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What a great honor to have been invited as a Visiting Professor Grand Rounds Speaker at @MayoClinic
A truly incredible experience made possible by @KalagaraHari! 🙏
Eduardo R Argaiz
10.5K posts
Eduardo R Argaiz
@ArgaizR
Dad | Professor of Medicine @TecdeMonterrey @incmnszmx | Honorary Visiting Professor, Mayo Clinic Florida, USA and Cleveland Clinic, USA
- Case of mine: Young patient, O2sat <50% room air; 80% on 15 L NRM. Completely normal mental status, no shortness of breath, no increased WOB, no tachypnea. Pt feeling ok and looked happy. (1/4)
- Fluid management in acute kidney injury: from evaluating fluid responsiveness towards assessment of fluid tolerance I hope you guys like our Educational Review! doi.org/10.1093/ehjacc… drive.google.com/file/d/1Arbd3S…
- Imagine assessing femoral pulse w Doppler.... You hear some music 🎵🎼 Try a different device.... yup, music is still there 🤔 Try it on yourself... no music 🧐 💡Prosthetic hips picking up a radio signal? 📻 Publish in NEJM 😎 (10.1056/NEJMicm1911324) Author is Wise 😉
00:00 - 👴 w Cirrhosis ➡️🏥 with spontaneous bacterial peritonitis and septic shock After fluid resuscitation, vasopressors and antibiotics shock resolved However now with oliguria and ⬆️ Na (165 meq/L). Cr 1.0 mg/dl, BUN 30 mg/dl 1/10
- 📞 Nurse: Patient has a blood pressure of 226/118 mmHg! 📞 Resident: Nifedipine 30 mg STAT! ..... 📞 Me: About that last call, please hold Nifedipine until we assess the patient A 🧵of some cases of Inpatient Hypertension 👇 1/15
GIF - AKI Consult: 👵 ➡️ ED with severe DKA. CT Abdomen and Chest to look for infectious trigger: negative. Tx with IV insulin and balanced crystalloid + 6 L with obvious improvement. Cr was 2.7 Remained oliguric, now in sudden shock with increasing NE dose (0.5 ucg/kg/min) 🚨 1/12
00:00- Young pt ➡️ 🏥 worsening shortness of breath PMH: ESRD. Only 1 HD session/week. However, residual urine volume has now decreased substantially On exam: BP 134/94, 2L O2,🧠✅, elevated JVP, decreased 🫁 sounds at bases, No murmurs, very mild edema. Functional left BC AVF 1/13
- And old classic🏛️📚: "The correlation between CVP and circulating blood volume has never been found simply because it does not exist" Venous Function and Central Venous Pressure: A Physiologic Story doi.org/10.1097/ALN.0b…
GIF - #AKIConsultSeries:👨w T2DM➡️🏥 for fever, dysuria and CVA tenderness. On arrival: ⬇️BP, ⬆️Glucose, ⬆️AGMA. Dx UTI + DKA. Tx: Abx + Insulin Pump + 4 L Crystalloid + NE After resus, pt still oliguric, Cr 3.2. NE 0.7 ug/kg/min,🧠confused, BP 85/62, HR 123, 2L O2. CRT 4 sec 1/12
- Ambulatory Hemodialysis Unit Rounds: Called to see a patient with hypotension: BP 76/40,🧠 OK, CRT 5 seconds 1st step ➡️🛑Ultrafiltration + 300 ml bolus. BP 90/60 Pt is a middle aged ♂️ w ESRD and T2DM 1/9 🧵
