Kaspar Bachmann
@kasparbachmann.bsky.social
MD | ICU Physician & Researcher Passionate about gastrointestinal dysfunction, nutrition as well as ECMO and cardiopulmonary physiology. Enthusiast in #MatLab, signal analysis and data-driven research: https://pubmed.ncbi.nlm.nih.gov/?term=Kaspar+bachman
LEVOECMO RCT: early administration of levosimendan to facilitate weaning from VA #ECMO in severe but potentially reversible cardiogenic shock 🔍 205 adults/11 ICUs in 🇫🇷 ⚖️ early levosimendan administration did not significantly shorten the time to successful weaning of #ECLS at day 30 🔗 bit.ly/4iAwGwT
Thanks for sharing our review! Monitoring GI function when initiating / stepping up nutrition is key to prevent harm from too aggressive nutrition.
Critical Care Reviews@criticalcarereviews.com · last yr.GI function & nutrition in septic shock ➡️ Stabilise perfusion first, then start low-dose EN and advance as tolerated ➡️ Early aggressive EN can harm; monitor EFI and use PN if EN unsafe CCR Journal Watch https://criticalcarereviews.com/latest-evidence/journal-watch
New 📝 We know RV dysfunction occurs on VV-ECMO in ARDS despite ECMO mitigating many of the traditional RV dysfunction risk factors (hypercapnia etc) We don’t understand RV function dynamically over time on ECMO…
@gurujosh.bsky.social presents the results of the MSSA domain of the SNAP 🫰 trial at #ESCMID2025 fluclox caused more acute kidney injury than cefazolin; early mortality favored cefazolin Absolutely Herculean effort by the entire global trial team and practice changing data #teamcefazolin
Have you ever wondered what it takes before a clinical trial ends up in your timeline? Well… we recently published the DDx-BRO trial ⬇️ Here is a 🧵 of its lifecycle: from 💡to 🏁, well, if the latter actually exists.
Diagnoses supported by a computerised diagnostic decision support system versus conventional diagnoses in emergency patients (DDX-BRO): a multicentre, multiple-period, double-blind, cluster-randomised...
Use of a CDDSS did not reduce the occurrence of diagnostic quality risk compared with the usual diagnostic process in adults presenting to emergency departments. Future research should aim to identify...
thelancet.com
Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI) Thanks to @criticalcarereviews.com ccforum.biomedcentral.com/articles/10....
Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI) - Critical Care
Purpose Gastrointestinal (GI) dysfunction is common in critically ill patients and associated with poor outcomes. There is a lack of standardised methods for daily monitoring of GI function. COSMOGI a...
ccforum.biomedcentral.com
I got tired of opening a dozen PDFs to find the ECMO pressure/flow curve I need. So I made an app! Choose the cannula/size and you can see the max flow for a given pressure drop. Or compare multiple different cannula. Lmk what ya’ll think. Useful? What’s it need? onepagericu.com/ecmo-calcula...
Let us start 2025 in a positive mood: here are 10 methods things researchers can worry *less* about in 2025
a countdown clock with the number 10 in the center
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media.tenor.com
This was a fun study leveraging social media to demonstrate the high prevalence in Impella malrotation among cases shared on old Twitter. If it's malrotated, but it works well, without suction alarms or other problems, do you change it? #cccsky #cardiosky #emimcc www.pcronline.com/News/Whats-n...
Impella percutaneous ventricular assist device malrotation in social media: a call to action
This study suggests that correct Impella orientation is often overlooked, and that Impella malrotation is a common issue in real-world clinical practice, potentially associated with relevant complicat...
pcronline.com
Fresh off the press: COSMOGI 🗞️🗞️🔥🔥 What variables should we use to daily monitor #gastrointestinal function in #criticalcare? We have developed a core outcome set and have defined 13 variables for daily GI assessment. Published today in Critical Care: ccforum.biomedcentral.com/articles/10....
Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI) - Critical Care
Purpose Gastrointestinal (GI) dysfunction is common in critically ill patients and associated with poor outcomes. There is a lack of standardised methods for daily monitoring of GI function. COSMOGI a...
ccforum.biomedcentral.com
#MedSky #EMIMCC #IDsky #cardiosky @pulmcrit.bsky.social What is the culture at your hospital for potassium replacement? At most hospitals I'm at it seems to be a culture of replace to K 4.0 and the individual doctor makes the call. This paper confirms my bias... jamanetwork.com/journals/jam...
Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery
This randomized clinical trial examines whether a lower serum potassium concentration trigger for supplementation is noninferior to a high-normal trigger for the prevention of atrial fibrillation afte...
jamanetwork.com
Results of the #SAHARAtrial released after #CCRdownunder. A lot to discuss… www.nejm.org/doi/full/10.... #neurocriticalcare
Liberal or Restrictive Transfusion Strategy in Aneurysmal Subarachnoid Hemorrhage | NEJM
The effect of a liberal red-cell transfusion strategy as compared with a restrictive strategy in patients during the critical care period after an aneurysmal subarachnoid hemorrhage is unclear. We ...
