 15 things I usually discuss with the family members of patients who are the ventilator because of COVID-19.
Show Notes: https://eddyjoemd.com/expectations/
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Taking apart the TTM2 trial looking at Hypothermia (33°C) versus Normothermia (37.5°C) after Out-of-Hospital Cardiac Arrest.
Show Notes: https://eddyjoemd.com/normothermia/
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Citations:
Nielsen N, Wetterslev J, Cronberg T, Erlinge D, Gasche Y, Hassager C, Horn J, Hovdenes J, Kjaergaard J, Kuiper M, Pellis T, Stammet P, Wanscher M, Wise MP, Åneman A, Al-Subaie N, Boesgaard S, Bro-Jeppesen J, Brunetti I, Bugge JF, Hingston CD, Juffermans NP, Koopmans M, Køber L, Langørgen J, Lilja G, Møller JE, Rundgren M, Rylander C, Smid O, Werer C, Winkel P, Friberg H; TTM Trial Investigators. Targeted temperature management at 33°C versus 36°C after cardiac arrest. N Engl J Med. 2013 Dec 5;369(23):2197-206. doi: 10.1056/NEJMoa1310519. Epub 2013 Nov 17. PMID: 24237006.
Lascarrou JB, Merdji H, Le Gouge A, Colin G, Grillet G, Girardie P, Coupez E, Dequin PF, Cariou A, Boulain T, Brule N, Frat JP, Asfar P, Pichon N, Landais M, Plantefeve G, Quenot JP, Chakarian JC, Sirodot M, Legriel S, Letheulle J, Thevenin D, Desachy A, Delahaye A, Botoc V, Vimeux S, Martino F, Giraudeau B, Reignier J; CRICS-TRIGGERSEP Group. Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. N Engl J Med. 2019 Dec 12;381(24):2327-2337. doi: 10.1056/NEJMoa1906661. Epub 2019 Oct 2. PMID: 31577396.
Dankiewicz J, Cronberg T, Lilja G, Jakobsen JC, Levin H, Ullén S, Rylander C, Wise MP, Oddo M, Cariou A, Bělohlávek J, Hovdenes J, Saxena M, Kirkegaard H, Young PJ, Pelosi P, Storm C, Taccone FS, Joannidis M, Callaway C, Eastwood GM, Morgan MPG, Nordberg P, Erlinge D, Nichol AD, Chew MS, Hollenberg J, Thomas M, Bewley J, Sweet K, Grejs AM, Christensen S, Haenggi M, Levis A, Lundin A, Düring J, Schmidbauer S, Keeble TR, Karamasis GV, Schrag C, Faessler E, Smid O, Otáhal M, Maggiorini M, Wendel Garcia PD, Jaubert P, Cole JM, Solar M, Borgquist O, Leithner C, Abed-Maillard S, Navarra L, Annborn M, Undén J, Brunetti I, Awad A, McGuigan P, Bjørkholt Olsen R, Cassina T, Vignon P, Langeland H, Lange T, Friberg H, Nielsen N; TTM2 Trial Investigators. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. N Engl J Med. 2021 Jun 17;384(24):2283-2294. doi: 10.1056/NEJMoa2100591. PMID: 34133859.
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Cardiac power output is a calculation one should do when caring for patients with cardiogenic shock. Data has shown it to be the strongest hemodynamic correlate of mortality in cardiogenic shock. We should be using it in our practice to determine whether a patient will benefit from mechanical circulatory support (MCS).
Show Notes: https://eddyjoemd.com/cardiogenic-shock-mcs/
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Citations:
Fincke R, Hochman JS, Lowe AM, Menon V, Slater JN, Webb JG, LeJemtel TH, Cotter G; SHOCK Investigators. Cardiac power is the strongest hemodynamic correlate of mortality in cardiogenic shock: a report from the SHOCK trial registry. J Am Coll Cardiol. 2004 Jul 21;44(2):340-8. doi: 10.1016/j.jacc.2004.03.060. PMID: 15261929.
Lim HS. Cardiac Power Output Revisited. Circ Heart Fail. 2020 Oct;13(10):e007393. doi: 10.1161/CIRCHEARTFAILURE.120.007393. Epub 2020 Sep 30. PMID: 32993372.
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What are the functional outcomes of our COVID-19 patients who end up in the ICU and then on mechanical ventilation? Something to consider...
Show Notes: https://eddyjoemd.com/icu-covid/
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Citations: Musheyev B, Borg L, Janowicz R, Matarlo M, Boyle H, Singh G, Ende V, Babatsikos I, Hou W, Duong TQ. Functional status of mechanically ventilated COVID-19 survivors at ICU and hospital discharge. J Intensive Care. 2021 Mar 31;9(1):31. doi: 10.1186/s40560-021-00542-y. PMID: 33789772.
