Andrew Helt @CanEMDoc

Father & husband. Intensivist, ER doc, TTL, & POCUS proponent. Wilderness enthusiast. London, Ontario Joined November 2010

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J Gordon Boyd @jgordonboyd

11 months ago

Brilliant work! Congrats Dr. McKenzie and team!

Erica McKenzie @ericadmckenzie

11 months ago

Brilliant work! Congrats Dr. McKenzie and team!

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IMCrit @IM_Crit_

12 months ago

COPD - It did HAPPEN @JAMA_current:

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Thank you to @CIHR_IRSC ACT competition for funding a Phase 3 trial of inhaled furosemide as supportive therapy for resp. failure 2nd to pulmonary infection. This adaptive international trial in 50 centers will enroll up to 1540 pts and run on the PRACTICAL platform.

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𝙟𝙤𝙨𝙝 𝙛𝙖𝙧𝙠𝙖𝙨 💊 @PulmCrit

a year ago

after a week on service with lots of refractory shock, I added a section on refractory shock to IBCC. and also a section on hydroxocobalamin. better late than never 😬 any useful bits I left out? emcrit.org/ibcc/shock/

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Andrew Helt @CanEMDoc

a year ago

#CCR24 Day 3 Overview: DEFENDER: No benefit with SLG2Is for allcomers in ICU, but safe. REMAPCAP-steroid: Hard to make sense of this one, but no benefit to steroids in CAP. NAVIGATE: Early NIV prevents worsening of resp failure. REVISE: SUP with PPI ⬇️ GIBs @CritCareReviews

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Andrew Helt @CanEMDoc

a year ago

For the PO vs IV PPI (and H2 blocker vs PPI for that matter) PEPTIC (which was discussed at CCR in 2020) provides me some reassurance that the options for SUP are all similarly effective.

Julian Owen @JulianOwenEM_CC

a year ago

For the PO vs IV PPI (and H2 blocker vs PPI for that matter) PEPTIC (which was discussed at CCR in 2020) provides me some reassurance that the options for SUP are all similarly effective.

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NEJM @NEJM

a year ago

Presented at #CCR24: In a randomized trial involving patients undergoing invasive ventilation, pantoprazole decreased the risk of upper gastrointestinal bleeding as compared with placebo but did not affect mortality. Read the full REVISE trial results: nej.md/3KD01Xp

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Andrew Helt @CanEMDoc

a year ago

This might be the most insightful part of the entire trial. What matters to clinicians may not be what matters to our patients. Transfusion of a single unit, CT angio, and diagnostic endoscopy, all things that really matter to patients. #CCR24 #REVISEtrial

J Gordon Boyd @jgordonboyd

a year ago

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Andrew Althouse @ADAlthousePhD

a year ago

Since @CritCareReviews and #CCR24 have had a couple of win ratio analyses, here’s a little plug for a video I made with @CMichaelGibson a few years back that is meant to be an accessible explainer of how it works. Please excuse my hair. It was a different time.

C. Michael Gibson MD @CMichaelGibson

3 years ago

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Andrew Helt @CanEMDoc

a year ago

The #NAVIGATEtrial shows a very impressive decrease in severe resp failure with WARD-BASED NIV. If findings external valid, then this could be BIG! #CCR24 I'm skeptical & still have Qs. Unsure my centre would replicate these results. Regardless, early NIV seems SAFE and SMART.

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Julian Owen @JulianOwenEM_CC

a year ago

#CCR24 @CritCareReviews #REMAPCAP Recommendation to not change practice based on latest REMAP-CAP steroid arm. Challenges with rate adaptive randomization and complexity of study design. Difficult to reconcile prior strong evidence base for steroids in severe CAP (CAPE COD).

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Andrew Helt @CanEMDoc

a year ago

Is it possible that there are multiple miscoding errors? A double negative? The point estimate of benefit in CAPE-COD is not dissimilar to the risk of harm in REMAP-CAP. I assume not, but would be great to see the initial group randomised was similar to patients later on. #CCR24

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Andrew Helt @CanEMDoc

a year ago

All I can say is thank-you Steve Webb, Scott Berry & @ADAlthousePhD for going through @remap_cap's CAP steroid arm. Bayesian analysis alone are confusing... but adaptive platform design trials are mind-boggling at times... then the "unique" events in this domain... 🙃 #ccr24

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Andrew Helt @CanEMDoc

a year ago

Does #REMAPCAP end steroids for severe CAP's honeymoon period? There were some wild ups and downs in the trial, which accumulated in what on the surface appears to be harm from hydrocortisone, but at the very least showed no benefit. @remap_cap @CritCareReviews #CCR24