Consultant Intensivist. Honorary Secretary Intensive Care Society @ICS_updates @turningthe_tide
Joined June 2021
- Tweets 169
- Following 348
- Followers 602
- Likes 245
10 Photos and videos
Pinned Tweet
20 Oct 2022
I think I'll retweet this every day until I retire.
2 Jan 2021
Take home points:
✅ Prescribe IV fluid with the care you would warfarin
✅ Achieve euvolaemia, then sit on your hands
✅ If urine output or BP stays low think “Is a different approach needed here?” rather than autoreaching for more IV fluid
✅ Break your AKI ➡️ fluid reflex
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Andy Breen retweeted
Apr 16
Check out the latest episode of ICSCast!
@icmteaching @PARADicmSHIFT and @ross_prager debunk the myths about oedema, IV fluid mal-prescribing, cardiac output and……
How to max out your credit card! 💳 😂
👇👇
open.spotify.com/episode/68g…
#FOAMed #POCUS #FOAMcc
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Andy Breen retweeted
Mar 12
Fluid accumulation in ICU is clearly associated with harm.
Deresuscitation is sometimes necessary once overload has occurred.
But the bigger challenge is preventing unnecessary fluid accumulation in the first place.
Getting the physiology right early is the real goal.
That’s why we started @Turningthe_Tide
doi.org/10.1007/s00134-025-0…
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Andy Breen retweeted
Mar 12
Neurological emergencies demand rapid bedside insight into cerebral physiology.
In this review we summarise the evidence for NeuroPOCUS—including TCD, TCCD and optic nerve sheath ultrasound—and outline the new UK accreditation pathway for paediatric & adult practice.
🧠 Non-invasive neuromonitoring is coming of age.
#FUSIC
doi.org/10.1177/175114372614…
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Andy Breen retweeted
Thank you to the @Official_DRS for the opportunity to present our research:
Standardising care through the implementation of the Leeds Post-Extubation Dysphagia Screen: a multi-centre, data-enabled QIP
Thanks to my co-authors and to @ICNARC for providing data.
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Andy Breen retweeted
Jan 27
Many harms from IV fluids and vasoactive drugs don’t come from bad intentions — they come from misunderstanding basic physiology, especially the difference between description and causation.
Language matters. Physiology matters.
Jan 27
🧵 Thread: Why cardiovascular physiology feels confusing (even to experts)
Part 1 of my 'The physics of circulation' series
Cardiovascular physiology isn’t confusing because it’s complex.
It’s confusing because we routinely mix up description with causation. And our language subtly reinforces the error.
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Andy Breen retweeted
Jan 21
The latest episode is out.👇👇👇
open.spotify.com/episode/7AK…
#FOAMed #FOAMcc
🤔
- Should palliative care involvement on ICU be given higher priority?
- Should all critical care clinicians embrace core palliative principles as an integral part of their practice.
We care for the critically ill so well, but what about care of the dying patient? 🤷♂️
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15 Dec 2025
It's time to start paying attention to how we prescribe IV fluids. Read here ⬇️
15 Dec 2025
Published in BMJ Open Quality, Turning the Tide discuss what we have found about the state of intravenous fluid use in the UK, and what should be done about it.
Low education, little management and under realisation of potential harms.
It will change.
bmjopenquality.bmj.com/conte…
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Andy Breen retweeted
20 Nov 2025
Really pleased to announce the @ICS_updates first podcast “ICSCast” is out!
Take a listen to an episode where I talk to an Imam about where Critical Care and religion meet.
#FOAMed #FOAMcc
ics.ac.uk/policy-news/podcas…
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Andy Breen retweeted
8 Oct 2025
Proud to be speaker together with Eduardo Kattan at the 38th ESICM Annual Congress in Munich (25-29 Oct). Talk about “Personalized Hemodynamic Resuscitation”. Moreover, Prof Gustavo Ospina-Tascón will present the long-awaited results of A2 in the Hot-Topics Session (29 Oct)😍😍
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Andy Breen retweeted
As a member of the @Turningthe_Tide group I am passionate about good fluid stewardship. So is @Wilkinsonjonny
If you’d like to hear us talk about the issues and the solutions, register and join us!
📆 Thursday 11th September
🕧 18:00–19:15 UK time
🔗 baxterglobal.com/Fluid_Manag…
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Andy Breen retweeted
5 Sep 2025
🔊 Come and hear about the dangers of IV fluid prescription….
👀 Where are the hidden evils?
Register here👇👇
baxterglobal.com/Fluid_Manag…
#FOAMed #POCUS #FOAMcc
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Andy Breen retweeted
29 Aug 2025
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How much IV fluid is really needed during major surgery? You’ll hear: wet vs dry, liberal vs conservative, zero-balance.
“The thoracic surgeons like them dry.”
“The transplant surgeons want them well-filled.”
All these describe extremes: too little vs too much.
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11 Jul 2025
This right here ⬇️
@Turningthe_Tide
11 Jul 2025
Tip of the day, unless you were blasting a euvolemic patient with diuretics, if your creatinine doubles overnight look for the septic source. They’re not hypovolemic.
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Andy Breen retweeted
Great start to the LACE course! 3 days of advanced echocardiography 😍
Awesome and engaged delegates as always and a faculty strain workshop the highlights!
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Andy Breen retweeted
7 Jul 2025
The team at turning the tide are killing it with evidence informed, reasonable, approaches to fluid, diuresis, and now sodium. Love it!
7 Jul 2025
🧵Why does low protein intake cause hyponatraemia?
Most people find this confusing.
But the underlying physiology is beautifully simple.
Let’s walk through it 👇
#Hyponatraemia #FluidBalance #MedTwitter #FOAMed
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Andy Breen retweeted
Some of the @Turningthe_Tide team at @ICS_updates #SOA2025 delivering a tour de force of macro and micro circulation physiology, but also a reminder of how not to cause unintentional harm to critically unwell patients by not carefully managing fluid therapy.
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Andy Breen retweeted
2 Jul 2025
Care plans and improving outcomes key priorities 🎯for frail patients. Anyone over CF4 are at risk. Screen early avoid a delay ⏰ in rehab. Fabulously delivered by Prof Rockwood (🤘🏼🪵) @ICS_updates #SOA25
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Andy Breen retweeted
30 Jun 2025
Excellent day speaking at #SOA25 with the @ICS_Updates Legal & Ethical Group, exploring how religion & spirituality shape end-of-life care. A space to reflect, learn & grow in delivering culturally competent care. #CriticalCare #EOLC #SpiritualCare #ICU @Leic_hospital @LPTnhs
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Andy Breen retweeted
1 Jul 2025
What a fantastic morning it’s been! 💫
The speakers, the sessions and the conversations have been State of the Art!
Before we wrap up Day 1, don’t forget to share what’s inspired you today using #SOA25 🥳
Let’s keep the vibe going! 💬✨
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