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Double triggering of the ventilator in critically patients has long been suspected to lead to poor outcomes. New data has confirmed this.
Show Notes: https://eddyjoemd.com/double-triggering/
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Citations: Sousa, Mayson Laérciod e Araújo PT, PhD; Magrans, Rudys PhD; Hayashi, Fátima K. RRT, PhD; Blanch, Lluís MD, PhD; Kacmarek, Robert M. RRT, PhD; Ferreira, Juliana C. MD, PhD. Clusters of Double Triggering Impact Clinical Outcomes, Critical Care Medicine: April 21, 2021 - Volume Latest Articles - Issue - doi: 10.1097/CCM.0000000000005029
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Reviewing the evidence supporting the utilization of peripheral vasopressors to avoid central lines in the critically ill patients.
Show Notes: https://eddyjoemd.com/peripheral-vasopressors/
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Citations: Owen VS, Rosgen BK, Cherak SJ, Ferland A, Stelfox HT, Fiest KM, Niven DJ. Adverse events associated with administration of vasopressor medications through a peripheral intravenous catheter: a systematic review and meta-analysis. Crit Care. 2021 Apr 16;25(1):146. doi: 10.1186/s13054-021-03553-1. PMID: 33863361.
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Septic shock patients need some IV fluids for resuscitation, there's no argument about that. But there seems to be a tendency of proving too much IV fluids which can be deleterious to our patients as I will discuss in this podcast.
Show Notes: https://eddyjoemd.com/fluid-resuscitation
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Citations:
Malbrain MLNG, Van Regenmortel N, Saugel B, De Tavernier B, Van Gaal PJ, Joannes-Boyau O, Teboul JL, Rice TW, Mythen M, Monnet X. Principles of fluid management and stewardship in septic shock: it is time to consider the four D's and the four phases of fluid therapy. Ann Intensive Care. 2018 May 22;8(1):66. doi: 10.1186/s13613-018-0402-x. PMID: 29789983; PMCID: PMC5964054.
Chaudhuri D, Herritt B, Lewis K, Diaz-Gomez JL, Fox-Robichaud A, Ball I, Granton J, Rochwerg B. Dosing Fluids in Early Septic Shock. Chest. 2020 Oct 13:S0012-3692(20)34890-X. doi: 10.1016/j.chest.2020.09.269. Epub ahead of print. PMID: 33058814.
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An examination of the five reasons listed by a group of Italian physicians as to why COVID-19 patients die.
Show Notes: https://eddyjoemd.com/covid-death/
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Citation: Marilena Marmiere, Filippo D’Amico, Alberto Zangrillo, Giovanni Landoni. The five reasons why people die of COVID-19. Journal of Cardiothoracic and Vascular Anesthesia (2021). doi: https://doi.org/10.1053/j.jvca.2021.03.045
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When should we be intubating our COVID-19 patients? Soon upon arrival to the ICU or should we delay? This paper attempts to answer the clinical question we all have to find what is the optimal strategy to care for these patients and avoid their unfortunate demise.
Show Notes: https://eddyjoemd.com/intubation-timing/
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Citation: Papoutsi E, Giannakoulis VG, Xourgia E, Routsi C, Kotanidou A, Siempos II. Effect of timing of intubation on clinical outcomes of critically ill patients with COVID-19: a systematic review and meta-analysis of non-randomized cohort studies. Crit Care. 2021 Mar 25;25(1):121. doi: 10.1186/s13054-021-03540-6. PMID: 33766109.
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Median 37yo patients w/a median BMI of 26 were provided Ivermectin to see if it helped with their mild COVID-19 and it didn't. Big surprise.
Show Notes: https://eddyjoemd.com/ivermectin-covid19/
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Citation: López-Medina E, López P, Hurtado IC, et al. Effect of Ivermectin on Time to Resolution of Symptoms Among Adults With Mild COVID-19: A Randomized Clinical Trial. JAMA. Published online March 04, 2021. doi:10.1001/jama.2021.3071
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Is azithromycin use in the outpatient setting for COVID-19 beneficial for our patients? The latest data from The Lancet says no.
Show Notes: https://eddyjoemd.com/azithromycin-covid/
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Citation: coming soon!
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Should we be using indirect calorimetry to give our critically ill patients an edge to survive their insult that landed them in the ICU? This systematic review and meta-analysis suggests that we should!
Show Notes: https://eddyjoemd.com/icu-nutrition/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Duan JY, Zheng WH, Zhou H, Xu Y, Huang HB. Energy delivery guided by indirect calorimetry in critically ill patients: a systematic review and meta-analysis. Crit Care. 2021 Feb 27;25(1):88. doi: 10.1186/s13054-021-03508-6. PMID: 33639997.
