I think this highlights the challenge with 2ary endpoints that don't have standardized initiation criteria that vary by physician/centre such as RRT, mech ventilation, tMCS escalation, or even destination therapies. Our prior #CCCTN work showed a 16% variation in CICU CRRT use

✍️ Revised expert opinion on cardiac arrest systems of care (see image ⬇️)
onlinecjc.ca/article/S0828-… #CJC 11/11 🔚

✍️ Revised expert opinion #2 on Temperature Control:
In patients who do not purposefully respond to verbal commands after a resuscitated OHCA with an initial non-shockable rhythm, it is reasonable to target a core temperature target of ≤ 37.5°C onlinecjc.ca/article/S0828-… #CJC 4/11

✍️ Revised expert opinion #1 on Temperature Control:
In patients who do not purposefully respond to verbal commands after a resuscitated OHCA with an initial shockable rhythm, it is reasonable to target a core temperature target of ≤ 37.5°C onlinecjc.ca/article/S0828-… #CJC 3/11

✍️ Revised expert opinion:
In comatose patients with a resuscitated OHCA without STEMI, delaying angiography might be considered unless there is hemodynamic instability, high-risk ischemic ECG changes, or recurrent ventricular arrhythmias onlinecjc.ca/article/S0828-… #CJC 2/11

📣 #Tweetorial : The CCS CANCARESociety Clinical Practice Update “Optimal Post Cardiac Arrest and Refractory Cardiac Arrest Patient Care” has been published. See all expert opinions here 👉 onlinecjc.ca/article/S0828-… #CJC 1/11 🧵

Updated cardiac arrest management guidelines based on latest RCts. Amazing work by Janek Senaratne Erin Rayner-Hartley Christopher Fordyce Graham Wong Emilie Belley-Côté, MD, PhD rebecca mathew CJC Journals Stanley Nattel

📝 This new CCS Clinical Practice Update provides 19 expert opinions on contemporary best practices for post-cardiac arrest care, the treatment of refractory cardiac arrest, and regionalized systems of care 👉 onlinecjc.ca/article/S0828-… #CJC

An incredible #ACC24

🫀1st time presenting on TTM
🫀sharing the stage with good friend Sean van Diepen
🫀PD/APD dream team w/Julie Damp
🫀Building Nashville connections w/Ann Gage
🫀Reconnecting with so many friends 🥰

Vanderbilt Health VUMC Heart/Vascular Vanderbilt Cardiology Fellowship Jane Freedman MD

Topical compared to IV tranexamic acid in patient undergoing CV surgery lowers risk of seizure but increases risk of RBC transfusion Jason N. Katz American College of Cardiology Shashank Sinha, MD, MSc, FACC, FAHA

I think Canadian centers will need to change practice, but costs of the pump remain a challenge.

REDUCE AMI. Evidence for de-ad option of BBlockers in lower risk patients with MI and preserved LV function. Patients will love taking 1 less pill! Shelley Zieroth Jason N. Katz Shashank Sinha, MD, MSc, FACC, FAHA Timothy Henry

Agree, The higher vascular complications expected, but the RRT and sepsis signals suggest a need to sort out if this is survival bias (allowing for more complications to occur) or if these are 'device specific.' Alex Truesdell Jason N. Katz Saraschandra Vallabhajosyula, MD MSc Ann Gage Carlos L. Alviar MD, FACC

Congrats to Danger team Christian Hassager! Impressive results, now after SHOCK and Culprit-Shock 3rd positive RCT. Nevertheless, multiple questions remain: 1) is it the device? 2) patient selection? 3) treatment bias? 4) longer follow-up? Sean van Diepen Johann Bauersachs Navin Kapur

I like the trial and the results. However, a treatment bias with more intensive care treatment as shown by the non-pathophysiological explainable RRT increase may also be a confounder of the trial results.

Sean van Diepen Shashank Sinha, MD, MSc, FACC, FAHA Shelley Zieroth Holger Thiele Abdulla A. Damluji, MD, PhD Alex Truesdell Michelle Graham Bravo to those investigators! A true endurance test. Patient selection most certainly matters for shock trials. They have given us a wonderful blueprint for future trials too!

DanGer Shock! The first temporary mechanical support device shown to reduce mortality in patients with cardiogenic shock but there is an increased risk of complications. Shashank Sinha, MD, MSc, FACC, FAHA Shelley Zieroth Jason N. Katz Holger Thiele Abdulla A. Damluji, MD, PhD Alex Truesdell Michelle Graham

In a large CICU registry, critical care therapies varied 4-fold with 80% of the variability due to patient variables and admission acuity. Institutional differences accounted for 5% of the variability. No differences were observed in adjusted mortality between ...

low, intermediate, and high critical care therapy utilization sites @loridanielsMD Jason N. Katz Sammy Zakaria @brianjpotter11 Jeff Teuteberg @coobrien @sunitchaudhryMD @kevinshahmd Sean van Diepen #AHAJournals
ahajournals.org/doi/10.1161/CI…

Join us today at 6pm for the last 3rd and final session of the #CritCareCards online summit with presentations by Ann Gage & Jason N. Katz and the annual CCC FIT ZOLL_Medical Jeopardy! Free registration 👉🏼 FellowsEducation.com/Critical-Care-… Shashank Sinha, MD, MSc, FACC, FAHA Dr. Rosy Thachil Sean van Diepen