🧵🫁⚠️ 𝗥𝗦𝗜 𝗲𝗻 𝗽𝗮𝗰𝗶𝗲𝗻𝘁𝗲𝘀 𝗱𝗲 𝗮𝗹𝘁𝗼 𝗿𝗶𝗲𝘀𝗴𝗼: 𝗵𝗼𝘆 𝗹𝗮 𝗺𝗲𝘁𝗮 𝘆𝗮 𝗻𝗼 𝗲𝘀 𝘀𝗼𝗹𝗼 “𝗶𝗻𝘁𝘂𝗯𝗮𝗿 𝗿𝗮́𝗽𝗶𝗱𝗼”, 𝘀𝗶𝗻𝗼 𝗶𝗻𝘁𝘂𝗯𝗮𝗿 𝘀𝗶𝗻 𝗱𝗲𝘀𝗮𝘁𝘂𝗿𝗮𝗿 𝗻𝗶 𝗰𝗼𝗹𝗮𝗽𝘀𝗮𝗿 𝗮𝗹 𝗽𝗮𝗰𝗶𝗲𝗻𝘁𝗲 🚨 @ElsevierConnect @sciencedirect La 𝙍𝙎𝙄 debe equilibrar 3 objetivos a la vez: ✅ asegurar vía aérea ✅ minimizar aspiración ✅ evitar 𝙝𝙞𝙥𝙤𝙭𝙚𝙢𝙞𝙖 e 𝙞𝙣𝙚𝙨𝙩𝙖𝙗𝙞𝙡𝙞𝙙𝙖𝙙 𝙝𝙚𝙢𝙤𝙙𝙞𝙣𝙖́𝙢𝙞𝙘𝙖 👉 En el paciente crítico, muchas veces el mayor peligro no es la aspiración, sino la 𝙙𝙚𝙨𝙖𝙩𝙪𝙧𝙖𝙘𝙞𝙤́𝙣 𝙤 𝙚𝙡 𝙘𝙤𝙡𝙖𝙥𝙨𝙤 𝙘𝙖𝙧𝙙𝙞𝙤𝙫𝙖𝙨𝙘𝙪𝙡𝙖𝙧 𝙥𝙚𝙧𝙞𝙞𝙣𝙩𝙪𝙗𝙖𝙘𝙞𝙤́𝙣. 🧠📉 𝙀𝙡 𝙙𝙖𝙩𝙤 𝙞𝙣𝙘𝙤́𝙢𝙤𝙙𝙤: 𝙡𝙖 𝙍𝙎𝙄 𝙩𝙞𝙚𝙣𝙚 𝙘𝙤𝙢𝙥𝙡𝙞𝙘𝙖𝙘𝙞𝙤𝙣𝙚𝙨 𝙘𝙤𝙣 𝙢𝙪𝙘𝙝𝙖 𝙛𝙧𝙚𝙘𝙪𝙚𝙣𝙘𝙞𝙖 Casi 𝟱𝟬% de los pacientes pueden presentar al menos un evento adverso periintubación 😵‍💫 Los más importantes: 🫀 𝙞𝙣𝙚𝙨𝙩𝙖𝙗𝙞𝙡𝙞𝙙𝙖𝙙 𝙘𝙖𝙧𝙙𝙞𝙤𝙫𝙖𝙨𝙘𝙪𝙡𝙖𝙧 🫁 𝙝𝙞𝙥𝙤𝙭𝙚𝙢𝙞𝙖 𝙨𝙚𝙫𝙚𝙧𝙖 💀 𝙥𝙖𝙧𝙤 𝙘𝙖𝙧𝙙𝙞𝙖𝙘𝙤 Y algo clave: 🎯 el gran objetivo operativo sigue siendo el 𝙚́𝙭𝙞𝙩𝙤 𝙚𝙣 𝙚𝙡 𝙥𝙧𝙞𝙢𝙚𝙧 𝙥𝙖𝙨𝙚, porque múltiples intentos aumentan mucho los eventos adversos. 💨🫁 𝙋𝙧𝙚𝙤𝙭𝙞𝙜𝙚𝙣𝙖𝙘𝙞𝙤́𝙣: 𝙖𝙦𝙪𝙞́ 𝙨𝙚 𝙜𝙖𝙣𝙖𝙣 𝙤 𝙨𝙚 𝙥𝙞𝙚𝙧𝙙𝙚𝙣 𝙢𝙪𝙘𝙝𝙤𝙨 𝙍𝙎𝙄 El review favorece claramente: ✅ 𝙫𝙚𝙣𝙩𝙞𝙡𝙖𝙘𝙞𝙤́𝙣 𝙣𝙤 𝙞𝙣𝙫𝙖𝙨𝙞𝙫𝙖 (𝙉𝙄𝙑) sobre mascarilla facial estándar en pacientes de alto riesgo ✅ posición 𝙨𝙚𝙢𝙞𝙞𝙣𝙘𝙤𝙧𝙥𝙤𝙧𝙖𝙙𝙖 cuando sea posible ✅ considerar 𝙃𝙁𝙉𝙊 como complemento, no necesariamente como sustituto en hipoxemia severa Y deja otra idea importante 👇 👉 la 𝙫𝙚𝙣𝙩𝙞𝙡𝙖𝙘𝙞𝙤́𝙣 𝙨𝙪𝙖𝙫𝙚 𝙘𝙤𝙣 𝙗𝙤𝙡𝙨𝙖-𝙢𝙖𝙨𝙘𝙖𝙧𝙞𝙡𝙡𝙖 entre inducción e intubación puede reducir hipoxemia 𝙨𝙞𝙣 𝙖𝙪𝙢𝙚𝙣𝙩𝙖𝙧 𝙖𝙨𝙥𝙞𝙧𝙖𝙘𝙞𝙤́𝙣 en UCI, en pacientes seleccionados. 