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Should we be proning COVID patients who are not intubated/spontaneously breathing? The short answer is yes. Prone positioning works.
Show Notes: https://eddyjoemd.com/proning-covid/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Fazzini B, Fowler AJ, Zolfaghari P. Effectiveness of prone position in spontaneously breathing patients with COVID-19: A prospective cohort study. Journal of the Intensive Care Society. February 2021. doi:10.1177/1751143721996542
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I have admittedly zero clinical experience with angiotensin II/Giapreza. My colleague Rishi Kumar, MD explains how he uses Giapreza in his practice.
Check out Rishi's website: rk.md
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Check out his videos on YouTube: www.youtube.com/RishiKumarMD
Show Notes: https://eddyjoemd.com/vasopressors/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citations for Articles Discussed in the Podcast:
Khanna A, English SW, Wang XS, Ham K, Tumlin J, Szerlip H, Busse LW, Altaweel L, Albertson TE, Mackey C, McCurdy MT, Boldt DW, Chock S, Young PJ, Krell K, Wunderink RG, Ostermann M, Murugan R, Gong MN, Panwar R, Hästbacka J, Favory R, Venkatesh B, Thompson BT, Bellomo R, Jensen J, Kroll S, Chawla LS, Tidmarsh GF, Deane AM; ATHOS-3 Investigators. Angiotensin II for the Treatment of Vasodilatory Shock. N Engl J Med. 2017 Aug 3;377(5):419-430. doi: 10.1056/NEJMoa1704154. Epub 2017 May 21. PMID: 28528561.
Wieruszewski PM, Wittwer ED, Kashani KB, Brown DR, Butler SO, Clark AM, Cooper CJ, Davison DL, Gajic O, Gunnerson KJ, Tendler R, Mara KC, Barreto EF. Angiotensin II Infusion for Shock: A Multicenter Study of Postmarketing Use. Chest. 2021 Feb;159(2):596-605. doi: 10.1016/j.chest.2020.08.2074. Epub 2020 Aug 31. PMID: 32882250.
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Reviewing a new article published in this month's issue of CHEST looking at the safety and effectiveness of angiotensin II in patients with shock of differing etiologies.
Show Notes: https://eddyjoemd.com/vasopressors/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Wieruszewski PM, Wittwer ED, Kashani KB, Brown DR, Butler SO, Clark AM, Cooper CJ, Davison DL, Gajic O, Gunnerson KJ, Tendler R, Mara KC, Barreto EF. Angiotensin II Infusion for Shock: A Multicenter Study of Postmarketing Use. Chest. 2021 Feb;159(2):596-605. doi: 10.1016/j.chest.2020.08.2074. Epub 2020 Aug 31. PMID: 32882250.
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Looking at the new (and old) Choosing Wisely recommendations for critical care patients who are in the Intensive Care Unit (ICU).
Show Notes: https://eddyjoemd.com/choosing-wisely/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Zimmerman JJ, Harmon LA, Smithburger PL, Chaykosky D, Heffner AC, Hravnak M, Kane JM, Kayser JB, Lane-Fall MB, Matos RI, Mauricio RV, Murphy DJ, Nurok M, Reddy AJ, Ringle E, Seferian EG, Smalls-Mantey NM, To KB, Kaplan LJ. Choosing Wisely For Critical Care: The Next Five. Crit Care Med. 2021 Jan 28. doi: 10.1097/CCM.0000000000004876. Epub ahead of print. PMID: 33555779.
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Looking at using mild hypothermia (34°C) to decrease inflammation and mitigate the coagulopathy (amongst other benefits) in our COVID-19 patients.
Show Notes: https://eddyjoemd.com/covid-hypothermia/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Raul dos Reis Ururahy, Marcelo Park, Cheap and simple, could it get even cooler? Mild hypothermia and COVID-19, Journal of Critical Care, 2021,ISSN 0883-9441, https://doi.org/10.1016/j.jcrc.2021.01.009.
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Analyzing the RECOVERY analysis of Tocilizumab in COVID-19 patients. Is it time to put it back into the arsenal after several failed trials? Hat tip to the authors.
