Great time at @nyulangone for #critcarecards26 with @CardioNerds @BrototoD @YoavKarpenshif @KatieVanchiere @RebeccaGarberMD @RohangantiMD

VA-ECMO: To Vent❓@emilyzernMD #critcarecards26 w/ panel discussion @jason_bartos Which has more influence in PCWP in VA-ECMO: ⬆️ LV afterload or ⬆️ venous drainage❓ Interesting study in @JACCJournals 🔗 jacc.org/doi/10.1016/j.jacc.… @CardioNerds @BrototoD

Anticoagulation in tMCS #critcarecards26 Thrombosis ↔️ Bleeding ‼️Not a 1 size fits all principle aPTT is often strongly prolonged in critically ill in the absence of heparin Measure other labs such as anti-Xa, fibrinogen @CardioNerds @BrototoD

Panel on how to educate the next generation of critical care cardiologists @BalimSenmanMD @jameshorowitzmd @AndreaElliottUM #critcarecards26 Many resources including: 🔗soccc.org 🔗cardionerds.com/cardiaccriti… @SocietyOfCCC @CardioNerds @BrototoD

Role of MRSA swab & empiric vanc in CICU @seanvandiepen #critcarecards26 Clinical utility depends on the type of infection & epi. MRSA swab not typically indicated for -UTI -Intraabdominal infx -Mild/moderate nonpurulent cellulitis -Neutropenic fever @CardioNerds @BrototoD

Cuff leak before extubation: Ritual or Requirement? #cardscritcare26 @ElliottMillerMD While safe & cheap, cuff leak testing could delay extubation If absent cuff leak, give steroids atleast 4 hrs before extubation Largely ritual but subset of pts where it’s reasonable

Use of stimulants in comatose survivors of cardiac arrest @RickyHansra Fact or fiction ⁉️ Stimulants include amantadine, methylphenidate, modafinil Multicenter RCT of amantadine stopped early for slow enrollment Bottom line: not much evidence, not endorsed by guidelines

Starting off @nyulangone Critical Care Cardiology Symposium with case presentation by Michael Miller (@BrighamMedRes alum & ⭐️ co-resident!) & Dr. Ciancarelli discussing 1st steps for evaluation in VT storm #critcarecards26 @CardioNerds @BrototoD

Framework for managing electrical storm in the CICU ⤵️ Great talk by @CriticalCardio at NYU CCC Symposium 🔗 pubmed.ncbi.nlm.nih.gov/3725… #critcarecards26 @CardioNerds @BrototoD

Propranolol: B1/B2 blocker, may reduce sympathetic outflow Procainamide: class 1A Quinidine: consider in Brugada, idiopathic VF, short QT, short coupled VF Dexmedetomidine: alpha-2 agonist, can ⬇️ catechol release, ⬆️ vagal tone #critcarecards26 @BrototoD @CardioNerds

Autonomic modulation CICU 🔴B-blocker: established treatment 🔴Analgesia/sedation 🔴Stellate ganglion block 🔴 Thoracic epidural analgesia (logistics/bleeding make it hard to use) 🔴🫀 sympathetic denervation 🔴Renal sympathetic denervation (experimental) #critcarecards26

VA ECMO basics at #critcarecards26 by @AndreaElliottUM Think peripheral vs central Where is drainage venous catheter❓ Where is return arterial catheter ❓ @CardioNerds @BrototoD

VA ECMO Settings by @zilgiovineMD #critcarecards26 🔺 Flow 🔺 Oxygenation 🔺 Sweep Hybrid/advanced configurations depending on situation @CardioNerds @BrototoD