📹🛠️ 𝙑𝙞𝙙𝙚𝙤𝙡𝙖𝙧𝙞𝙣𝙜𝙤𝙨𝙘𝙤𝙥𝙞𝙤 𝙚𝙨𝙩𝙞𝙡𝙚𝙩𝙚: 𝙘𝙖𝙙𝙖 𝙫𝙚𝙯 𝙢𝙖́𝙨 𝙚𝙡 𝙘𝙤𝙢𝙗𝙤 𝙚𝙨𝙩𝙖́𝙣𝙙𝙖𝙧 📹 𝙫𝙞𝙙𝙚𝙤𝙡𝙖𝙧𝙞𝙣𝙜𝙤𝙨𝙘𝙤𝙥𝙞𝙤 mejora visualización y aumenta el éxito al primer intento 🧵 𝙚𝙨𝙩𝙞𝙡𝙚𝙩𝙚 también mejora el éxito del primer intento comparado con tubo solo 👉 Estrategias más recomendadas para reducir complicaciones. En cambio: 🚫 𝙥𝙧𝙚𝙨𝙞𝙤́𝙣 𝙘𝙧𝙞𝙘𝙤𝙞𝙙𝙚𝙖 𝙧𝙪𝙩𝙞𝙣𝙖𝙧𝙞𝙖 ya no sale bien parada: no demuestra beneficio consistente y puede estorbar. 💉🫀 𝙄𝙣𝙙𝙪𝙘𝙩𝙤𝙧 𝙚𝙣 𝙞𝙣𝙚𝙨𝙩𝙖𝙗𝙡𝙚𝙨: 𝙚𝙩𝙤𝙢𝙞𝙙𝙖𝙩𝙤 𝙮 𝙠𝙚𝙩𝙖𝙢𝙞𝙣𝙖 𝙨𝙞𝙜𝙪𝙚𝙣 𝙖𝙡 𝙘𝙚𝙣𝙩𝙧𝙤 𝙙𝙚𝙡 𝙙𝙚𝙗𝙖𝙩𝙚 Para pacientes con compromiso hemodinámico, el review favorece: ✅ 𝙚𝙩𝙤𝙢𝙞𝙙𝙖𝙩𝙤 ✅ 𝙠𝙚𝙩𝙖𝙢𝙞𝙣𝙖 más que propofol Pero hay un matiz muy importante: 📌 un ensayo reciente citado en el artículo encontró que 𝙠𝙚𝙩𝙖𝙢𝙞𝙣𝙖 se asoció con 𝙢𝙖́𝙨 𝙘𝙤𝙡𝙖𝙥𝙨𝙤 𝙘𝙖𝙧𝙙𝙞𝙤𝙫𝙖𝙨𝙘𝙪𝙡𝙖𝙧 𝙥𝙚𝙧𝙞𝙞𝙣𝙩𝙪𝙗𝙖𝙘𝙞𝙤́𝙣 que 𝙚𝙩𝙤𝙢𝙞𝙙𝙖𝙩𝙤, aunque sin diferencia en mortalidad hospitalaria a 28 días. 👉 Traducción práctica: en el paciente 𝙨𝙚́𝙥𝙩𝙞𝙘𝙤 𝙤 𝙢𝙪𝙮 𝙛𝙧𝙖́𝙜𝙞𝙡 𝙝𝙚𝙢𝙤𝙙𝙞𝙣𝙖́𝙢𝙞𝙘𝙖𝙢𝙚𝙣𝙩𝙚, 𝙚𝙩𝙤𝙢𝙞𝙙𝙖𝙩𝙤 sigue siendo una opción muy fuerte. 🚫💧 𝘿𝙤𝙨 𝙧𝙚𝙛𝙡𝙚𝙟𝙤𝙨 𝙘𝙡𝙖́𝙨𝙞𝙘𝙤𝙨 𝙦𝙪𝙚 𝙚𝙡 𝙥𝙖𝙥𝙚𝙧 𝙘𝙪𝙚𝙨𝙩𝙞𝙤𝙣𝙖: 𝙛𝙡𝙪𝙞𝙙𝙤𝙨 𝙥𝙖𝙧𝙖 𝙩𝙤𝙙𝙤𝙨 𝙮 𝙤𝙥𝙞𝙤𝙞𝙙𝙚𝙨 𝙥𝙤𝙧 𝙧𝙪𝙩𝙞𝙣𝙖 El review no apoya: 🚫 𝙗𝙤𝙡𝙤 𝙙𝙚 𝙛𝙡𝙪𝙞𝙙𝙤𝙨 𝙧𝙪𝙩𝙞𝙣𝙖𝙧𝙞𝙤 previo a la intubación porque ensayos de alta calidad no mostraron reducción de colapso cardiovascular Y también pide cautela con: 💊 𝙤𝙥𝙞𝙤𝙞𝙙𝙚𝙨 y 𝙢𝙞𝙙𝙖𝙯𝙤𝙡𝙖𝙢 en inestables, por mayor riesgo de hipotensión En cambio, propone pensar en: 🫀 𝙫𝙖𝙨𝙤𝙥𝙧𝙚𝙨𝙤𝙧 𝙥𝙧𝙤𝙛𝙞𝙡𝙖́𝙘𝙩𝙞𝙘𝙤 𝙨𝙚𝙡𝙚𝙘𝙩𝙞𝙫𝙤 (fenilefrina o norepinefrina en dosis bajas) en pacientes con poca reserva hemodinámica. 