Himanshu Rawal MD
@rawalmdPCCSM physician |MAMC alum l tweets my own 🇮🇳🇺🇸
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Thrilled to announce our invited review on #stroke and #SleepApnea recently published in CHEST @accpchest ... kudos to @LaavanyaDharma @uoftneurons @Sunnybrook @UofT_DoM @uoftmedicine @UofTIMS @UofTNeurology ! doi.org/10.1016/j.ches…
‼️Updates ‼️ PICS after ARDS 🫁 @AnesthChestClin Free Full-Text Access Until Nov. 9 authors.elsevier.com/a/1joVnzzkx-yVn @Arooj47013193 @V_Dinglas @DrDaleNeedham
Goodbye to direct videolaryngoscopy Pros and cons of reusable videolaryngoscopy A good body of data demonstrating the superiority of VL to DL #LIVES2024
1/2 🎯 NEW PRECISe ICU Protein & #ICURehab trial in @TheLancet ➡️ 935 pt RCT: High (2.0 g/kg/d) vs Std (1.3) protein dose ➡️ High protein (2.0) led to ⬇️ EQ-5D QoL scores vs 1.3 g/kg 🎯 1.2-1.5 g/kg/d protein likely BEST TARGET for ICU pts in 1st 10 d- see 2nd new trial!👇…
Incidence of post-extubation dysphagia among critical care patients undergoing orotracheal intubation: a systematic review and meta-analysis eurjmedres.biomedcentral.com/articles/10.11…
Interesting study: changing DNR terminology to beneficial care only didn’t change the decision to forgo CPR. Though the recipients did feel that the patient will receive beneficial care in the BCO group.
I am very excited to share that @journal_CHEST has accepted my empirical study with @GinaPiscitello for publication. Here is a sneak peek of the pre-print version. sciencedirect.com/science/articl…
Today, in the penultimate episode in our RFJC Summer Series on ARDS we are discussing the DEXA-ARDS trial examining the impact of dexamethasone on mortality and duration of MV in patients with ARDS. You can listen now! pulmpeeps.com/2024/08/27/83-… 👇 key points
Evaluating Quality of Care for Patients with Asthma in the Readmission Penalty Era @atscommunity 🔗 tinyurl.com/4h3nb6cz
Original Article: “A Patient-Level Meta-Analysis of Intensive Glucose Control in Critically Ill Adults” by Derick Adigbli, MBBS, PhD, Simon Finfer, MD, et al.: eviden.cc/4cdAtvB @georgeinstitute #CriticalCare
6. Initial Tlow is usually ~0.5 sec. The popular teaching is to “cut” the breath at 75% of peak expiratory flow (figure 👇 from my friend @ThinkingCC PMID: 35480043 DOI: 10.3389/fphys.2022.787231)
Original sleep research highlights the differences in endotypes between nonpositional OSA and positional #OSA. Read more in the July issue: hubs.la/Q02GFHPh0 #MedTwitter #MedEd
Review findings from a review exploring the laryngeal basis of two commonly encountered clinical problems within respiratory medicine, chronic refractory cough and inducible laryngeal obstruction, in the journal CHEST®: hubs.la/Q02FjZZK0 #MedTwitter #JournalCHEST
Absolutely astonishing study by @AtulMalhotra13 and colleagues: a game changer for pts with #OSA. Well done!
Presented at #ADASciSessions: Excess adiposity is a reversible etiologic risk factor for obstructive sleep apnea. In the SURMOUNT-OSA trial, tirzepatide reduced the apnea hypopnea index of participants with obstructive sleep apnea and obesity. nej.md/4coe9zv
My last graduation after 15 years of medical training, finally! ⚕️ My PD summed it up nicely:”you came to 🦬 as a couple but leaving as a family.”
Just published: "Proton-Pump Inhibitors to Prevent Gastrointestinal Bleeding — An Updated Meta-Analysis” by Ying Wang, MSc, Deborah Cook, MD, MSc, et al. eviden.cc/4aONMBD @YaseenarabiYa @DogICUma #CCR24
EMCrit 377 - Breaking News - The PREOXI Trial changes everything for Preoxygenation in Intubations in the Critically Ill! I interview the lead authors and give my RECs. [#FOAMed] I've been advocating for this for years and now we have a beautiful trial... emcrit.org/377
If you intubate you need to read the #PREOXI trial! -n=1301 people requiring intubation in ED/ ICU were randomized to preoxygenation with oxygen mask vs non-invasive ventilation (NIV) -NIV HALVED the risk of hypoxemia: 9 vs 18% -NIV reduced mortality: 0.2% vs 1.1% #CCR24 🧵 1/
Results from #PROTECTION presented #CCR24 & published @NEJM - DB RCT of amino acid infusion vs placebo in n=3511 people undergoing cardiac surgery w/ bypass. - Reduced incidence of AKI (26.9% vs 31.7% NNT=20) & need for RRT (1.4% vs 1.9% NNT=200) Potential game changer! 🧵 1/
Among adults in the ICU who had sepsis or septic shock, the use of prolonged β-lactam antibiotic infusions was associated with a reduced risk of 90-day mortality compared with intermittent infusions, finds meta-analysis. ja.ma/4beJZhv #CCR24
A CHEST How I Do It reviews the newest evidence and current guidelines on long-term noninvasive ventilation in severe #COPD. Read more in the June issue of the journal CHEST®: hubs.la/Q02Bnr3m0 #JournalCHEST #MedEd
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