Show Notes: www.eddyjoemd.com/tocilizumab-recovery
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): preliminary results of a randomised, controlled, open-label, platform trialPeter W Horby, Mark Campbell, Natalie Staplin, Enti Spata, Jonathan R Emberson, Guilherme Pessoa-Amorim, Leon Peto, Christopher E Brightling, Rahuldeb Sarkar, Koshy Thomas, Vandana Jeebun, Abdul Ashish, Redmond Tully, David Chadwick, Muhammad Sharafat, Richard Stewart, Banu Rudran, J Kenneth Baillie, Maya H Buch, Lucy C Chappell, Jeremy N Day, Saul N Furst, Thomas Jaki, Katie Jeffery, EdmundJuszczak, Wei Shen Lim, Alan Montgomery, Andrew Mumford, Kathryn Rowan, GuyThwaites, Marion Mafham, Richard Haynes, Martin J LandraymedRxiv 2021.02.11.21249258; doi:https://doi.org/10.1101/2021.02.11.21249258
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Does colchicine work for COVID-19 patients in the outpatient setting? Let's closely examine the COLCORONA study out of Canada which has NOT been yet peer-reviewed to see what the hype is all about.
Show Notes: https://eddyjoemd.com/colchicine-covid/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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I really can't believe that this is the 50th episode of the Saving Lives Podcast. It feels like I only started it yesterday which is partly true. I started it back in late September. I would like to thank you all for your support as I work through the kinks of this podcasting business.
Show Notes: https://eddyjoemd.com/saving-lives-50/
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Show Notes: https://eddyjoemd.com/covid-vaccine/
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Hypercapnic respiratory failure happens occurs often in patients on mechanical ventilation. How could we go about fixing this and should we?
Show Notes: https://eddyjoemd.com/hypercapnia
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Tiruvoipati R, Gupta S, Pilcher D, Bailey M. Management of hypercapnia in critically ill mechanically ventilated patients—A narrative review of literature. Journal of the Intensive Care Society. 2020;21(4):327-333.
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Can we use non-invasive ventilation (NIV/BiPAP/BPAP) to improve outcomes acute severe asthma exacerbations in patients? Looking at evidence from this very recently published paper.
Show Notes: https://eddyjoemd.com/niv-asthma
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Althoff MD, Holguin F, Yang F, Grunwald GK, Moss M, Vandivier RW, Ho PM, Kiser TH, Burnham EL. Noninvasive Ventilation Use in Critically Ill Patients with Acute Asthma Exacerbations. Am J Respir Crit Care Med. 2020 Dec 1;202(11):1520-1530. doi: 10.1164/rccm.201910-2021OC. PMID: 32663410; PMCID: PMC7706169.
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Can we use high flow nasal cannula (HFNC/HFO/NHF) devices to manage acute severe asthma exacerbations in patients? Looking at evidence.
Show Notes: https://eddyjoemd.com/high-flow-asthma/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Ruangsomboon O, Limsuwat C, Praphruetkit N, Monsomboon A, Chakorn T. Nasal High Flow Oxygen Versus Conventional Oxygen Therapy for Acute Severe Asthma Patients: A Pilot Randomized Controlled Trial. Acad Emerg Med. 2020 Nov 30. doi: 10.1111/acem.14187. Epub ahead of print. PMID: 33258213.
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This is meant to encourage you to pursue a career in the many branches of Critical Care Medicine, whether you're a physician, NP, PA, or nurse. I love my job/career and I love my team. I would love it if you had the same career satisfaction as well. These are my opinions and I could be wrong.
Show Notes: https://eddyjoemd.com/yes-critical-care/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This is meant to encourage you to pursue a career in the many branches of Critical Care Medicine, whether you're a physician, NP, PA, or nurse. I love my job/career and I love my team. I would love it if you had the same career satisfaction as well. These are my opinions and I could be wrong.
Show Notes: https://eddyjoemd.com/yes-critical-care/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Convalescent Plasma did not quite pan out the way we all wish it did in this study (PlasmAr) published today in the New England Journal of Medicine
Show Notes: www.eddyjoemd.com/conplas
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Simonovich VA, Burgos Pratx LD, Scibona P, Beruto MV, Vallone MG, Vázquez C, Savoy N, Giunta DH, Pérez LG, Sánchez MDL, Gamarnik AV, Ojeda DS, Santoro DM, Camino PJ, Antelo S, Rainero K, Vidiella GP, Miyazaki EA, Cornistein W, Trabadelo OA, Ross FM, Spotti M, Funtowicz G, Scordo WE, Losso MH, Ferniot I, Pardo PE, Rodriguez E, Rucci P, Pasquali J, Fuentes NA, Esperatti M, Speroni GA, Nannini EC, Matteaccio A, Michelangelo HG, Follmann D, Lane HC, Belloso WH; PlasmAr Study Group. A Randomized Trial of Convalescent Plasma in Covid-19 Severe Pneumonia. N Engl J Med. 2020 Nov 24. doi: 10.1056/NEJMoa2031304. Epub ahead of print. PMID: 33232588.