🎯🤝 𝙏𝙖𝙠𝙚-𝙝𝙤𝙢𝙚: 𝙡𝙖 𝙍𝙎𝙄 𝙨𝙚𝙜𝙪𝙧𝙖 𝙙𝙚𝙥𝙚𝙣𝙙𝙚 𝙩𝙖𝙣𝙩𝙤 𝙙𝙚 𝙛𝙞𝙨𝙞𝙤𝙡𝙤𝙜𝙞́𝙖 𝙮 𝙚𝙦𝙪𝙞𝙥𝙤 𝙘𝙤𝙢𝙤 𝙙𝙚 𝙛𝙖́𝙧𝙢𝙖𝙘𝙤𝙨 El cierre del artículo es muy bueno 🔥 La RSI de alto riesgo hoy exige: 🧾 preparación estructurada 🤝 trabajo en equipo 📹 VL de primera línea 💨 buena preoxigenación 💉 selección individualizada de fármacos 🫀 prevención activa de hipotensión 👉 Antes de inducir, ya debes tener pensados oxigenación, dispositivo, apoyo hemodinámico y plan del primer intento. En otras palabras: 𝙍𝙎𝙄 𝙮𝙖 𝙣𝙤 𝙚𝙨 𝙨𝙤𝙡𝙤 𝙪𝙣𝙖 𝙩𝙚́𝙘𝙣𝙞𝙘𝙖 𝙧𝙖́𝙥𝙞𝙙𝙖; 𝙚𝙨 𝙪𝙣𝙖 𝙚𝙨𝙩𝙧𝙖𝙩𝙚𝙜𝙞𝙖 𝙘𝙤𝙢𝙥𝙡𝙚𝙩𝙖 𝙥𝙖𝙧𝙖 𝙚𝙫𝙞𝙩𝙖𝙧 𝙙𝙚𝙨𝙖𝙩𝙪𝙧𝙖𝙘𝙞𝙤́𝙣, 𝙘𝙤𝙡𝙖𝙥𝙨𝙤 𝙮 𝙛𝙧𝙖𝙘𝙖𝙨𝙤 𝙖𝙡 𝙥𝙧𝙞𝙢𝙚𝙧 𝙥𝙖𝙨𝙤. ‼️Si te sirve: ❤️ Me gusta | 🔁 Repost | ➕ Follow para más👇🏼👇🏼👇🏼👇🏼 📚📖#ClubCrit👨🏻‍⚕️👨🏻‍🏫🧠🫶 📚📖 Más en el blog 👉 [buff.ly/61OGR7B] #RSI #Airway #FOAMed #FOAMcc #ClubCrit #RSI #FirstPassSuccess #ICUAirway #EmergencyAirway #Preoxygenation #NIV #HFNO #Videolaryngoscopy #Stylet #AirwayManagement #Etomidate #Ketamine #Hemodynamics #PeriIntubationHypotension #Vasopressors #CriticalCare #CriticalCare #CuidadoCrítico #MedTwitter #CritCare #icu #intensivecare #diagnosis #management #UCI #MedicinaBasadaEnEvidencia #MedEd #MedX #IntensiveCare #MedIntensiva #MedXCommunity #MedED #ICUmanagement #MustRead #LecturaRecomendada

