Eddy J. Gutierrez, MD

Norepinephrine raises MAP. It also hits beta-2-adrenergic receptors on immune cells, which contributes to immunoparalysis. Perhaps too nuanced to ever get a good trial on, sadly. 🎩 tip to the authors.
eddyjoemd.com/foamed

Peripheral VA-ECMO fixes flow but adds afterload. Retrograde return can keep the aortic valve shut and distend the LV, making things worse. Fix it by unloading the already struggling LV. Here's the why and how. 🎩 tip to the authors.
eddyjoemd.com/foamed

"Capillary leak" is still a clinical guess. We cannot measure permeability at the bedside, so a multimodal look at edema, congestion, and endothelial injury is the best we have. 🎩 tip to the authors, including @fabio_taccone and @PhilGuerci. eddyjoemd.com/foamed

Harlequin syndrome isn't a flow-rate problem. The brain + coronaries can desat while the legs look fine. Check a right-hand sat, then change the circuit config. 🎩 tip to the authors including @DrMohEldiasty, @ElgudinYakov, @ProfDrPopov & @adham_sherbini eddyjoemd.com/foamed

Is anyone using methylene blue for septic shock? This paper discusses its "potential," but the research space has been relatively dormant since I published The Vasopressor & Inotrope Handbook almost 3 years ago. 🎩 tip to the authors.
eddyjoemd.com/foamed