Balanced Crystalloids Probably Reduce Mortality in the Critically-Ill
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] “What time is this, to trade the handshake for the fist?” -Joni Mitchell  Background As remarked by the authors of the recent PLUS trial, a systematic review and meta-analysis of randomized controlled trials comparing balanced resuscitation fluid to 0.9% saline was reported in the New England Journal of Medicine Evidence.  This [... read more] The post Balanced Crystalloids Probably Reduce Mortality in the Critically-Ill appeared first on PulmCCM ..read more
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Register for the 2022 Hospitalist and the Resuscitationist Conference: May 18-21 in Montreal
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] The tremendous, Hospitalist and the Resuscitationist [H & R] conference returns this May 18-21st in Montreal, Canada. I am humbled to participate this year and look forward especially since the conference was paused for 2021.  I am certain that Dr. Philippe Rola, who has been organizing this meeting since 2018, will [... read more] The post Register for the 2022 Hospitalist and the Resuscitationist Conference: May 18-21 in Montreal appeared first on PulmCCM ..read more
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Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] “The world wavered and quivered and threatened to burst into flames.” -Virginia Woolf  Background Intravenous fluid therapy is one of the most commonly-performed interventions in all of critical care medicine.  Numerous trials over the last 20 years have attempted to identify the ideal fluid for those in the intensive care unit, [... read more] The post Balanced Fluid Resuscitation for the Critically-Ill: the PLUS study mirrors the BaSICS appeared first on PulmCCM ..read more
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Nirmatrelvir-Ritonavir for ‘Standard Risk’ COVID-19
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] “… but prejudices, like odorous bodies, have a double existence, both solid and subtle – solid as the pyramids, subtle as the twentieth echo of an echo, or as the memory of hyacinths which once scented the darkness.” -Mary Ann Evans  Background As previously described, the SARS-CoV-2 main protease inhibitor [Mpro] [... read more] The post Nirmatrelvir-Ritonavir for ‘Standard Risk’ COVID-19 appeared first on PulmCCM ..read more
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EPIC-HR Evaluates Nirmatrelvir-Ritonavir for COVID-19
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] “When she smiles without her teeth in place she looks like a witch. But with them in her mouth she’s very pretty.” -Judy Blume  Basic Biology The SARS-CoV-2 genome encodes structural proteins [i.e., spike, envelope, membrane, nucleocapsid] and polyproteins [i.e., pp1a and pp1ab]. When the guts of SARS-CoV-2 spew into a [... read more] The post EPIC-HR Evaluates Nirmatrelvir-Ritonavir for COVID-19 appeared first on PulmCCM ..read more
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What Minimal Volume of Intravenous Fluid Challenges the Heart?
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] “I find real life challenging enough.  If I get to the dry cleaners without having a huge fight, that’s challenging enough.” -Fran Lebowitz  Background Quite recently, the BaSICS investigators evaluated the infusion rate of a fluid bolus on patient outcome.  As considered, however, contrast should be made between a fluid bolus, [... read more] The post What Minimal Volume of Intravenous Fluid Challenges the Heart? appeared first on PulmCCM ..read more
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COVID STEROID 2 Trial Investigates Dexamethasone 6 mg or 12 mg in COVID-19
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] “If you’re afraid of butter, use cream.” -Julia Child  Background Early observational studies and the RECOVERY collaborative group initially demonstrated the benefit of corticosteroid therapy in oxygen-requiring, COVID-19-patients; additional randomized studies as well as a meta-analysis of these reports corroborated this. Yet the dosing of corticosteroids across the above studies was [... read more] The post COVID STEROID 2 Trial Investigates Dexamethasone 6 mg or 12 mg in COVID-19 appeared first on PulmCCM ..read more
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Fact-Checking Buffalo Chest
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] “It was after this realization that I began trying to find the ‘point’ of California, to locate some message in its history.” -Joan Didion  Background A few months ago, I found myself in one of my favourite places – the American Museum of Natural History in New York City.  Meandering through [... read more] The post Fact-Checking Buffalo Chest appeared first on PulmCCM ..read more
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PRINCIPLE Investigators Study Inhaled Budesonide for COVID-19
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] “… Sartre tells us that man makes himself this lack of being in order that there might be being.” -Simone de Beauvoir  Background Like many early, proposed therapies for COVID-19, inhaled corticosteroids [ICS] had suggestive, conflicting evidence.  For example, in a very large observational investigation – the OpenSAFELY platform – patients with both [... read more] The post PRINCIPLE Investigators Study Inhaled Budesonide for COVID-19 appeared first on PulmCCM ..read more
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ICU Physiology in 1000 Words: Phenylephrine Pushes & Stroke Volume
PulmCCM Blog
by Jon-Emile S. Kenny
2y ago
Jon-Emile S. Kenny MD [@heart_lung] About a decade ago, a handful of terrific reviews and investigations about phenylephrine – an alpha1 agonist – were published [1-3].  While this vasoactive medication might be thought only to ‘increase afterload,’ phenylephrine’s hemodynamic effects are knotty and noteworthy.  Therefore, this dedicated dispatch delineates the difficulties encountered when predicting the hemodynamics [... read more] The post ICU Physiology in 1000 Words: Phenylephrine Pushes & Stroke Volume appeared first on PulmCCM ..read more
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