Crit/Care research physician. CoAuthor of “The Physician’s War” The Battle between Physicians & Pathological Consensus https://nitter.cf/t.co/l8sZ0gKPTI
Joined August 2012
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Lawrence Lynn retweeted
"3 second graders do not equal a sixth grader". Listen to FGEBM Ep. 4 now podcasts.apple.com/us/podcas…
Lawrence Lynn retweeted
The public notices cars overheating and funds experts from the Petty/Bone school of mechanics. The experts name the problem “auto overheating syndrome” (AOS).
They know overheating can result from low water or low oil. Nevertheless, they randomize the next thousand overheating cars to receive water or oil without distinguishing the cause.
The average outcomes are identical. They announce: “Water and oil are equally effective for AOS.”
After 30 years of failure of cause agnostic RCT, the public eventually realizes that equal outcomes across a mixture of problems do not make the remedies interchangeable.
They replace the experts with auto pathophysiologists, who begin by asking why each engine is overheating.
Lawrence Lynn retweeted
"Today, Oct. 10, is the birthday of my son, Daniel Pearl, who would have been 63 years old today.
Lacking eloquent words to describe his life, his work, and his vision until his brutal murder in 2002, I am posting a poem I wrote in his memory, called 'The Lion's Den': ucla.in/4AT0ddW
followed by David Broza's recording, written for that poem: youtube.com/watch?v=L0yUsBN3…, ending with Benjamin Lapidus "Kaddish Para Daniel" open.spotify.com/track/2VOZK…"
Join me in Yitgadal V'Yitkadash Shmei Rabah
Lawrence Lynn retweeted
The Surviving Sepsis Campaign has shaped sepsis care for decades. But do some of its core recommendations now lag behind the physiology and the evidence?
Rory Spiegel @TheEMNerd led this new dissenting opinion, which I was very pleased to contribute to.
We challenge:
• fixed 30 mL/kg fluid loading
• chasing lactate with fluid
• fluid responsiveness as a sufficient reason to give fluid
• pressure-centric resuscitation
• the omission of POCUS from modern haemodynamic assessment
• rigid bundle-driven care
The argument is not for less treatment. It is for more individualised, physiology-driven treatment of shock.
authors.elsevier.com/c/1npdk…
The 2026 Surviving Sepsis Campaign Guidelines: The dissenting opinion
Spiegel et al. AJEM, just published.
Lawrence Lynn retweeted
Cómo medir correctamente el Tiempo de (re)Llenado Capilar en Choque Séptico?
Del Maestro. @ShockAndromeda2
link.springer.com/article/10…
Lawrence Lynn retweeted
Truly honored and grateful to have been part of H&R.
An incredible few days surrounded by people who share a passion for physiology, hemodynamics, and POCUS. I came as a faculty, but I’m leaving having learned so much myself.Quite simply, the best congress I’ve ever attended. Thank you to everyone who made it so special! A very special thank you to @ThinkingCC , whose vision, passion, and incredible work made all of this possible. You created something truly special.
Lawrence Lynn retweeted
Two nephrologists and one cardiologist bound by #POCUS, physiology, and a shared obsession with hemodynamics.
Nephron-friendly #cardiology meets cardiac-friendly #nephrology. Happens only at H & R 🇨🇦 #HR26
@ArgaizR @FH_Verbrugge
Lawrence Lynn retweeted
High praise (exaggerated I think) from one of the greatest POCUS educators of our time 🙌🏻
. @icmteaching, one of the greatest hemodynamic educators of our time, gives a fantastic talk on circulation - making pressures, volumes, and all the other confusing stuff feel simple and intuitive. #HR26
Lawrence Lynn retweeted
Only a handful of spots left. Closing registration tonight, if anyone forgot or was on the fence, this is your chance! Bedside applied physiology in shock and respiratory failure at it’s very best. Magder/Marino/Crager/Denault/Weingart/Augustin/Miller/Spiegel/Haycock hrpresents2026.squarespace.c…
Lawrence Lynn retweeted
Over the (Tony) Moon that @RoofKorean7’s Rooftop Korean arrived in today’s post. Thanks Tony and @wargate Books. Nothing but respect ✊
Lawrence Lynn retweeted
Thank you for sharing this. You make a lot of points which I need to ponder. For now I will share something that you might find interesting. Charles Manski makes a lot of points, many with which I agree:
arxiv.org/pdf/2607.23660
Lawrence Lynn retweeted
The ICU runs on nurses. Always did. Doctors visit. Nurses live there. If your mental model of a hospital is “the physician in charge,” you have never been in the building at 3am. Ask a nurse who actually made the call that saved the patient. Then listen.
Lawrence Lynn retweeted
Fluid and vasopressors are some of the commonest treatments for critically ill patients.
Fluid adds blood volume.
Venous tone changes venous pressure–volume behaviour and redistributes the blood already there.
What happens next depends on whether the cardiopulmonary circulation can accept the resulting increase in potential delivery as flow, or whether it appears mainly as pressure and congestion.
That is the argument in my latest piece:
What Actually Happens When We Give Fluid or Vasopressors?
If you spend your life giving both, it is worth thinking about what they are actually doing.
thedependentvariable.com/p/w…
Lawrence Lynn retweeted
🧵 3/4
The Army had spent years insisting that Black soldiers were unsuited to cold climates and unfit for demanding work. In 1942 it sent three segregated Black engineer regiments, the 93rd, 95th and 97th, to build a road through the sub-Arctic.
There were 3,695 of them, almost exactly a third of the engineer soldiers on the project. Most were not told where they were going until they got there. They were barred from entering towns and kept out in the bush. The 95th, the regiment with the most bulldozer experience, had its machines taken away and given to a white regiment, and was handed picks, shovels, axes and saws instead.
Then there was the country itself. Temperatures could plunge as low as 70 below. Mosquitoes and gnats in summer, and 20 hours of daylight, so the work never really stopped.
Lawrence Lynn retweeted
This is spot on
We too often assume conflicts of interest and biases = financial
But what about when your main motivation isn’t financial? Maybe it’s “being right”, for instance, or tenure, or fame, or importance, etc
For academics, financials are almost universally NOT the main motivation
So do we allow a majority of COI to slip through by having a lens essentially only on financial COI?
Many of the most powerful conflicts of interest in science are not financial but reputational and career-embedded.
These arise when individuals or institutions have invested decades of intellectual labor, prestige, and authority into a dominant paradigm. That sunk career cost creates a strong incentive to defend and never interrogate the framework itself, even in the face of contradictory evidence.
Lawrence Lynn retweeted
It’s Time to Bring Causal Inference Into Clinical Trials - Lawrence Lynn
@PatientStormDoc
oncodaily.com/voices/lawrenc…
Lawrence Lynn retweeted
Our latest paper out today! Teamwork at tying pathophysiology to bedside understanding and management! With @icmteaching @TheEMNerd @khaycock2 @edu_kattan @AndromedaShock hard to go wrong! mdpi.com/2077-0383/15/15/581…
