icmteaching's profile picture. #zentensivist #FUSIC Haemodynamics National Lead. ICS trustee. BSE level 2. BJJ ⬛️⬛️🟥⬛️ @Turningthe_Tide.  No politics, just #foamed #pocus #haemodynamics

Ashley Miller

@icmteaching

#zentensivist #FUSIC Haemodynamics National Lead. ICS trustee. BSE level 2. BJJ ⬛️⬛️🟥⬛️ @Turningthe_Tide. No politics, just #foamed #pocus #haemodynamics

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Pinned: Cardiovascular Physiology Hub Discovering physiology together: untangling the concepts most often misunderstood at the bedside. Foundations – Starling’s law as servo-control x.com/icmteaching/st… – Cardiac output & Anderson’s model x.com/icmteaching/st… – Preload…

1/ Most people think the heart drives circulation. But what if that’s backwards? Anderson’s model flips the whole idea of cardiac output on its head — and it changes how you think about fluid, flow, and failure. 🧵👇 #physiology #FOAMed #MedTwitter #criticalCare #cardiacOutput

icmteaching's tweet image. 1/
Most people think the heart drives circulation.
But what if that’s backwards?
Anderson’s model flips the whole idea of cardiac output on its head — and it changes how you think about fluid, flow, and failure.
🧵👇
#physiology #FOAMed #MedTwitter #criticalCare #cardiacOutput


Very cool

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Ashley Miller reposted

If timing wasn’t good for you, register for the recording, including Q&A.

Hello all, we would like to invite you to join us tomorrow for a webinar! Expert Insights in Fluid Stewardship 📆 25 Nov 2025 🕧 18:00 GMT



Good point. That interpretation of ALBIOS commonly comes up. I think it'sImportant to clarify what the trial actually showed (and didn’t show), because this misunderstanding drives a lot of albumin use. The “benefit” in the ALBIOS shock/MODS subgroup only appeared in post-hoc,…

Agree, in the heterogeneous ALBIOSIS population routine supplementation didn't benefit but it did in the more shocked/MODS subgroup (usual caveats). Presume higher shock burden had greater glycocalyx shedding/did benefit. HAS may have a role but need to define population better



There’s a hypothesis that albumin “protects” the glycocalyx but the evidence is extremely thin, and almost all of it is in vitro. Cultured endothelial cells shed their glycocalyx in protein-free media, and adding albumin back restores some features, but this doesn’t translate to…

Is albumin glycocalyx friendly? Does it have a glycocalyx protective effect especially in hyperinflammatory states like sepsis?



Ashley Miller reposted

Hello all, we would like to invite you to join us tomorrow for a webinar! Expert Insights in Fluid Stewardship 📆 25 Nov 2025 🕧 18:00 GMT


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