⚕️Critical Care & Neurocritical Care Physician | Research | Evidence-Based Medicine
Joined January 2025
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Intensive Care Unit Algorithms Lab retweeted
Published today, Evidence Update for Minimally Invasive Surgical Evacuation of Supratentorial Spontaneous Intracerebral Hemorrhage A Science Advisory from the American Heart Association.
More recent clinical trial evidence has rekindled the role of surgical intervention for improving outcomes after spontaneous intracerebral hemorrhage (ICH).
Recent advancements in minimally invasive surgical techniques suggest potential improvements in functional recovery, broadening consideration for surgical treatment of certain populations, such as lobar hemorrhage after spontaneous intracerebral hemorrhage. professional.heart.org/en/sc…
✍🏼 @kevin_n_sheth @umasschan_ncc
📷 Minimally invasive surgery techniques
Intensive Care Unit Algorithms Lab retweeted
Supplementation with #Menaquinone7 for 2 years modestly slowed progression of #CoronaryArteryCalcification in patients with coronary artery disease, with no major adverse effects. ja.ma/4ggKJqy
Intensive Care Unit Algorithms Lab retweeted
Increased #Lp(a) levels were associated with higher risk of #CoronaryArteryDisease, but only #IL6 modified Lp(a)-associated CAD risk among UK Biobank participants. ja.ma/4hFp9Pc
Intensive Care Unit Algorithms Lab retweeted
#STROKE: A deep diffusion model generated synthetic T-max maps from routine DWI and FLAIR, accurately capturing key perfusion patterns and mismatch volumes. This approach may shorten imaging protocols and accelerate treatment decisions. ahajrnls.org/4wLtYub
ALT Graphic abstract in Matsulevits et al.
Intensive Care Unit Algorithms Lab retweeted
August #Stroke #EditorPick: In a randomized controlled, phase 2 clinical trial, prophylactic intravenous tirofiban combined with DAPT reduced the burden of new post-operative infarcts without a corresponding increase in bleeding complications or mortality. ahajournals.org/doi/full/10.…
ALT Graphic abstract in Hu et al.
Intensive Care Unit Algorithms Lab retweeted
🦠En tu Hospital Hay un CÓDIGO SEPSIS… O Cada Quien la Maneja Como Puede?
📖Consenso Internacional 2026
⏱️Reconocimiento Temprano
🧫Diagnóstico Microbiológico
💊Antibióticos
💧Hemodinamia
🫀Control de Foco
Artículo Completo👇🏻✅🆓
t.me/DeCaUMX
Intensive Care Unit Algorithms Lab retweeted
📊 Research Summary: In major elective noncardiac #Surgery, total intravenous #Anesthesia and volatile inhalational anesthesia had similar recovery and safety outcomes, although thirst, hoarseness, and nausea or vomiting were less frequent with total intravenous anesthesia.
ja.ma/3Ucegue
Intensive Care Unit Algorithms Lab retweeted
Sakurada et al: Association of Impaired Hematoma Clearance After Aneurysmal Subarachnoid Hemorrhage with Delayed Cerebral Ischemia, Hydrocephalus, and Long-Term Outcomes
Link: link.springer.com/article/10…
@neurocritical #neurocritcare
Intensive Care Unit Algorithms Lab retweeted
📝 Case Report: Dual-phase computed tomography demonstrated acute #cardiac tamponade developing within seconds in a hemodynamically stable patient with type A #aortic dissection, highlighting the need for immediate surgical readiness.
ja.ma/4vKgNdf
ALT Two axial chest CT scans. A: Arterial phase (0 sec) shows the heart and lungs. B: Delayed phase (35 sec) reveals a darker pericardial effusion surrounding the heart, highlighted by multiple yellow arrowheads.
Intensive Care Unit Algorithms Lab retweeted
「重症患者での利尿薬について、最初に読みたい論文は？」
と聞かれたら、このBJAのレビューがオススメです。
ループに始まり、サイアザイド、アセタゾラミド、浸透圧利尿薬、K保持性利尿薬に至るまで、作用機序から実臨床での使い方まで一気にまとまった1本です。
bjanaesthesia.org/article/S0…
Intensive Care Unit Algorithms Lab retweeted
⚡️Our paper about the STORM classification is now freely available in open access
Pubmed link here ⬇️
pubmed.ncbi.nlm.nih.gov/4134…
⚡️New ELECTRICAL STORM paper out
We propose the 5-stage STORM classification for electrical storm – a simple bedside scale that stratifies 30-day mortality from 5% to 50% and helps structure multidisciplinary care
academic.oup.com/ehjacc/adva…
Intensive Care Unit Algorithms Lab retweeted
Meta-analysis indicates #Prasugrel provides optimal balance of efficacy and safety for patients after #PCI, with lower major adverse cardiovascular events and stent thrombosis compared with ticagrelor and clopidogrel. ja.ma/3SFHCjY
Intensive Care Unit Algorithms Lab retweeted
An international consensus process established a football-specific standardized on-pitch concussion assessment protocol (#FOCUS) to address the need for rapid, evidence-informed evaluation of suspected concussion during match play.
ja.ma/4eGhkXp
Intensive Care Unit Algorithms Lab retweeted
Review article
Brainer Clares de Andrade et al: Cerebral Vasospasm Detection and Delayed Cerebral Ischemia Prediction after Aneurysmal Subarachnoid Hemorrhage: A Scoping Review
Link: link.springer.com/article/10…
@neurocritical #neurocritcare
Intensive Care Unit Algorithms Lab retweeted
📚 NEW REVIEW-Parenteral Nutrition and Supplemental Parenteral Nutrition: Should We Use More?
