The Educational Newsletter From  CriticalCareNow!

What is ZEEP? 

Are you intubating someone who is hemodynamically unstable....don't forget about ZEEP! ZEEP, or zero PEEP can be a good inital strategy with patients who are mechanically ventilated and hemodynamically unstable. This is not a long term strategy, but consider this to minimize positive intrathoracic pressure and to maintain pre-load.

Check out the video for more and follow @ICUDoctorofTikTok!

Epinephrine in Arrest

In this informative YouTube video from ResusX:ROSC, Dr. Corey Slovis delves into crucial aspects of managing cardiac arrest situations. He examines the effectiveness of key medications—epinephrine, bicarbonate, and calcium—shedding light on their benefits and limitations. Dr. Slovis emphasizes that while epinephrine is the preferred drug for cardiac arrest, its impact on survival with good neurological outcomes is debatable. He presents a large-scale trial's findings, which indicate that epinephrine increases the return to spontaneous circulation and hospital admissions, yet doesn't necessarily improve neurologic outcomes. Dr. Slovis advises careful administration of epinephrine based on rhythm and timing. Moving on to bicarbonate and calcium, he asserts that their routine use in cardiac arrest lacks substantial evidence of effectiveness, with potential harm to neurological outcomes. Dr. Slovis underscores the importance of selective use for specific cases. Ultimately, his insightful presentation urges a balanced and evidence-based approach to managing cardiac arrest situations.

Check out his amazing video now!

The Great TTM Debate

In "The Great TTM Debate" podcast episode, the host introduces a spirited discussion between Sara Gray and Swarna Rajagopala on the topic of targeted temperature management (TTM) post-cardiac arrest. Swarna passionately argues for the benefits of cooling patients to 33 degrees Celsius, citing various studies and pathophysiological evidence that demonstrate its neuroprotective effects after cardiac arrest. She emphasizes the importance of TTM in improving neurological outcomes and criticizes the potential misapplication of findings from the TTM2 study. On the other hand, Sara Gray champions the practice of normothermia, maintaining that it's just as effective, more manageable, safer, and allows for quicker neuro prognostication. She references the TTM2 study, which found no significant difference between cooling to 33 degrees and maintaining normothermia. The debate concludes with both participants defending their points, but the host encourages listeners to make their own informed decisions based on the presented arguments.

Here are 5 key takeaways:

1. Targeted temperature management (TTM) post-cardiac arrest is a controversial topic with solid arguments on both sides.
2. Swarna Rajagopala advocates for cooling patients to 33 degrees Celsius, citing numerous studies and evidence of its neuroprotective effects.
3. Sara Gray argues for the practice of normothermia, referencing the TTM2 study which found no significant difference between cooling and maintaining normothermia.
4. Both participants emphasize the importance of evidence-based practice and the potential implications of their respective approaches on patient outcomes.
5. The debate underscores the evolving nature of medical practices and the importance of continuous research and discussion in the field.