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Mitigating errors and improving patient care in the transition of patients who are s/p cardiac surgery as they move from the cardiovascular operating room to the cardiovascular intensive care unit (CVICU).
Show Notes: www.eddyjoemd.com/cvicu
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Gleicher Y, Mosko JD, McGhee I. Improving cardiac operating room to intensive care unit handover using a standardised handover process. BMJ Open Qual. 2017;6(2):e000076. Published 2017 Nov 6. doi:10.1136/bmjoq-2017-000076
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Could a CBC w/diff tell us who's going to do poorly with COVID? Using the neutrophil to lymphocyte ratio could be quite helpful.
Show Notes: www.eddyjoemd.com/NLR
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Li, X., Liu, C., Mao, Z. et al. Predictive values of neutrophil-to-lymphocyte ratio on disease severity and mortality in COVID-19 patients: a systematic review and meta-analysis. Crit Care 24, 647 (2020). https://doi.org/10.1186/s13054-020-03374-8
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Looking into which fluids we should use to resuscitate our patients who are in Diabetic Ketoacidosis based on the findings of the SALT-ED and SMART trials.
Show Notes: www.eddyjoemd.com/ivf-guide
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Citation: Self WH, Evans CS, Jenkins CA, Brown RM, Casey JD, Collins SP, Coston TD, Felbinger M, Flemmons LN, Hellervik SM, Lindsell CJ, Liu D, McCoin NS, Niswender KD, Slovis CM, Stollings JL, Wang L, Rice TW, Semler MW; Pragmatic Critical Care Research Group. Clinical Effects of Balanced Crystalloids vs Saline in Adults With Diabetic Ketoacidosis: A Subgroup Analysis of Cluster Randomized Clinical Trials. JAMA Netw Open. 2020 Nov 2;3(11):e2024596. doi: 10.1001/jamanetworkopen.2020.24596. PMID: 33196806.
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The ROX index is defined as the ratio of oxygen saturation as measured by pulse oximetry (SpO2)/FIO2 to respiratory rate (RR). It stands for Respiratory rate - OXygenation. ROX ≥ 4.88 at 2, 6, and 12 hours means they're likely in the safe zone. ROX < 2.85 at 2 hours, ROX < 3.47 at 6 hours, ROX < 3.85 at 12 hours means the patient likely needs to be intubated.
Show Notes: www.eddyjoemd.com/rox
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Fluvoxamine is an SSRI that may improve outcomes in COVID-19 when administered in the outpatient setting. This small trial published in JAMA two days ago looks into the positive effects of this therapy to prevent clinical worsening of patients with COVID.
Show Notes: https://eddyjoemd.com/fluvoxamine
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Lenze EJ, Mattar C, Zorumski CF, Stevens A, Schweiger J, Nicol GE, Miller JP, Yang L, Yingling M, Avidan MS, Reiersen AM. Fluvoxamine vs Placebo and Clinical Deterioration in Outpatients With Symptomatic COVID-19: A Randomized Clinical Trial. JAMA. 2020 Nov 12. doi: 10.1001/jama.2020.22760. Epub ahead of print. PMID: 33180097.
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Could Aspirin 81mg in COVID-19 patients help keep them off of mechanical ventilation, out of the ICU, and decrease mortality? Let's explore!
Show Notes: https://eddyjoemd.com/aspirin-covid/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Chow JH, Khanna AK, Kethireddy S, Yamane D, Levine A, Jackson AM, McCurdy MT, Tabatabai A, Kumar G, Park P, Benjenk I, Menaker J, Ahmed N, Glidewell E, Presutto E, Cain S, Haridasa N, Field W, Fowler JG, Trinh D, Johnson KN, Kaur A, Lee A, Sebastian K, Ulrich A, Peña S, Carpenter R, Sudhakar S, Uppal P, Fedeles BT, Sachs A, Dahbour L, Teeter W, Tanaka K, Galvagno SM, Herr DL, Scalea TM, Mazzeffi MA. Aspirin Use is Associated with Decreased Mechanical Ventilation, ICU Admission, and In-Hospital Mortality in Hospitalized Patients with COVID-19. Anesth Analg. 2020 Oct 21. doi: 10.1213/ANE.0000000000005292. Epub ahead of print. PMID: 33093359.
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Do COVID-19 patients who suffer a cardiac arrest in the hospital survive? Should we even attempt CPR on these COVID patients? We should.