nejm.org
Awesome and interesting work by the late Luciano Gattinoni and colleagues. #emimcc
#ADAPTtrial released & the results are interesting… Compared to SOC, Procalcitonin guided antibiotics in sepsis resulted in: - FEWER antibiotic days: 10.7 vs 9.8 (p=0.01) BUT - HIGHER 28 day mortality: 19.4% vs 20.9% (p=0.02) though this did not meet the pre-specified non-inferiority margin 🤔 1/
The #Renovate Trial was just published. Kudos to the authors for this large trial. HFNO was non-inferior to NIPPV in 1776 patients with acute respiratory failure. I have some comments and discussions; feel free to join in. 👇 1/n #emimcc #ccr
JAMA@jama.com · 2y agoHigh-flow nasal oxygen was noninferior to noninvasive ventilation for rates of endotracheal intubation or death within 7 days in 4 of the 5 patient groups with acute respiratory failure. #CCRdownunder @criticalcarereviews.com ja.ma/41s0Lbx
It's amazing that Esmolol can show such consistency in effect size that has never been seen in sepsis, while Landiolol has a natural variation across trials. Add to that that the single trials vary more than the larger multicenter trials and one might almost get suspicious... #emimcc
1/ Anemia happens frequently in our aSAH patients. These patients are at risk for delayed cerebral ischemia and other neurologic insults It would seem having adequate oxygen to the brain tissue would be a good thing to prevent such injury. But how much hgb is adequate? A #skytorial on SAHARA
#PCCMSky Update 146 members- only 4 more slots in this starter pack Repost so the noobs know who the cool PCCM kids are Reply if you are not included and should be (make sure your creds are in your bio I am not putting randos on here) go.bsky.app/88wg6oG
jamanetwork.com/journals/jam... ADAPT-SEPSIS just published in JAMA #ccrdownunder
Biomarker-Guided Antibiotic Duration for Patients With Suspected Sepsis
This clinical trial assessed whether treatment protocols for monitoring C-reactive protein or procalcitonin safely reduced the amount of time critically ill adults with suspected sepsis received antib...
jamanetwork.com
👇ICU strain is measurable & impacts outcomes. “Measuring the Impact of ICU Strain on Mortality, After-Hours Discharge, Discharge Delay, Interhospital Transfer, and Readmission in Australia With the Activity Index.” David Pilcher et al. 🩺Critical Care Medicine. 🔗 journals.lww.com/ccmjournal/f...
Measuring the Impact of ICU Strain on Mortality,... : Critical Care Medicine
tive national registry-based cohort study. SETTING: One hundred seventy-five public and private hospitals in Australia (June 2020 through March 2022). SUBJECTS: Two hundred seventy-seven thousan...
journals.lww.com
Skytorial: pH management in DKA! I've been following debates about this for a *long* time (eg wrote this blog in 2016, which stands up pretty darn well: emcrit.org/pulmcrit/bic...) after years of arguing, lemme break down my take on this 😁
a cartoon of donald duck with the words " do you want to fight lets get it on then "
ALT: a cartoon of donald duck with the words " do you want to fight lets get it on then "
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Are you interested in #Sustainability in #Anesthesiology and how reusing TIVA lines could help reduce greenhouse gas emissions? Per Werner Moller, originally an expert in #AppliedPhysiology and #VenousReturn, discusses their environmental paper on the #EJA podcast. open.spotify.com/episode/2RCa...
Bacterial contamination and greenhouse gas emissions: A... : European Journal of Anaesthesiology | EJA
roorganisms, and eliminating the risk for patient-to-patient cross-contamination. However, infusion-set contamination from compromised aseptic handling could affect quality of care. INTERVENTIONS T...
journals.lww.com
Kaspar Bachmann@kasparbachmann.bsky.social · 2y agoSo the author Per Werner Moller, who is an amazing researcher and extremely insightful person, has answered these questions and talks about the paper in a podcast for #EJA, which is absolutely worth a listen: #Sustainability #Anesthesiology open.spotify.com/episode/2RCa...
Sadly, one of the great minds of intensive care medicine, Luciano Gattinoni, has passed away. His work is beyond impressive and has shaped many concepts that remain a hallmark of critical care. www.esicm.org/obituary-luc...
Obituary: Luciano Gattinoni - ESICM
In Memory of Professor Luciano Gattinoni
esicm.org
Since we’re entering the last month of 2024, here is a non-systematic review of #pulmcrit trials published this year that I found particularly noteworthy. Not comprehensive, so please include any that I may have missed! (🧵1/11) #emimcc #critcare #pulmsky #medsky
a man in a blue shirt and tie is standing in front of a bulletin board with papers on it .
ALT: a man in a blue shirt and tie is standing in front of a bulletin board with papers on it .
media.tenor.com
This is a not uncolmon scenario in the ICU. I have seen this in long term neuro ICU patients on valproat with sepsis during their ICU stay and mero being because of suspected multiresistant bacteria.
@IM_Crit_@imcrit.bsky.social · 2y agoICU Stories: Middle-aged patient w multiple co-morbidities (CAD/DM2/strokes/seizures/peripheral vasc dz/atrial fibrillation/chronic Foley - UTIs etc) was sent from nursing home to the ED for evaluation of fever/ hypotension. Urine was purulent. CT showed hydronephrosis & bladder wall thickening:
A thread 🧵 on trials I think have changed or will change ICU practice (at least my own). #emimcc
