Discover and read the best of Twitter Threads about #CHEST2021

First up for tweet-ucation on this final day of live #CHEST2021 is “The Wave of the Future: Beyond the Ultrasound Basics"! 1/

Dr. Orlando Garner (@ogarnerccm) will discuss "Brain Drain: Neuro-Ultrasound for the non-Neurointensivist." #CHEST2021 2/

Transcranial US anatomy and probe positioning. #CHEST2021 3/

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Next up for me: Changing Landscape of Prone Positioning with @sqsimp @GallodeMoraesMD @md_ritwick and Dr. Bosch.

Follow this thread 🧵 for pearls from this session.

#CHEST2021 #CHESTtrainees

Abbreviations:
PP = Prone Positioning
APP = Awake Prone Positioning
ARDS = You know it!
ARF = Acute Resp Failre

So then, let's learn!

#CHEST2021

Dr. Bosch:
What is APP? Proning patients who are not mechanically ventilated (MV)

He's presenting a case, let me ask you in the meanwhile; Do you perform Awake Proning?

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Attending "Approach to Management of Pulmonary Infections in Immunocompromised Patients", LIVE right now on the #CHEST2021 platform, a thread🧵

. @kriscrothers: Diagnostic evaluation in patients with HIV include (pic 1)
* Historical elements
* CD4 count
* Chest imaging pattern

Know you infectious and non-infectious processes that can happen with decreasing CD4 counts (see pic 2)

#CHEST2021

.@kriscrothers: Compares bacterial pneumonia vs. PCP vs. TB
* > 1 infectious process in 10-20% pts with HIV
* Targeted Rx is key

W/U:
* Expectorated/induced sputum
* Sputum AFB x 3 w/ NAAT in 1 sample
* Bronch: If sputum negative for TB or no sputum for PCP

#CHEST2021

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Last for tweet-ucation in day 3 of #CHEST2021 - "Controversies in Septic Shock: Vasopressors and Corticosteroids"! #CHEST2021 1/

First up is Dr. Angel Coz Yataco will discuss "Adding Vasopressin Early" #CHEST2021 2/

Improved urine output and creatinine clearance with Vasopressin vs Levophed. #CHEST2021 3/

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Emily Fridenmaker

@emily_fri

Time for Fix The Vent! #CHEST2021

This vent screen seems popular on twitter but I have never seen one irl. What brand is it?

#1

65M, intubated for ARDS.
High pressure alarm, low volume going off.

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The next #CHEST2021 session for tweet-ucation is "COVID-19: Other Considerations in Management"! 1/

Derlis Fleitas Sosa talks on "Significant dyspnea in post-acute COVID-19 is associated with abnormal pulmonary vasculature on CT during the acute phase." #CHEST2021 2/

Their hypothesis #CHEST2021 3/

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And now we have some tweet-ucation from the FINAL ROUND of "Pardon the Interruption" featuring Kristin Burkart (@KristinBurkart3), Gabe Bosslet (@gbosslet) and Ron Goldenberg! #CHEST2021 1/

First topic: What is the role for empiric AC in critically-ill COVID patients, and at what degree of AC? #CHEST2021 2/

@gbosslett says prophylactic anticoagulation should be given, but not therapeutic dose AC without a clear indication. #CHEST2021 3/

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Let's start day 3 of #CHEST2021 with tweet-ucation from "Severe-ARDS: New Frontiers in Management"! 1/

First up, Dr. Daniel Ouellette with "Optimization of PEEP" #CHEST2021 2/

You can continue to incrementally augment PEEP as long as the plateau pressure remains less than or equal to 28-30 cm H2O. #CHEST2021 3/

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Next for some tweet-ucation is "Critical Care Year In Review 2"! #CHEST2021 1/

Dr. Robert Hyzy (@bhyzy) talks about "What's New in Mechanical Ventilation". #CHEST2021 2/

This trial showed that stylet use improved the success of the first attempt at intubation. #CHEST2021 3/

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Get ready for some tweet-ucation with "Critical Care Year in Review 1"! #CHEST2021 1/

First up is Dr. Robert Hyzy(@bhyzy) with "Update in ARDS". #CHEST2021 2/

We are seeing an increase in ARF and higher mortality in black, non-urban, and older patients. #CHEST2021 3/

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Next up I'm gonna hop into "Harness the Power of Media: Enhancing Your Professional Brand" with Soraya Herbert (@sorayajanae)! #CHEST2021 1/

When you start developing your professional brand you first need to know your audience. Ask your followers what content they like. Create a persona for your audience in your head, then create content for that persona. #CHEST2021 2/

Communication is key. Make sure your content is at the level of your audience. How, when, and to whom you communicate are all important. #CHEST2021 3/

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Starting off day 2 of #CHEST2021 with "Ventilator Basics to Advanced Modes"! 1/

First up is Dr. Amik Sodhi with "The Basics"! #CHEST2021 2/

The 3 variables that set a breath are the 3Ts. The trigger is what makes the breath start. The target variable is the breath delivery (something that must be achieved, but not exceeded during the breath. The termination variable is what tells the breath to stop. #CHEST2021 3/

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#TeamCriticalCare (he/him)

Live-tweeting #PardonTheInterruption with @davidschulman

1. Will Bender
2. Bennett Deboisblanc
3. Ronald Goldenberg

Some punches are being thrown already ..

