Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Stages in the development of HF and recommended therapy by stage. ACEI indicates angiotensin-converting enzyme inhibitor;
, heart failure; ... mechanical circulatory support ... #CHF #Congestive ... Stages #ACCAHA #Algorithm ... #Management #Cardiology
Extracorporeal Membrane Oxygenation (ECMO) - Basics
Mode of cardiopulmonary support used to treat pulmonary and/or cardiovascular failure
cardiovascular failure ... cardiopulmonary failure ... institutional protocol ... #ECMO #Basics #management ... #pulmonary #criticalcare
BiPAP titration in CHF
 - Mean airway pressure provides goodness 
 - Ramp up the ePAP
BiPAP titration in CHF ... Driving pressure supports ... BiPAP #Titration #CHF ... CongestiveHeartFailure #Management ... #CriticalCare #
Approach to Selecting Respiratory Support:
-The role of noninvasive respiratory support is generally to reduce the patient's
Selecting Respiratory Support ... noninvasive respiratory support ... pneumonia vs. heart failure ... #Management #CriticalCare ... RespiratorySupport #Selection #Algorithm
β–Ί
Proposed Respiratory Support Algorithm in COVID19

The β€˜intubate early’ paradigm, where patients who β€œfail” low flow oxygen
Algorithm in COVID19 ... #COVID19 #management ... #schema #criticalcare ... #hypoxia #failure ... #algorithm
COVID-19 Hypoxia Management

Indication for endotracheal intubation?
Tolerating supplemental oxygen?
Consider HFNC
Not tolerating HFNC or HFNC is not available?
Consider
COVID-19 Hypoxia Management ... #respiratory #support ... #schema #criticalcare ... #hypoxia #failure ... #algorithm #survivingsepsis
Possible Ventilator Allocation Protocol

BLUE (Exclusion criterion or SOFA > 11)
 - No Ventilator Provided
 - Use
Ventilator Allocation Protocol ... or Single organ failure ... significant organ failure ... #COVID19 #CriticalCare ... #Management #Ethics
Understanding & Treating ARDS - Acute Respiratory Distress Syndrome

β€’  Timing - within one week of
- respiratory failure ... volume overload or CHF ... Syndrome #Diagnosis #Management ... #CriticalCare
Shock - Differential Diagnosis Framework
 - MAP <65. SBP <90, drop in SBP > 40
 -
Insufficiency, Liver Failure ... Decompensated CHF ... Differential #Diagnosis #criticalcare ... #algorithm #treatment ... #management
Flowchart to diuretic use in acute heart failure.

(A) Congestion with volume overload. 

(B) Treatment algorithm after
in acute heart failure ... (B) Treatment algorithm ... , heart failure; ... Diuretic #Diuresis #CHF ... HeartFailure #Cardiology #Management