# critical care (blogs) — RSS Amplifier Recent posts from the 4 feeds in the RSS Amplifier directory that cover critical care. Page: Feed: --- ## [The Hardest Cognitive Move a Healthcare Professional Makes. What the Peer-Reviewed Literature on Professional Identity Formation, Imposter Syndrome, and Role Reconstruction Tells Every ICU Discipline](https://iccn.substack.com/p/the-hardest-cognitive-move-a-healthcare) _2026-08-23 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ The 2020 Bravata systematic review of 62 studies with 14,161 participants documented imposter syndrome prevalence of 9 to 82 percent across professional populations. ## [The Trial Passed. Read the Table Anyway.](https://iccn.substack.com/p/the-trial-passed-read-the-table-anyway) _2026-08-22 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ CHIPS met its non-inferiority criterion for 21-day cold-stored platelets with better than 99.9 percent posterior probability. ## [Weight loss is associated with improved vascular function in patients with metabolic dysfunction-associated steatotic liver disease](https://www.2minutemedicine.com/weight-loss-is-associated-with-improved-vascular-function-in-patients-with-metabolic-dysfunction-associated-steatotic-liver-disease/) _2026-08-21 · Paary Balakumar · Cardiology | 2 Minute Medicine_ 1. Short-term dietary weight loss targeting hepatic fat reduction was associated with measurable improvements in arterial stiffness, endothelial function, and cardiovascular risk scores in metabolic dysfunction-associated steatotic liver disease (MASLD) patients. 2. These vascular improvements did not correlate directly with the magnitude of hepatic triglyceride reduction, suggesting the vascular… ## [Three Frontier Models Were Asked to Write Something They Knew Was False. All Three Did It Every Single Time.](https://iccn.substack.com/p/three-frontier-models-were-asked) _2026-08-21 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ Researchers at Mass General Brigham asked five leading language models to argue that a brand-name drug was unsafe and patients should switch to its own generic. ## [Who Chose 0.2? The Non-Inferiority Margin Is the Whole Trial](https://iccn.substack.com/p/who-chose-02-the-non-inferiority) _2026-08-20 · Javier Amador-Castaneda, FCCM · Interprofessional Critical Care Network (ICCN)_ In a superiority trial, the data decide. ## [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. ## [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. ## [AI publishing with human taste (Sponsored)](https://crawlproof.com/a/0VlQnWycEXeH) _2026-08-15 · **Sponsored**_ Convert AI research into blogs, podcasts, and newsletters with optional human review. ## [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. ## [A health coaching intervention may improve blood pressure control in postpartum women](https://www.2minutemedicine.com/a-health-coaching-intervention-may-improve-blood-pressure-control-in-postpartum-women/) _2026-08-12 · Alex Xiang · Cardiology | 2 Minute Medicine_ 1. A health coaching intervention combined with self-measured blood pressure (SMBP) monitoring for postpartum women was associated with significantly greater engagement with primary care and significantly greater reductions in systolic and diastolic blood pressure (BP). Evidence Rating Level: 1 (Excellent) Hypertensive disorders of pregnancy (HDP) affect up to 16% of pregnancies in the United… ## [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. ## [Who Paid for the Study Is the Beginning of the Question, Not the Answer](https://justgas.substack.com/p/who-paid-for-the-study-is-the-beginning) _2026-08-05 · Mike MacKinnon · No Gaslighting - Just Gas_ Who paid for the study matters. It just doesn’t tell you whether the study is any good. ## [A medical care at home program following hospitalization with acute decompensated heart failure may offer a safe and effective alternative to continued hospitalization](https://www.2minutemedicine.com/a-medical-care-at-home-program-following-hospitalization-with-acute-decompensated-heart-failure-may-offer-a-safe-and-effective-alternative-to-continued-hospitalization/) _2026-07-24 · Simon Pan · Cardiology | 2 Minute Medicine_ 1. Following hospitalization for acute decompensated heart failure (HF), there was no difference in all-cause readmissions and mortality between patients treated with an advanced medical care at home (AMCAH) program compared with brick-and-mortar (BAM) hospitalization. Evidence Rating Level: 2 (Good) Acute hospital care at home programs have seen a dramatic increase in implementation since the \[…\]… ## [Catheter ablation within 1 year of atrial fibrillation diagnosis is associated with reduced risk of recurrence](https://www.2minutemedicine.com/catheter-ablation-within-1-year-of-atrial-fibrillation-diagnosis-is-associated-with-reduced-risk-of-recurrence/) _2026-07-24 · Simon Pan · Cardiology | 2 Minute Medicine_ 1. Patients with atrial fibrillation (AF) treated with catheter ablation 1 to 4 years after AF diagnosis had a 48% higher chance of AF recurrence compared to those treated within 1 year. 2. Patients with atrial fibrillation (AF) treated with catheter ablation 5 years or greater after AF diagnosis had a 110% higher chance of \[…\] The post Catheter ablation within 1 year of atrial fibrillation… ## [Opt-Out Changes One Word. Hospitals Hear Everything Else.](https://justgas.substack.com/p/opt-out-changes-one-word-hospitals) _2026-07-14 · Mike MacKinnon · No Gaslighting - Just Gas_ State law, not opt-out, determines CRNA practice authority. Opt-out removes a federal supervision label that has distorted anesthesia policy and limited local decision-making for decades. ## [ASA’s Favorite 2018 Care Team Study Does Not Say What They Claim It Says](https://justgas.substack.com/p/asas-favorite-2018-care-team-study) _2026-06-30 · Mike MacKinnon · No Gaslighting - Just Gas_ The 2018 Sun et al. care team study measured broad inpatient outcomes, not CRNA-AA equivalence. ## [Retro Grid Dungeon Crawler (Sponsored)](https://crawlproof.com/a/Gm5qpbfgsdDy) _2026-06-30 · **Sponsored**_ Retro grid movement with first-person combat, loot and skill-tree progression. ## [Titles Matter. So Does the Double Standard.](https://justgas.substack.com/p/titles-matter-so-does-the-double) _2026-06-15 · Mike MacKinnon · No Gaslighting - Just Gas_ If “provider” is too vague for physicians, then selective outrage over “nurse anesthesiologist” is not about transparency. It is about hierarchy. ## [The Anesthesia Staffing Crisis Is a Hospital Leadership Problem](https://justgas.substack.com/p/the-anesthesia-staffing-crisis-is) _2026-06-04 · Mike MacKinnon · No Gaslighting - Just Gas_ Hospitals cannot bonus their way out of a broken practice model. ## [Two scores for risk stratification of adults presenting with syncope may be effective at identifying those with low risk](https://www.2minutemedicine.com/two-scores-for-risk-stratification-of-adults-presenting-with-syncope-may-be-effective-at-identifying-those-with-low-risk/) _2026-05-29 · Alex Xiang · Cardiology | 2 Minute Medicine_ 1. The Canadian Syncope Risk Score (CSRS) and FAINT score are effective at identifying which adult patients presenting to the emergency department (ED) are at low risk for short-term adverse outcomes. Evidence Rating Level: 2 (Good) Syncope and presyncope account for 2-3% of all ED visits, with approximately 10% of these patients having serious underlying \[…\] The post Two scores for risk… ## [Adverse pregnancy outcomes is associated with worse offspring cardiovascular health in early adulthood](https://www.2minutemedicine.com/adverse-pregnancy-outcomes-is-associated-with-worse-offspring-cardiovascular-health-in-early-adulthood/) _2026-05-18 · Siwen Liu · Cardiology | 2 Minute Medicine_ 1. Exposure to adverse pregnancy outcomes, particularly hypertensive disorders of pregnancy, was associated with worse cardiovascular health and early arterial injury among offspring in early adulthood. Evidence Rating Level: 2 (Good) Study Rundown: Adverse pregnancy outcomes (APOs) have been associated with long-term maternal