In this episode, we talk all things critical care the one and only, Dr. Jean-Louis Vincent aka. JLV.  This episode is a MUST listen. We touch upon the evolution of early goal directed therapy, measures of fluid responsiveness, optimizing oxygen delivery, and the importance of integrating data points versus examining  them in isolation when caring for our critically ill and injured patients. This and MUCH MUCH more in arguably one of my favorite episodes to date!!Timestamps00:00 Introduction01:21 What happened to SG catheters and should we use them?04:05 What decreases mortality in critical care patients?05:30 When to transfuse critical care patient? Use your brain! 08:55 Measures of tissue perfusion and fluid responsiveness09:36 JLV breaks down the Rivers trial10:36 Recent EGDT papers 10:54 How to optimize O2 delivery? Late ScVO2, dob challenge, and fluid challenges13:21 Dynamic measures of fluid responsiveness13:46 CVP as a relative value15:14 Passive leg raising (PLR) as a measure of fluid responsiveness21:20 JLV's take on therapeutic nihilism24:45 Don’t isolate; integrate!26:46 Navigating the future of critical care – JLV’s thoughts on AI in the ICU29:55 Rapid fire hot topics in the ICU – Yes or No -Metabolic cocktail-Corticosteroids for septic shock-Albumin and Lasix or Lasix alonePCT/CRP and sepsis/AbxResources:International Symposium on Intensive Care and Emergency Medicine (ISICEM):https://www.isicem.orgISICEM Chats Platform:https://www.isicem.org/e-chat/index.asp          Articles:Passive leg raising:five rules, not a drop of fluid! https://ccforum.biomedcentral.com/articles/10.1186/s13054-014-0708-5The fluid challengehttps://ccforum.biomedcentral.com/articles/10.1186/s13054-020-03443-yBlood lactate levels in sepsis: 8 questionsVincent JL, Bakker J. Blood lactate levels in sepsis: in 8 questions. Curr Opin Crit Care. 2021 Jun 1;27(3):298-302. doi: 10.1097/MCC.0000000000000824. PMID: 33852499.We should avoid the term "fluid overload"https://ccforum.biomedcentral.com/articles/10.1186/s13054-018-2141-7EGDT in the Treatment of Severe Sepsis and Septic Shockhttps://www.nejm.org/doi/full/10.1056/nejmoa010307A Randomized Trial of Protocol-Based Care for Early Septic Shockhttps://www.nejm.org/doi/full/10.1056/nejmoa1401602Support the show