# atrial (blogs) — RSS Amplifier Recent posts from the 2 feeds in the RSS Amplifier directory that cover atrial. Page: Feed: --- ## [Half Your Hemodynamic Monitoring Stops Working the Moment the Rhythm Goes Irregular, and the Monitor Never Tells You](https://iccn.substack.com/p/half-your-hemodynamic-monitoring-020) _2026-08-19 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ One sorting rule separates the tests that survive atrial fibrillation from the ones that quietly become decoration. It takes a sentence to learn and it changes what you do tonight. ## [Forty Percent Never Got the Tube Out](https://iccn.substack.com/p/forty-percent-never-got-the-tube) _2026-08-18 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ We have argued about tracheostomy timing for twenty years. A 738-patient German cohort published in March suggests we have been arguing about the wrong thing entirely ## [198,494 Patient Encounters Across 9 Hospitals Just Delivered the Fairest Test Yet of the Epic Sepsis Model Version 2. Predictive Performance Depends on Which Sepsis Definition You Apply, and False....](https://iccn.substack.com/p/198494-patient-encounters-across) _2026-08-17 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ The April 2026 JAMA Network Open study from Massachusetts General Brigham, senior-authored by Chanu Rhee, evaluated the widely deployed Epic Sepsis Model version 2 across three standard sepsis definitions (Sepsis-3, SEP-1, and CDC Adult Sepsis Event). ## [Forty to Fifty Percent of New Leaders Fail Within Eighteen Months. The First 90 Days as an ICU Charge Nurse, RT Supervisor, APP Lead, Pharmacy Director, or Medical Director, and the Onboarding....](https://iccn.substack.com/p/forty-to-fifty-percent-of-new-leaders) _2026-08-16 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ Michael Watkins' First 90 Days framework has been the leadership transition standard for two decades. ## [Tripping From Nitrous Oxide to Prefrontal Lobotomies](https://theskepticalcardiologist.substack.com/p/tripping-from-nitrous-oxide-to-prefrontal) _2026-08-15 · The Skeptical Cardiologist · The Skeptical Cardiologist_ The Skepcardashians will be investigating the history of cardiovascular medicine and surgery in the UK and Portugal ## [The Number Under Every Ventilator Setting Was Never Measured](https://iccn.substack.com/p/the-number-under-every-ventilator) _2026-08-15 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ Predicted body weight is a formula built from height and sex. ## [We Have Been Auditing the Wrong Layer. In Critical Care, the Bias Enters at the Probe Before Any Algorithm Sees It.](https://iccn.substack.com/p/we-have-been-auditing-the-wrong-layer) _2026-08-14 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ A 2026 head-to-head comparison of 34 pulse oximeters found that device performance across skin pigmentation varies by manufacturer, and that 18 of them could pass or fail depending on which participants you tested. ## [One Hundred Seventy-Eight of Two Hundred: How to Open a Composite Endpoint Before You Believe It](https://iccn.substack.com/p/one-hundred-seventy-eight-of-two-a02) _2026-08-13 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ A JAMA trial reported that a new catheter lock solution reduced central line complications by 32 percent. ## [Who Counts as High Risk?](https://iccn.substack.com/p/who-counts-as-high-risk) _2026-08-11 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ Two 2026 meta-analyses found high-flow and noninvasive ventilation indistinguishable after extubation. The harder finding is that no two trials agreed on which patients they were studying ## [25,481 Michigan Sepsis Patients Just Provided the Clearest Observational Evidence Yet That the 30 mL/kg Fluid Mandate Should Bend to Individual Comorbidity](https://iccn.substack.com/p/25481-michigan-sepsis-patients-just) _2026-08-10 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ The June 2026 JAMA Network Open cohort study from the Michigan Hospital Medicine Safety Consortium, senior-authored by Hallie Prescott, analyzed weight-based fluid resuscitation across 67 hospitals and four clinical subgroups defined by hypoperfusion severity and comorbidity burden. ## [Ship everywhere from one CLI (Sponsored)](https://crawlproof.com/a/hSXH13S3rxt9) _2026-08-10 · **Sponsored**_ One codebase, hosted runners, encrypted credentials, and automated submissions across stores ## [Profiles in Prevention: A Youngish Woman with Silent Advanced Coronary Disease](https://theskepticalcardiologist.substack.com/p/profiles-in-prevention-a-youngish) _2026-08-09 · The Skeptical Cardiologist · The Skeptical Cardiologist_ Let's check in on Lisa, who I first profiled a dozen years ago ## [Excess Exercise, Part II: Coronary Inflammation in Marathon Runners](https://theskepticalcardiologist.substack.com/p/excess-exercise-part-ii-coronary) _2026-08-02 · The Skeptical Cardiologist · The Skeptical Cardiologist_ An emerging tool for assessing coronary risk sheds light on the athlete's calcification paradox ## [Was I Wrong to Check a Blood Test for Alzheimer's Dementia on Myself?](https://theskepticalcardiologist.substack.com/p/was-i-wrong-to-check-a-blood-test) _2026-07-26 · The Skeptical Cardiologist · The Skeptical Cardiologist_ Primary doctors and most neurologists are not recommending you get these tests unless you have cognitive impairment, but I wanted to know my levels ## [Pill In The Pocket Approaches to the Management of Atrial Fibrillation](https://theskepticalcardiologist.substack.com/p/pill-in-the-pocket-approaches-to) _2026-07-24 · The Skeptical Cardiologist · The Skeptical Cardiologist_ For some patients with paroxysmal atrial fib and relatively infrequent episodes of symptomatic afib, taking an oral anti-arrhythmic on an as-needed basis rather than continuously may be preferable. ## [Are You on the Fence About Starting a Blood Pressure Medication?](https://theskepticalcardiologist.substack.com/p/are-you-on-the-fence-about-starting) _2026-07-19 · The Skeptical Cardiologist · The Skeptical Cardiologist_ Millions of Americans have Stage I hypertension with mild elevations of systolic blood pressure between 130 and 140 mm Hg. When does it make sense to start a pill to get them below 130 mm Hg? ## [Is the New Cholesterol-Slashing Pill Approved by the FDA Right for You?](https://theskepticalcardiologist.substack.com/p/is-the-new-cholesterol-slashing-pill) _2026-07-17 · The Skeptical Cardiologist · The Skeptical Cardiologist_ Two skeptical cardiologists weigh in ## [Lindsay Graham Died Suddenly From a Tear in His Aorta: Are You Next?](https://theskepticalcardiologist.substack.com/p/lindsay-graham-died-suddenly-from) _2026-07-13 · The Skeptical Cardiologist · The Skeptical Cardiologist_ On the importance of knowing with certainty how your loved ones die ## [Ablation versus Medicine for Atrial Flutter](https://theskepticalcardiologist.substack.com/p/ablation-versus-medicine-for-atrial) _2026-07-10 · The Skeptical Cardiologist · The Skeptical Cardiologist_ Ablation for atrial flutter is highly effective and safe relative to afib ablation. Should my patient proceed to the procedure directly or pursue other more conservative approaches? ## [Should We be Screening Cardiac Patients for Disordered Sleep Breathing?](https://theskepticalcardiologist.substack.com/p/association-without-causation-the) _2026-07-03 · The Skeptical Cardiologist · The Skeptical Cardiologist_ There's a constant drumbeat in the medical community to screen and test patients for sleep apnea despite new studies confirming that various sleep apnea treatment modalities don't reduce heart disease