Keep an intubation logbook and improve your first pass succes rate for basic and advanced airways 👇🏼This is how it is done with “My intubations” feature of @AirwayTriageApp @jducanto @dave1olvera @HouthoffKavita @dasairway @NaveenEipe @emcrit @SafeAirway @NicholasChrimes @doctimcook @ProfEllenO @wei_huafeng @VirtueOfNothing @altgm #anaesthesia #airwaytriage #airway #firstpasssuccess

#DoTheDropZone at #LINNCParis, June 1–3! 🧠 Drop Zone™ technology. Two platforms. Zero compromises. #NeVa – #FirstPassSuccess across all clot types #NeVaNET – the only stent retriever with microfiltration @Diane_Demet @LINNConline #stroke

#AINR Vicenza🧠 #NeVa & #NeVaNET for #FirstPassSuccess. New: #NeVaVS for aSAH vasospasm. NeVa 3mm in pilot. #DoTheDropZone NeVa & NeVa NET are CE-marked; not currently available in the U.S. NeVa VS is FDA-approved, CE Marked for the treatment of cerebral vasospasm due to aSAH.

🧠 #DoTheDropZone at Congresso #AINR - Neuroradiologia Interventistica, March 22–24. #NeVa & #NeVaNET — built for #FirstPassSuccess in stroke #thrombectomy. 👋 Find Jennifer Geluso on the floor. NeVa & NeVa NET are CE-marked; not currently available in the U.S. #stroke

Vicenza 🧠 March 22–24. Looking forward to connecting with the neurointerventional community at Congresso AINR - Neuroradiologia Interventistica. #NeVa & #NeVaNET — first-pass success in #stroke thrombectomy. Hope to see you there! #DoTheDropZone #AINR #FirstPassSuccess

#DoTheDropZone at #SFNR2026! 📳DM @Diane_Demet or visit our station for #𝗡𝗲𝗩𝗮 – designed for #FirstPassSuccess with 𝗔𝗟𝗟 𝗰𝗹𝗼𝘁 𝘁𝘆𝗽𝗲𝘀 Hope to see you there! NeVa is CE-marked and reimbursed in France; not currently available in the U.S. #stroke #thrombectomy