For years, parenteral nutrition (PN) was often viewed as a “last resort.” It is definitely time to rethink that approach!
This outstanding review examines the evolving evidence and highlights several important concepts:
🔹 Modern data suggest many historical concerns about PN were likely driven by overfeeding, not the intravenous route itself.
🔹 When the gastrointestinal tract is not functional, total parenteral nutrition (TPN) remains essential.
🔹 Supplemental parenteral nutrition (SPN) should be considered when enteral nutrition alone cannot meet energy and protein requirements—particularly during the later phases of critical illness.
🔹 The review emphasizes phase-specific nutrition, recognizing that nutritional strategies should evolve from the early acute ICU phase through ward recovery and post-ICU rehabilitation.
🔹 Recovery doesn’t end at ICU discharge. Significant nutrition deficits often persist, and thoughtfully using SPN may help bridge this gap to support muscle recovery and functional outcomes.
This paper reflects an important shift in critical care nutrition: moving away from one-size-fits-all nutrition toward personalized, phase-specific metabolic support.
Congratulations to Tam Lac, Lee-anne Chapple, and Emma Ridley on an excellent and thought-provoking review.
📖 Read the paper here:
journals.lww.com/co-critical…
🙋♂️ I’d love to hear your thoughts:
❓Are you using supplemental parenteral nutrition early (day 2-3) when enteral nutrition alone is insufficient, or are you still waiting until day 7?
I’m honored to serve as Guest Editor for the new Nutrition & Metabolism issue of Current Opinion in Critical Care, bringing together leading experts to explore the latest advances shaping nutrition therapy in critical illness. Stay tuned for more cutting-edge articles from issue about to be published in full!
Intensive Care Unit Algorithms Lab retweeted
Understanding the WHO Critical Pathway for Deceased Organ Donation
Every deceased organ donor follows a structured pathway to ensure ethical, legal, and medically appropriate organ donation. The goal is to identify eligible donors, maximize organ utilization, and maintain public trust.
Two pathways exist:
🟦 Donation after Brain Death (DBD): The patient fulfills legal brain death criteria while circulation is maintained with life support.
⬜ Donation after Circulatory Death (DCD): Organs are donated after irreversible cessation of circulatory and respiratory function.
Both pathways progress through the same stages:
🔺Potential donor: A patient with devastating brain injury or circulatory failure who may be suitable for donation.
🔺Eligible donor: Death has been legally confirmed and the individual meets medical criteria.
🔺Actual donor: Organ recovery has begun or at least one organ has been retrieved.
🔺 Utilized donor: At least one recovered organ has been successfully transplanted.
Not every potential donor becomes a utilized donor. Common barriers include: - Failure to identify or refer a donor.
- Medical unsuitability or organ dysfunction.
- Hemodynamic instability before organ recovery.
- Lack of a compatible recipient.
- Family refusal or legal restrictions.
The WHO critical pathway standardizes deceased organ donation worldwide, helping improve donor identification, optimize organ utilization, and ensure that donation occurs only after death has been legally established.
Reference: Domínguez-Gil B, Delmonico FL, Shaheen FA, et al. The Critical Pathway for Deceased Donation. Transplant International. 2011;24:373-378.
Intensive Care Unit Algorithms Lab retweeted
Despite strong evidence for their efficacy & safety, DOACs remain underused & at times inappropriately dosed, especially in high-risk pts. New ACC Scientific Statement provides guidance for primary & secondary prevention of thrombotic events jacc.org/doi/10.1016/j.jacc.… #JACC #cvPrev
Intensive Care Unit Algorithms Lab retweeted
Qu et al: Malignant Cerebral Edema after Large-Core Anterior Circulation Stroke in the Thrombectomy Era: Prediction and Neurocritical Care Pathways
Link: link.springer.com/article/10…
@neurocritical #neurocritcare
Intensive Care Unit Algorithms Lab retweeted
In a cluster-randomized trial involving patients having major noncardiac surgery, tranexamic acid reduced the need for red-cell transfusion during hospitalization and was noninferior to placebo for venous thromboembolism within 90 days. Full TRACTION trial results and Research Summary: nej.md/4e8QKF4
ALT This image is from a Research Summary published in the New England Journal of Medicine about a study on tranexamic acid in major noncardiac surgery. It includes a diagram of a blood bag labeled "Red-cell transfusion" and graphics of syringes labeled "Tranexamic Acid" and "Placebo" with participant numbers: N = 4156 and N = 4117 respectively. It also lists patient details: 8273 adults, median age 64 years, with 53% women and 47% men. There is a prompt at the bottom to read the full Research Summary at NEJM.org.
Intensive Care Unit Algorithms Lab retweeted
Building on the First Definition of Heart Failure, the Second Definition refines HF staging with sharper stage criteria, emphasizing early detection and individualized risk reduction and introduces the universal classification of HF causes, with explicit acknowledgment of geographic variation in HF risk and outcomes. professional.heart.org/en/sc…
This updated document provides a unified, internationally harmonized framework intended to standardize terminology. It addresses changes in disease manifestations, diagnostic strategies, and understanding of pathophysiology.
✍🏼 @MinnowWalsh @KarenSliwa @amibanerjee1 @BiykemB @akshaydesaimd @DukeHFDoc @MKIttlesonMD @lamcardio @WilfriedMullens @NutritionHF