Somehow we brought up national chocolate cupcake day, whut? :-p

#CHEST2021

Topic: Role of Remdesivir for COVID-19:
WB: No data to support, even @WHO doesn't support it.
BD: Cost for quality low. Mortality benefit from best MA shows mortality benefit.
RG: No way, we don't do that up north! Maybe there is dec LOS, hell no on mortality.
#CHEST2021

What if pt already on Remdesivir prior to coming to ICU:
WB & RG: We continue
BD: Why, why, why? You don't want to start it, but want to hold on to it?
#CHEST2021

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@laxswamy

I had the chance to speak about individual well-being strategies... I opened by saying it's like asking a patient coming in with gunshot wounds if they've had their colonoscopy yet. It is a hard subject to talk about... 🧵#CHEST2021

https://twitter.com/gretchemaben/status/1449786069411586050

I started with what I think of as 🚩🚩🚩 when I hear about wellbeing. Especially during covid. Especially in the ICU. See this thread for more! #CHEST2021

https://twitter.com/laxswamy/status/1449203321718427648?t=RLO6uy0CBEL52S8AZ4WaWQ&s=19

For the next portion of the talk, I share content from an AMA module I helped write for medical students in toxic or stressful environments. I think a lot of it applies to all of us in 2021. #CHEST2021 edhub.ama-assn.org/med-student-le…

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There's a lot to take in on the #CHEST2021 platform, but don't forget to check out the e-posters. I want to highlight a few that caught my attention!

Pic 1: Aerobic exercise improves #Asthma phenotype in severe asthma
Pic2: Positive correlation b/w ONSD and ICH volume #POCUS1st

Silvestri & co:
** Remimazolam safe & effective to achieve moderate sedation for flex bronch
** Faster sedation onset & recovery vs. placebo w/ rescue vs. open-label midazolam
** Ready for discharge sooner

#CHESTIP #Bronchoscopy #CHEST2021

.@sarangspatil1: Preop HFNC in patients undergoing cardiac surgery associated with reduction in postop pulmonary complications & risk of post-op infections.

Scan the QR code for more details.

#CHEST2021

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The #CHEST2021 Keynote Session: "Perseverance and Motivation: Empathic Medicine" with Dr. Demondes Haynes (@DemondesHaynes)! #CHEST2021 1/

“The only way to be truly happy is to make others happy." Wiliam Carlos Williamss
We must remember to be giving people, but recognize that many of the things we can give are intangible. #CHEST2021 2/

"The greater the difficulty, the more glory in surmounting it." Epicurus
Medicine is hard, both the path to get there and the job we do. But it is worth it.
Try to find joy in overcoming obstacles, including this pandemic.
#CHEST2021 3/

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Done with the talks for today at #CHEST2021 .. Now to the opening session. So nice to see leaders sharing gratitude and giving thanks. It’s the small things that matter! @CHESTPrez

.@CHESTPrez acknowledges massive amount of work performed diligently by the #COVID19 task force and the @accpchest staff who led this virtual pivot with aplomb.
#on a personal note I’m so proud of my friends @GallodeMoraesMD @drdangayach for the presidential citation

#CHEST2021

.@CHESTFoundation award winners honored and now @davidschulman has taken on the mantle of @CHESTPrez!!

#CHEST2021

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Let's learn about "Viruses, Variants, Vaccines, and Virulence: The Present and Future of COVID-19"! #CHEST2021 1/

First up is Dr. Shazia Jamil (@MdShaziajamil) with "Alpha, Beta, Lambda, and Delta: The Epidemiology of COVID-19 Variants"! #CHEST2021 2/

Understanding the terminology #CHEST2021 3/

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Live at 1400 ET: chestmeeting2021.junolive.co/live/mainstage…

"Airway management in the era of severe pneumonia" with #CHESTairways experts from the Airway Domain Task Force.

Will live tweet this talk on this #CHEST2021 thread.

Speakers:
@Chaeface @KDoerschug @J_Mendelson_MD and yours truly!

Let's get started with WHY our session is important:
🔥 Appx. 10% emergent intubations may result in failed airway
🔥 It's not just anatomical challenges, but physiological ones that have to be considered, esp with severe pneumonia
🔥 Lessons from the pandemic

#CHEST2021

* Let's talk about the vicious cycle of injury that occurs in acute resp failure (pic 1)
* Clinical course of disease imp for decision to intubate (pic 2)
* Ideal timing related to worsening work of breathing (pic 3)

PMID: 32747391
PMID: 27626833

#CHEST2021 #CHESTairways

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