Howdy ho, campers! A pleasure as usual. Following the recent publication of the Extend Trial [1] on the NEJM, something became very clear to me: nothing is what it used to be with stroke management in the ED and ICU. For the past 3 years, new trials have really pushed the envelope of what is going to be considered gold standard treatment for future guidelines. So, without further ado, let’s check out some new evidence these past years have brought us.   The sun also rises For a while, researchers had a hard time finding which stroke patients would actually benefit from thrombectomy. Patie ..read more

    Last week I started watching a new tv show: CHERNOBYL from HBO. It was funny that some people were saying, hey, I want to see this show! No spoilers, ok? Maybe they didn’t know that the story was already concluded, and everybody else in the world knew the end. Just like HBO, I decided to bring back to life an old post, not because I’m lazy, although I am, but because new studies were recently launched (and they support my previous point of view). So, here we go: Once upon a time, there was a man called Don Quixote. He was a huge book fan, but life was not a big fan of him. One day he star ..read more

    Every paradigm shift needs a pinch or two of chaos. This wouldn’t be different in this situation when an unscrupulous critical care doctor from an underdeveloped country will tell you that our beloved oxygen can kill you. Of course, we know how much O2 is vital for us, ATP metabolizers, mitochondria’s addicts. On the other hand, O2 is used to propel rockets, so, perhaps it might not be the safest thing in the world. The thing is, most doctors do not consider O2 as a drug, which it is. And it’s not easy to go against the basic instinct we are taught since we were kids. Oxygen indiscriminat ..read more

    Hey guys! Long time since my last post here. Many things are happening right now: my quest for my doctoral degree is whitening my hair; my dear residents doing what they do better, being a pain in my ass (I love them!); Game of Thrones coming to its series finale. So, as you can see, priorities first! While reviewing some data from our blog accesses on the last year I felt the need to talk about a topic we haven’t addressed yet: FOAM (Free Open Access Meducation)! Yeah, we are enthusiasts in the FOAM initiative, but we haven’t had (yet) a place here at the blog to discuss this topic. So ..read more

  Since we’re on the mood of publishing ultrasound beginners material, we could not leave lung ultrasound aside. To be honest, if I had to choose one ultrasound ability, lung ultrasound (LUS) would be it. And I’ll tell you why: -It has a steep learning curve. -It can give A LOT of information in a few seconds. -You can use it to detect central line complications (pneumothorax, hemothorax). -It’s useful to guide procedures (thoracocentesis and pleural drainage). So, if you already lost some of your brain cells due to illegal activities or from voting in Trump or the equivalent in your country ..read more

    It’s been a while that I’m thinking about writing a beginners’ guide to critical care echo (CCE), and when I mean beginners I mean those guys who don’t even know what an ultrasound probe is, like I once did. We’re here for those guys! We will discuss some technical aspects, how the views are obtained and a bit of image interpretation. Nothing too fancy, just some words, images and videos for the working class doctor in the middle of nowhere who doesn’t have anything better to do because the hospital blocked the Netflix access. 
First things first Of course with proper training and dedicat ..read more

    Howdy, Y’all! How’s it you lovely people are doing tonight? This post was especially hand-crafted for all you orotracheal tube thrusters, late-night CPR providers, cardioversion enthusiast and yes… platelet apheresis lovers. I know I might sound a bit too excited, but how could I not be as I prepare to talk to you about Platelets, the Ringo Starr of blood products! No more lollygagging! Onward! But Ringo was an OK drummer… I know that most of the evidence we have for platelet transfusion in emergency/critical care setting is extrapolated from hematologic patients (and God knows how bizarr ..read more

    All right! We know we got lost the past couple of months, and we’re ashamed of it. But we’re back! Are you ready for some news?!? Starting today, all of our posts will also be published in Portuguese! That’s cool, right? And as a gift to our Brazilian readers, we also released some of our old posts in our mother tongue too! All you gotta do is click on the language flag in our top menu (unfortunately, we were able to translate to Portuguese only 10% of our posts). Enjoy Cheers The post ICU Revisited now bilingual appeared first on ICU Revisited ..read more

      Last night I was scrolling through our blog and realized something. We have already covered a lot of ground in our quest to make fun of every maybe-evidence-based Critical Care-Emergency Medicine controversial topics out there. Hooray for us! But! I also noticed we haven’t given enough attention to some questions regarding those 2 bean-shaped organs resting in our retroperitoneum that receive ridiculous amounts of blood for their relatively small size. Yes! You’re right! I’m going to talk to you about our kidneys! Here’s a Scooby snack for you! Actually, a couple of years ago we discuss ..read more

    Sedation Intensity in the First 48 Hours of Mechanical Ventilation and 180-Day Mortality: A Multinational Prospective Longitudinal Cohort Study, by Yahya Shehabi et al. [1] It’s late at night, and there you are with your cup of coffee, fighting with your eyelids to maintain yourself awake. You take a sip of your black elixir and look at all those mechanically ventilated patients, hoping for those alarm’s beeps to stay calm all night long, so you can take a “RASS -5” nap and wake up minutes before the shift ends. During my still short medical career, I can point, unfortunately, many collea ..read more