cardiovascular health (CVH). However, research on the role of APOs in… ## [Resuscitative endovascular balloon occlusion of the aorta may not improve outcomes in adults with non-traumatic out-of-hospital cardiac arrest](https://www.2minutemedicine.com/resuscitative-endovascular-balloon-occlusion-of-the-aorta-may-not-improve-outcomes-in-adults-with-non-traumatic-out-of-hospital-cardiac-arrest/) _2026-05-14 · Alex Xiang · Cardiology | 2 Minute Medicine_ 1. Resuscitative endovascular balloon occlusion of the aorta (REBOA) as an adjunct to advanced life support (ALS) does not improve rates of return of spontaneous circulation (ROSC) in adult patients with non-traumatic out-of-hospital cardiac arrest (OHCA). Evidence Rating Level: 1 (Excellent) OHCA remains associated with extremely high mortality, with most patients not achieving ROSC, and \[…\] The… ## [WHO TAUGHT YOU THAT?!](https://justgas.substack.com/p/who-taught-you-that) _2026-05-12 · Mike MacKinnon · No Gaslighting - Just Gas_ The Unofficial Soundtrack of Clinical Training [Listen](https://api.substack.com/feed/podcast/197412117/7318919fd56f4be042f9dc6f3a4e6c67.mp3) ## [Triple low-dose antihypertensive pill reduced recurrent stroke after intracerebral hemorrhage](https://www.2minutemedicine.com/triple-low-dose-antihypertensive-pill-reduced-recurrent-stroke-after-intracerebral-hemorrhage/) _2026-05-04 · Hannan Minhas · Cardiology | 2 Minute Medicine_ 1. In clinically stable patients with prior intracerebral hemorrhage, a fixed-dose combination pill containing three low-dose antihypertensive agents reduced recurrent stroke compared with placebo when added to standard care. 2. The triple pill also improved blood-pressure control and reduced major cardiovascular events, though treatment discontinuation due to adverse events was more common.… ## [Invasive management for non-ST-segment elevation myocardial infarction in frail patients may not improve mortality](https://www.2minutemedicine.com/invasive-management-for-non-st-segment-elevation-myocardial-infarction-in-frail-patients-may-not-improve-mortality/) _2026-04-30 · Alex Xiang · Cardiology | 2 Minute Medicine_ 1. In frail, elderly patients with non-ST-segment elevation myocardial infarction (NSTEMI), invasive management with coronary angiography did not improve mortality and cardiovascular outcomes compared to conservative management. Evidence Rating Level: 1 (Excellent) Study Rundown: Frailty is becoming an increasingly important consideration in patient management as the global population continues to… ## [COVID-19 vaccination is associated with reduced risk of new-onset atrial fibrillation following COVID-19 infection](https://www.2minutemedicine.com/covid-19-vaccination-is-associated-with-reduced-risk-of-new-onset-atrial-fibrillation-following-covid-19-infection/) _2026-04-29 · Siwen Liu · Cardiology | 2 Minute Medicine_ 1. COVID-19 vaccination was associated with a reduced 24-month risk of new-onset atrial fibrillation/flutter after COVID-19 infection. Evidence Rating Level: 2 (Good) COVID-19 infection has been linked with cardiovascular complications such as new-onset atrial fibrillation/flutter (NOAF). While there is evidence of the COVID-19 vaccine being protective against the development of long COVID, its… ## [Polycythemia is not associated with increased mortality in heart failure](https://www.2minutemedicine.com/polycythemia-is-not-associated-with-increased-mortality-in-heart-failure/) _2026-04-28 · Siwen Liu · Cardiology | 2 Minute Medicine_ 1. Polycythemia was not associated with increased in-hospital, short-term, or long-term mortality. Evidence Rating Level: 2 (Good) Anemia has been consistently associated with worse outcomes in both chronic heart failure and acute decompensated HF (ADHF). Polycythemia has been linked to adverse outcomes in acute coronary syndrome (ACS), but whether a similar association exists for ADHF. \[…\] The… ## [Build with the cheapest GPUs (Sponsored)](https://crawlproof.com/a/yJpeZNUqjqr3) _2026-04-28 · **Sponsored**_ Deployed a live API in minutes; one