#DoTheDropZone in Prague! Vesalio is excited to support the #EXMINT 8.2 training initiative for ischemic #stroke. Stop by our station for hands-on experience with #NeVa, and updates on #NeVa & #NeVaNET for #FirstPassSuccess in stroke thrombectomy. See you there! @esmintsociety

Excited to be at Rencontres Nationales des Centres de Thrombectomie de Mention A! We're at Booth 13 connecting w/ the neurointerventional community to share updates on #NeVa & #NeVaNET & their role in #FirstPassSuccess for #stroke #thrombectomy. #DoTheDropZone #SFNR @SFNRadio

#DoTheDropZone in Salzburg 🧠 We look forward to connecting with the neurointerventional community at #IROS2026 this week. We’ll be sharing the latest updates on #NeVa and #NeVaNET, and how they support #FirstPassSuccess in #stroke thrombectomy. Hope to see you there!

#DoTheDropZone at #ESIR2025 Hands-On Course Join the Vesalio training session to discover all-clot capabilities of ➡️ #NeVa, for achieving impressive #FirstPassSuccess on all clot types ➡️ #NeVaNET, the world's only stent retriever with microfiltration technology See you there!

#DoTheDropZone at #BRAINConference🎄 TOMORROW 📅 Dec 3, 15:05–15:20 “NeVa – The Story So Far” w/ @drpaulbhogal Visit our booth or DM @Diane_Demet for 🧠 #NeVa, #FirstPassSuccess on ALL clots 🧠 #NeVaNET, Only stent retriever w/ microfiltration See you there! @EdenMoe

#DoTheDropZone at #ESNR! We’re excited to join the INR community for impactful sessions and the ECINR 4-1 Stroke Module Let's connect ➡️ DM @Diane_Demet 🧠 #NeVa for #FirstPassSuccess on all clot types 🧠 #NeVaNET only stent retriever w/ microfiltration technology See you there!

#DoTheDropZone at #BRAINConference in London! Plan to stop by our booth or DM @Diane_Demet for: 🧠 #NeVa: #FirstPassSuccess on ALL clots 🧠 #NeVaNET: World's only stent retriever with microfiltration for max clot retention See you there! @brainconferenc1

Vesalio is thrilled to be in Buenos Aires for #CANI2025! We’re eager to reconnect with our Drop Zone adepts & meet new professionals interested in discovering #FirstPassSuccess with #NeVa & #NeVaNET! Are you there? Please stop by. Hope to see you there! #DoTheDropZone

🌍 Vesalio is excited for #ESMINT2025, 3–6 Sep in Marseille! 📍 Booth 13 to catch up & see what’s new: 🧠 #NeVa – for high #FirstPassSuccess on all clot types 🧠 #NeVaNET – the only stent retriever with microfiltration tech to maximize clot retention See you there! @esmintsociety

#DoTheDropZone at #LINNCParis! Please stop by to say hello & learn about Drop Zone™ technology ➡️ #NeVa – delivering #FirstPassSuccess across all clot types ➡️ #NeVaNET – the world’s only stent retriever with microfiltration technology 📳 DM @Diane_Demet @LINNConline #stroke

#DoTheDropZone next week at #LINNCParis! Contact us for designed with Drop Zone™ technology ➡️ #NeVa – delivering #FirstPassSuccess across all clot types ➡️ #NeVaNET – the world’s only stent retriever with microfiltration technology 📳 DM @Diane_Demet @LINNConline #stroke

#DoTheDropZone in Amsterdam! Proud to partner with @esmintsociety for this week's ESMINT Skills Training. Designed with Drop Zone™ Technology ➡️ #NeVa – for #FirstPassSuccess across all clot types ➡️ #NeVaNET – only stent retriever with microfiltration technology @Diane_Demet

#DoTheDropZone in Colombia! We’re at #CCR2025 in Cartagena, sharing the latest innovation in #stroke and #vasospasm care. DM @JAntonio2105 to explore: ➡️ #NeVa – exceptional #FirstPassSuccess ➡️ #NeVaNET – stent retriever with microfiltration ➡️ #NeVaVS – for post-aSAH vasospasm