Super excited for this. No issues with travel this year, the H&R family all keen on getting together again, the lineup is awesome, most of the OGs able to make it, lots of new additions, and the programme is looking really sweet. Am totally amped to have Katie Wiskar as the Chair of The Hospitalist as she’s putting together a great group with sharp lectures and super interesting workshops. With help from the usual suspects (Rory Spiegel, Andre Denault, Korbin Haycock) we are focusing on some core areas in acute and critical care – sepsis, arrest and respiratory failure are perennials, but ..read more

Personally, I’ve never used it, so not really an issue to me. But it seems to generate a fair bit of emotion and debate, and having the pleasure of knowing some really smart and, in this case, highly experienced people, I think we have something good to share here, a story from Thomas Woodcock! This insight may help clinicians currently debating the issue… Edomidate – A Brief Personal History. By Thomas Woodcock, MD. We all want Evidence, good solid peer reviewed communications with verifiable data, ideally randomised and controlled. But we are human, and our practices are also informed by unp ..read more

Here is a lecture I gave for the International Fluid Academy annual meeting which is truly a terrific event. Many of us have been working hard at ushering in this concept, which we feel is vastly more important than that of fluid responsiveness. And for those interested, here is our paper: https://pubmed.ncbi.nlm.nih.gov/35660844/ Cheers! Philippe ..read more

So I’ve been meaning to put this up for a while, along with many other #FOAMed lectures I want to share and get out there in our neverending quest to cut down on the KT on bedside physiological management. For years now I have enjoyed collaborating with my friend Curro Miralles, who is a fantastic clinician on top of being the latin leading man heir apparent to Antonio Banderas who somehow ended up as a physician instead. Well, medicine should be greateful! Enjoy ..read more

It’s always a good time hanging with these guys (@khaycock2 and @Emnerd). Over the years I’ve learned a ton from them. Even if I thought I was pretty solid on something, they almost always have the ability to shed some additional light on it in a particularly useful way. So I always look forward to these discussions. Today we took some time to flesh out some of the questions and statements that came up about VExUS in the last few days on medtwitter. Hope you all enjoy ..read more

So I’m finally getting around to listening to the #HR2022 lectures I hadn’t had a chance to prior to the conference – it gets busy – that so many are raving about, and this was a really good one. This dynamic NeuroCrit duo hit on a lot of really important principles, including one of my favorite myths, that of neuroprognosticating based on an ICH score. It truly is disenheartening to see, in my experience, how few neurosurgeons either acknowledge or are aware of this, and, particularly in young patients, the self-fulfilling prophecy concept could be making us miss opportunities to save lives ..read more

So after much deliberation, we have decided and are excited to bring H&R back for 2022 – we had skipped 2021 to focus on some research papers and developing some courses (Flipping the Vent and The VExUS Course), but mostly because the virtual conferencing experience simply did not measure up to the live event. What makes boutique conferences like H&R so different (and awesome) is the similar mind-set of the faculty and the participants, the opportunity to interact and network, exchange and build. So much of what many of us have achieved in the last years was built on introductions, dis ..read more

So we had a blast with the VExUS Course a few weeks ago, it was really great to see how much enthusiasm and actual clinical use it is getting all over the world. Humbled, grateful and certainly feeling like the hard work was worth it to have this impact. So even after the workshop, there was a lot of questions, and some take more than a few lines to dig into, and since one participant, Dr. Rajiv Sinanan, a nephrologist, was so organized in his case questions, including a powerpoint with cases, I thought it was worth sharing. My life being busy and chaotic, I unfortunately had to do this on the ..read more

While the last few months had quieted down, the last few weeks have seen a serious resurgence in COVID cases, particularly in the southern US and in south and southeast Asia. I cam across several really disturbing posts and tweets across medical SoMe about the lack of ECMO beds and cases of refractory hypoxia. While TCAV(TM) will not save every COVID ARDS patient, in our experience it helps significantly, ideally from the get-go, but also in rescue after failure of traditional modes. This is why we decided to add this date – sooner than planned – as it seems it may have clinical impact in the ..read more

So it is with gradual amazement and a great sense of accomplishment that we have witnessed the remarkable interest that our field of acute care has taken in VExUS. This has also been tempered by the humility of experience, as all of us have seen fads come and go, and also because an interventional approach based on VExUS is not yet evidence-based, as the studies remain to be done, some being underway. At the same time, it has been a good 4-5 years that most of those involved in the VExUS papers have been using Doppler-enhanced POCUS assessment of venous congestion. Our pragmatic and empiric e ..read more