Show Notes: https://eddyjoemd.com/cardiac-arrest-covid/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Shah, Priyank MD, MPH, FACC1; Smith, Hallie ABJ, MS; Olarewaju, Ayodeji MD; Jani, Yash MS; Cobb, Abigail MSN, FNP; Owens, Jack MD, MPH; Moore, Justin MPH, PhD; Chenna, Avantika MD; Hess, David MD. Is Cardiopulmonary Resuscitation Futile in Coronavirus Disease 2019 Patients Experiencing In-Hospital Cardiac Arrest?, Critical Care Medicine: October 21, 2020 - Volume Online First - Issue - doi: 10.1097/CCM.0000000000004736
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Criticalcarereviews.com
Criticalcarenow.com
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This is meant to encourage you to pursue a career in the many branches of Critical Care Medicine, whether you're a physician, NP, PA, or nurse. I love my job/career and I love my team. I would love it if you had the same career satisfaction as well. These are my opinions and I could be wrong.
Show Notes: https://eddyjoemd.com/yes-critical-care/
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This paper by Dr. Stoller out of the Cleveland Clinic published in CHEST several days ago caught my eye. It describes how developing and practicing medicine with emotional intelligence helps us in healthcare with "enhanced patient satisfaction, lower burnout, lower litigation risk, and enhanced leadership success". Let's take a deeper dive on this.
Show Notes: https://eddyjoemd.com/emotional-intelligence-icu
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Citation: Stoller JK, Leadership Essentials for the Chest Physician: Emotional Intelligence, CHEST (2020), doi: https://doi.org/10.1016/j.chest.2020.09.093.
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This is not meant to deter you from going into the many branches of Critical Care Medicine, whether you're a physician, NP, PA, or nurse. I love my job/career and I love my team. Rather to inform you of the challenges that you will have to deal with so that you're not blindsided.
Show Notes: https://eddyjoemd.com/not-critical-care/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This is not meant to deter you from going into the many branches of Critical Care Medicine, whether you're a physician, NP, PA, or nurse. I love my job/career and I love my team. Rather to inform you of the challenges that you will have to deal with so that you're not blindsided.
Show Notes: https://eddyjoemd.com/not-critical-care/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This is not meant to deter you from going into the many branches of Critical Care Medicine, whether you're a physician, NP, PA, or nurse. I love my job/career and I love my team. Rather to inform you of the challenges that you will have to deal with so that you're not blindsided.
Show Notes: https://eddyjoemd.com/not-critical-care/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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When patients have hypokalemia, you want to fix it. So you give potassium to make the numbers pretty. You go ahead and give some potassium and do what the protocol says to do: recheck. Labs come back, poor patient got stuck for these labs. Potassium burned a bit on the way in because the IV was acting funny. Low and behold, the potassium did not go up. What just happened? Where did it go? Did you check the magnesium level? Probably not.
Show Notes: https://eddyjoemd.com/hypokalemia-magnesium/Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Huang CL, Kuo E. Mechanism of hypokalemia in magnesium deficiency. J Am Soc Nephrol. 2007;18(10):2649-2652. doi:10.1681/ASN.2007070792
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Can we wean patients off of vasopressors faster by providing them with Midodrine? The MIDAS trial (Effect of midodrine versus placebo on time to vasopressor discontinuation in patients with persistent hypotension in the intensive care unit) published on September 3rd, 2020 is a randomized-controlled trial looking at this question.
Show Notes: https://eddyjoemd.com/midodrine/Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Santer, P., Anstey, M.H., Patrocínio, M.D. et al. Effect of midodrine versus placebo on time to vasopressor discontinuation in patients with persistent hypotension in the intensive care unit (MIDAS): an international randomised clinical trial. Intensive Care Med (2020). https://doi.org/10.1007/s00134-020-06216-x
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Providing Calcifediol (25-hydroxyvitamin D3) to COVID patients in this Pilot Study showed that it decreased the need for transfer to the intensive care unit. Let's take a look at why we shouldn't exactly put it in the water... yet.
Show Notes: https://eddyjoemd.com/vitamind-covid/Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation:
Castillo ME, Entrenas Costa LM, Vaquero Barrios JM, et al. "Effect of Calcifediol Treatment and best Available Therapy versus best Available Therapy on Intensive Care Unit Admission and Mortality Among Patients Hospitalized for COVID-19: A Pilot Randomized Clinical study" [published online ahead of print, 2020 Aug 29]. J Steroid Biochem Mol Biol. 2020;105751. doi:10.1016/j.jsbmb.2020.105751
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Ever wonder when you should pull the trigger and call in the ECMO team or your ECMO center to determine whether your patient who is in severe ARDS is a good candidate for venovenous ECMO? I review some suggested criteria published in CHEST.
