Should have told cardio surgery that it affects him personally because if he reduces the incidence of AKI in his patients then he won’t have to consult nephrology as often. Win, win
I had open heart surgery CABG with 3 bypasses. I developed kidney failure, on dialysis for 6-7 weeks along with a leaking Chylothorax, that needed more surgery. I do not know if I had this type of IV fluid or if it would have helped prevent the kidney failure. Good news my kidneys are back woking at about 30 percent. LOVE your content.
I was honestly expecting nephrology to have kidnapped and secretly replaced anesthesia just so he could talk about that study. I was under the impression that anesthesia didn't like talking to surgeons.
Is this amino acid acetylcysteine i.e. mucomyst? It's been given to people with kidney risk pre-angio for years, at least where I worked. It was usually oral though, but according to some other lit can also be IV
@@giovannilandoni9381 My involvement in medicine is merely "being a patient" but I just wanted to come by and tell you that it's cool you're in here to answer questions directly and check out if things are well understood etc. :D
Out of curiosity (if anyone has read the study) what constitutes a "significant" reduction? As in what is the typical incidence of kidney injury, how significant was that injury and and how much was it reduced. Because if kidney injury only occurs 2% of the time and the procedure reduces the risk in that group by 2% it might be considered significant to a scientist but it could involve a lot of added stress to patients who have to go in three days early.
I believe in this context "significant" is shorthand for "statistically significant", aka the reduction is outside the margin of error for the test. I don't know the margin of error or the amount of reduction for this particular study though.
I wrote the article :) AKI occurred in 474 patients (26.9%) in the amino acid group and in 555 (31.7%) in the placebo group (relative risk, 0.85; 95% confidence interval [CI], 0.77 to 0.94; P=0.002). AKI3 occurred in 1.6% and 3.0%
@@giovannilandoni9381 Thank you for the response. A lot of these kind of articles get partially quoted and the results get distorted via the telephone game.
thank you @NEJM and @DGlaucomflecken for this video on our #PROTECTIONtrial ! (low-dose short-term amino acids infusion is improving perioperative renal function) this is exactly what is happening in the majority of cardiac surgical theaters worldwide @SRAnesthesiaICU same faces same sentences @giovannilandoni
Why isn't this how all journals are structured? Tell me what it says in plain English and if this is relevant to me, so many abstracts are incomprehensible
Would love Dr G to explain Covid vaccine to young healthy kiddos. Even though CDC recommends I just can’t figure it out. Maybe a brilliant doctor on this post could educate me?
Nephro would have protein everywhere, but salt make kidney go brr-r-r and aminos are apparently ok where proteins slow the works considerably (so. NPO when you could drink the aminos possibly, but the IV's certainly going to be there )
Wait, which hospital is this that allowed nephrology into the OR without surgical scrubs and a bouffant? 🤔 He's going to contaminate the aseptic environment! 😡
@@elielnham210 Yes, kidney. But my first thought skipped back 1,000 years to my High School Chemistry class and immediately thought "K = potassium". LOL!
I need this for every single paper ever
I second the motion
WAKE UP Dr. Glaucomflecken Journal club just dropped
LOVE THIS!!!
We need lady glaucoma to present some ob gyn stuff!!!
Surprised nephrology didn't get murdered by scrub for walking in without surgical attire.
If only all researches were presented in Dr. Glaucomflecken format, I'd be educated as f*ck
*Hiss hiss cardiology* 😆
I need this on a T-shirt
🤣🤣🤣🤣
I've never before watched NEJM. Not even once. But now I can't wait to learn about another study! 😂
It’s almost like perioperative nutrition affects clinical outcomes!
- Acute care RD
Now I need a hiss hiss cardiology shirt
Absolutely!
Front :Hiss Hiss Cardiology
Back: Now get outta here!
I am making one for myself as we speak! It will be great to sit in my cardiology class
Should have told cardio surgery that it affects him personally because if he reduces the incidence of AKI in his patients then he won’t have to consult nephrology as often. Win, win
The best way to convince Cardiology? Tell him he will have to deal with Nephrology less if he charts IV amino acids.
I love being educated in this manner. Thank you, Dr G!
Med student on standby with trial results😂😂
Dr. G out here dropping knowledge & comedy.
The med student sounded a lot like Russell from Up reading from his Wilderness Explorer guidebook when he first meets the old guy.
I thought he sounded like Trump trying to feign interest while he read the teleprompter!
ID just had a stroke because Staph doesnt care if the growth medium is salty or not, and the open patient is right there
I had open heart surgery CABG with 3 bypasses. I developed kidney failure, on dialysis for 6-7 weeks along with a leaking Chylothorax, that needed more surgery. I do not know if I had this type of IV fluid or if it would have helped prevent the kidney failure. Good news my kidneys are back woking at about 30 percent. LOVE your content.
These collabs are likely amazing and probably life-saving!