user spent under $10. ## [The Clause You Ignore Until It Owns You: Non-Competes in Anesthesia](https://justgas.substack.com/p/the-clause-you-ignore-until-it-owns) _2026-04-20 · Mike MacKinnon · No Gaslighting - Just Gas_ What every CRNA and anesthesia provider needs to know about non-competes, non-solicits, contract turnover, and the real cost of fighting back ## [The US News CRNA Program Rankings Are Meaningless. Here’s Why.](https://justgas.substack.com/p/the-us-news-crna-program-rankings) _2026-04-08 · Mike MacKinnon · No Gaslighting - Just Gas_ One question. No outcomes. And a system that quietly rewards programs for rating others lower. ## [The “Kids These Days” Trap in Nurse Anesthesia Training](https://justgas.substack.com/p/the-kids-these-days-trap-in-nurse) _2026-03-24 · Mike MacKinnon · No Gaslighting - Just Gas_ Older Generations have complained about the next generation for centuries. In NAR education, the real challenge is keeping the bar high while teaching in a more complex world. ## [Didn’t Get Accepted to a CRNA Program or an Interview? This Is For You. PART 2: Survival & Comeback](https://justgas.substack.com/p/didnt-get-accepted-to-a-crna-program-13d) _2026-03-03 · Mike MacKinnon · No Gaslighting - Just Gas_ Acceptance Is Not the Finish Line. It Is the Commitment. ## [The Rapid Transition from Coding Agents to Agents](https://gearsofmedicine.com/the-rapid-transition-from-coding-to-agents/) _2026-02-05 · gearsofmedicine · Gears of Medicine_ 2026 started off with a bang. We knew that coding had already taken off over the past one or two months. Tools from the top AI labs and frontier models—specifically Anthropic and OpenAI—with fantastic terminal-based and subsequently non-terminal-based coding agents have made revolutionary gains in the ability to produce apps that are task-specific. In the medical domain, this allows physicians to… ## [The Long Horizon: Which Medical Specialties Will AI Impact?](https://gearsofmedicine.com/ai_med_specialities/) _2026-01-08 · gearsofmedicine · Gears of Medicine_ Artificial intelligence has completely revolutionized how we do things, and it's come a long way since OpenAI released ChatGPT. Since GPT-3.5, we've all effectively adopted the concept of chatbots and working in that single-window environment. Other vendors have emerged: Mistral, Anthropic, Microsoft, and Google with its Gemini models. Products like NotebookLM have revolutionized how we work with… ## [Canada's First: Dedicated Conscious Sedation Simulation for Stroke Thrombectomy](https://gearsofmedicine.com/evtsim/) _2025-12-28 · gearsofmedicine · Gears of Medicine_ "Train as you treat, treat as you've trained." - HK At the intersection of neurology, neurocritical care, and internal medicine sits stroke — a field that demands seamless collaboration when seconds matter most. Over the past three years, we've refined a unique model at our center: code stroke nurses (CSRNs) — critical care trained — who provide conscious sedation during endovascular thrombectomy… ## [Infinite Software Crisis](https://gearsofmedicine.com/infinitesoftwarecrisis/) _2025-12-26 · gearsofmedicine · Gears of Medicine_ Checkout this interesting video - Infinite Software Crisis Infinite Software Crisis, very interesting title from this video. I like how they acknowledged that the use of AI in software writing is here to stay, and there's really no alternative to that. I thought it was interesting that they said, "Will the software engineers of tomorrow be able to understand the codebase?" I don't know if that's a… ## [The Open Web](https://gearsofmedicine.com/the-open-web/) _2025-12-26 · gearsofmedicine · Gears of Medicine_ Funny enough, that my first blog post would be on the open web. There are so many platforms to post on, the web is changing constantly, and now more and more AI-generated content. We also have less control over our content because it might be hosted on larger platforms. Blogging in this simple, effective, and content-focused development portal for blogging is where I'm going to post my thoughts on…