Show Notes: www.eddyjoemd.com/ECMOReceive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Citation: Bullen EC, Teijeiro-Paradis R, Fan E. How I Select Which Patients With ARDS Should Be Treated With Venovenous Extracorporeal Membrane Oxygenation [published online ahead of print, 2020 Apr 21]. Chest. 2020;S0012-3692(20)30752-2. doi:10.1016/j.chest.2020.04.016
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Do you use Central Venous Pressure (CVP) to assess whether your patient is fluid responsive or not? What about volume status? Let's take a deep dive into the data to see whether this actually works or not.
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Reviewing the rationale behind checking for hypophosphatemia in patients who are critically ill in the intensive care unit (ICU) exploring the functions of phosphate, phosphate metabolism, as well as causes of hypophophatemia. Unfortunately, there isn't much randomized controlled study data about this.
Show Notes: www.eddyjoemd.com/hypophosphatemia
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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When should we discontinue contact and isolation precautions in COVID-19 patients who are hospitalized? Let's take a look at the CDC recommendations as of August 16th, 2020.
Show Notes: https://eddyjoemd.com/covid-precautions/
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Lecture 1 on my IV Fluid Series. In this podcast, I discuss how much fluid we keep intravascularly after resuscitation, as well as the history behind the creation of Normal Saline, Ringer's lactate/lactated ringers, Plasma-lyte and Normosol.
Show Notes:https://eddyjoemd.com/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Reviewing the trial published in JAMA on 8/21/2020 where they looked at the clinical outcomes of Remdesivir in Moderate COVID-19.
Show Notes: https://eddyjoemd.com/remdesivir/
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Early intubation or a trial of high-flow nasal cannula for COVID-19 patients? This retrospective analysis out of Emory assesses the outcomes from the different strategies.
Show Notes: https://eddyjoemd.com/intubation-covid/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
Disclosure: I am a consultant for a HFNC company. I did not receive any compensation for the podcast.
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Have you ever wondered why we don't give sodium bicarbonate to patients with a metabolic acidosis or a lactic acidosis? In this podcast I discuss the historical context of it and bring forth more recent data that may change the mind of the naysayers.
Show Notes: https://eddyjoemd.com/lactic-acid-sepsis
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Another day, another IV vitamin C trial. It appears as if the dust is settling a bit on all this. This paper will be known as the ACTS trial for Ascorbic acid, Corticosteroids and Thiamine in Septic shock. Before digging into the paper, though, I provide a bit of a biologic rationale as why these trials should improve outcomes.
Show notes: https://eddyjoemd.com/vitaminc/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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The ATESS trial looked at IV thiamine and vitamin C in septic shock patients. They enrolled patients early in 4 academic ED's in South Korea. Here, I break down the paper, give my opinions, and provide you all with some insight.
Show notes: https://eddyjoemd.com/vitaminc/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Every hear these terms thrown around and wondered what they meant? ScvO2, SvO2, mixed venous blood gas. I break down these confusing terms and provide examples of how one should interpret them in the critically ill patient.
Show Notes: https://eddyjoemd.com/scvo2svo2/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Diving into the world of mechanical circulatory support and right ventricular assist devices, I'd like to introduce you to the ProtekDuo. I learned about this device while creating a lecture titled "Cardiogenic Shock: Rise of the Machines". Chances are that you'll more likely than not be caring for a patient with one of these sooner rather than later. Better to familiarize yourself with it now.
Show Notes: https://eddyjoemd.com/protekduo/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
My website: www.eddyjoemd.comInstagram: www.instagram.com/eddyjoemdTwitter: www.twitter.com/eddyjoemdFacebook: www.facebook.com/eddyjoemdPodcast: https://anchor.fm/eddyjoemdMy Amazon store for resources you may find helpful: www.amazon.com/shop/eddyjoemd
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Could colchicine help keep patients out of the inflammatory phase of COVID-19 and help save lives? A quick look at the GRECCO-19 Trial out of Greece which was an open label trial looking at 105 patients with COVID and their outcomes.
Show Notes: https://eddyjoemd.com/colchicine-covid/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Should healthcare workers exposed to COVID take hydroxychloroquine to decreased their chances of contracting the virus? I take a dive into a journal article published in the New England Journal of Medicine that takes a look at this question.
Show Notes: https://eddyjoemd.com/hcq-prophylaxis/
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
My website: www.eddyjoemd.com
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Podcast: https://anchor.fm/eddyjoemd
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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An evaluation of the evidence to promote research looking at potential benefits of zinc administration to those who are critically ill with either bacterial or viral infections. Amongst things discuss include possible dosing, lab testing, defining zinc deficiencies, potential benefits for both viral as well as bacterial infections, and adverse effects.