Wish i could have " liked" this nejm initiative much more than once
There is like for you😅
And now you’re making us smarter, good job Dr.!
More of this please!
I was honestly expecting nephrology to have kidnapped and secretly replaced anesthesia just so he could talk about that study. I was under the impression that anesthesia didn't like talking to surgeons.
Thanks for the creative way to spread information and help people learn something new.
So....this was purely educational? Ok. Well done.
At least he didn't pour the salt in the incision wound.
Uhm who allowed the nephrologist and the med student to contaminate the OR by not changing into OR scrubs? 😂
Is this amino acid acetylcysteine i.e. mucomyst? It's been given to people with kidney risk pre-angio for years, at least where I worked. It was usually oral though, but according to some other lit can also be IV
in this study we used a balanced mixture of 15 amino acids at a dose of 2 g per kilogram pubmed.ncbi.nlm.nih.gov/38865168/
I can't wait to see someone cite one of these for a student paper or something. :D
Is this the same intravenous amino acids we use for kidney protection during Radioactive Lutetium infusion for Nuclear Therapy?
Same question
no, this is something new! in this study we used a balanced mixture of 15 amino acids at a dose of 2 g per kilogram pubmed.ncbi.nlm.nih.gov/38865168/
@@giovannilandoni9381 My involvement in medicine is merely "being a patient" but I just wanted to come by and tell you that it's cool you're in here to answer questions directly and check out if things are well understood etc. :D
Love the white coat and then the street clothes in the "cardiac OR."
Nephrology really be an alligator coming in all salty and hissing
Out of curiosity (if anyone has read the study) what constitutes a "significant" reduction? As in what is the typical incidence of kidney injury, how significant was that injury and and how much was it reduced. Because if kidney injury only occurs 2% of the time and the procedure reduces the risk in that group by 2% it might be considered significant to a scientist but it could involve a lot of added stress to patients who have to go in three days early.
I believe in this context "significant" is shorthand for "statistically significant", aka the reduction is outside the margin of error for the test.
I don't know the margin of error or the amount of reduction for this particular study though.
I wrote the article :) AKI occurred in 474 patients (26.9%) in the amino acid group and in 555 (31.7%) in the placebo group (relative risk, 0.85; 95% confidence interval [CI], 0.77 to 0.94; P=0.002). AKI3 occurred in 1.6% and 3.0%
@@giovannilandoni9381 Thank you for the response. A lot of these kind of articles get partially quoted and the results get distorted via the telephone game.
If only med school was this fun
Next we will be collecting CMEs here! Yeah!
thank you @NEJM and @DGlaucomflecken for this video on our #PROTECTIONtrial ! (low-dose short-term amino acids infusion is improving perioperative renal function)
this is exactly what is happening in the majority of cardiac surgical theaters worldwide @SRAnesthesiaICU
same faces
same sentences
@giovannilandoni
Why isn't this how all journals are structured? Tell me what it says in plain English and if this is relevant to me, so many abstracts are incomprehensible
Leave your salt outside the operating room 😂😂😂
Is anybody else bothered that Nephrology didn't wear a bouffant cap in the operating room?
Has nephrology been directing his anger of cardiology toward his Morton container? Poor thing looks all beat up
Would love Dr G to explain Covid vaccine to young healthy kiddos. Even though CDC recommends I just can’t figure it out. Maybe a brilliant doctor on this post could educate me?
"hiss hiss cardiology" 🤣
what kind of operating room is this lol
St.Glaucomflecken Clinic's best :P
Can you do one about the cardiologist who treats POTS by prescribing buffered salt pills to patients? Would nephrology be happy? Or feel competitive?
IV amino acids, eh? Would oral supplementation before surgery assist?
Just tell him "if you do this, you can focus on the heart more and less on arguing with me". Done.
Is... is this what journal club looks like?
Nephrology hates Cardiothoracic too? (They are not Cardiologists)
Pretty sure he hates anyone with cardio in the name. Full stop. lol
Oh, so THAT’S why they have beef
why nephro have salt everywhere?
Nephro would have protein everywhere, but salt make kidney go brr-r-r and aminos are apparently ok where proteins slow the works considerably (so. NPO when you could drink the aminos possibly, but the IV's certainly going to be there )
bad surgeon. He didn't let Nephrology finish.
I still don't know why nephrology likes salt so much. Is it because salt makes you pee?
so now they can charge an extra $10,000 for sterile chicken soup during heart surgery? no mention of NNT in the journal club.
Too bad there’s a national shortage of iv fluids right now
Wait, which hospital is this that allowed nephrology into the OR without surgical scrubs and a bouffant? 🤔 He's going to contaminate the aseptic environment! 😡
k word 😂
I thought he meant POTASSIUM. Anyone else?
I thought it was kidney?
@@elielnham210 Yes, kidney. But my first thought skipped back 1,000 years to my High School Chemistry class and immediately thought "K = potassium". LOL!
lololol cardiac nurse is hilarious
The k word!!!
😂😂