Show notes: https://eddyjoemd.com/zinc-metabolic-resuscitation/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
My website: www.eddyjoemd.com
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Support this podcast: https://anchor.fm/eddyjoemd/support
We need help. Can we prevent getting sick with COVID by taking Vitamin C or even use it as an adjunctive therapy to help decrease severity in patients who have contracted COVID-19? Reviewing an article that investigates the rationale as to how this could potentially work to improve outcomes.
Show notes: https://eddyjoemd.com/vitamin-c-covid/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom. My website: www.eddyjoemd.com
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Podcast: https://anchor.fm/eddyjoemd
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Support this podcast: https://anchor.fm/eddyjoemd/support
The RECOVERY Collaborative Group out of the UK performed an open-label trial where they looked at the effects of IV or PO Dexamethasone in patients with COVID-19. In particular, they noted a mortality benefit. This does not mean, however, that we should be putting it in the water.
Show Notes: https://eddyjoemd.com/dexamethasone-covid/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Support this podcast: https://anchor.fm/eddyjoemd/support
In this podcast, we tackle the "Carbon Dioxide" level in the basic metabolic panel that everyone seems to call "Bicarbonate". We discuss why this naming issue and why it shouldn't change. In addition, we explore the accuracy of bicarb levels in blood gases and discuss how they're calculated.
Show Notes: https://eddyjoemd.com/carbon-dioxide-bicarbonate/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Ever have a patient who is on low dose norepinephrine or another vasopressor who you can't get out of the ICU solely for that reason? Have you tried to administer midodrine to increase their blood pressure? This podcast describes the FDA-approved as well as the off-label uses of midodrine, pharmacology data explained in english, dosing, side effects, and a little about the studies.
Show Notes: https://eddyjoemd.com/midodrine/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Support this podcast: https://anchor.fm/eddyjoemd/support
We need all the help we can get in the ICU to help save the lives of our patients with severe COVID-19. Could plasmapheresis/plasma exchange/PLEX be a helpful tool to improve outcomes? Let's explore this concept based on evidence based practices.
Show Notes: https://eddyjoemd.com/plasma-exchange-covid/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Time to start thinking outside the box to help treat our patients with COVID-19. In this podcast, I explore data from 4 articles on how using melatonin, with its anti-inflammatory and antioxidant properties could potentially help patients.
Show notes: https://eddyjoemd.com/melatonin-covid/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
My website: www.eddyjoemd.com
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Roche published a press release on 7/29/2020 reflecting the results of the COVACTA study where Actemra/tocilizumab did not improve clinical outcomes nor mortality in patients who had Severe COVID-19 Infections.
Show notes: https://eddyjoemd.com/tocilizumab-covacta/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
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Lots of excitement today over this recent article/video about hydroxychloroquine, azithromycin and zinc. We need to take a deep breath and review the literature. Turns out there's no data support that it does work and no data supporting that it doesn't work. Thank you for your support.
Link to the show notes: https://eddyjoemd.com/hydroxychloroquine-outpatient/
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Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Support this podcast: https://anchor.fm/eddyjoemd/support
Are you a pre-med, med student, or resident who is considering becoming a Critical Care Specialist (aka Intensivist)? This podcast explores the different routes you can pursue to achieve your dreams and aspirations. I break down the numerous types of programs and lengths of time spent training.
Link to the show notes: https://eddyjoemd.com/critical-care-fellowship/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
Couple quick corrections. Pediatric Critical Care fellowship is 3 years, not 2. Anesthesia-CC fellowship is 1 year, not 2. Thanks for Dr Siuba and Dr Kumar for correcting this for me.
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
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Podcast: https://anchor.fm/eddyjoemd
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This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Support this podcast: https://anchor.fm/eddyjoemd/support
In this podcast, I describe a day in my life as a Critical Care Doctor starting at the beginning of my shift through the end of it. I provide organizational tips as well as strategies to increase efficiency throughout the day.
Show notes: https://eddyjoemd.com/intensivist-a-day-in-the-life/
Receive a FREE audiobook (TWO for Amazon Prime members) with your FREE 30-day trial by using my link for Audible: CLICK HERE! You will be reminded when your trial is ending, by the way. 😉
If you want to watch the 2+ year old youtube video that was inspiration to this podcast, it's at https://youtu.be/ONwFUp-mDsA
My website: www.eddyjoemd.com
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Podcast: https://anchor.fm/eddyjoemd
My Amazon store for resources you may find helpful: www.amazon.com/shop/eddyjoemd
Although great care has been taken to ensure that the information in this podcast are accurate, eddyjoe, LLC shall not be held responsible or in any way liable for the continued accuracy of the information, or for any errors, omissions or inaccuracies, or for any consequences arising therefrom.
This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app
Support this podcast: https://anchor.fm/eddyjoemd/support