Dad l ✝️ l Anesthesiologist+Intensivist l Mayo Clinic ➡️ KY l Medicine, Sports, Macro l Opinions my own l RT/Likes 🚫endorsements l 🚫medical/financial advice
Joined July 2009
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Matt Sexton, MD, MBA retweeted
I just watched a "skilled mechanic" use the wrong size wrench for that fitting, and, instead of getting the correct wrench, uses vice grips, instead.
Matt Sexton, MD, MBA retweeted
Coach, we’ve seen it before firsthand, a couple a years ago. Kids a stud
Matt Sexton, MD, MBA retweeted
Fanatics is defrauding millions of consumers.
How?
They're an unregulated casino, and they do not provide verifiable-randomness (VRF) to ensure hit-ratio's are accurate.
Why?
If they did, they couldn't defraud you to begin with.
That's why casinos are regulated.
@CardPurchaser — peep this, looks like Fanatics mistakenly put their "hit allocation" in the wrong breaker's box.
Whoops!
Matt Sexton, MD, MBA retweeted
This baseball field is on the side of an actual mountain 🤯
Floyd Central High School built its ball field in the Appalachian Mountains of Eastern Kentucky ⛰️
ALT Top photo: A view looking down on the baseball fields of Floyd Central High School. Bottom photo: A view from the main field of Floyd Central High School looking up at the side of a mountain.
Matt Sexton, MD, MBA retweeted
BREAKING: Hillsborough County Commission votes 5-2 to approve #Rays stadium deal, the second of two needed approvals. Site prep starts soon, stadium projected to open for 2029 season.
Matt Sexton, MD, MBA retweeted
Full behind the scenes video
As always, it's very cool to get a glimpse of what happens behind the curtain
youtu.be/8WYXM0RiKA4
Matt Sexton, MD, MBA retweeted
US nonprofit hospitals spent $7.8 billion on management consultants from 2009 to 2023, but contracts were not associated with meaningful changes in finance, operations, or quality of care. 🧵
ja.ma/4d46zfq
Now to Kentucky @EvanMiya
North Carolina Roster Outlook
With Veesaar leaving, Carolina would have a borderline NCAA tournament roster according to EvanMiya.com if they didn't make any other adds.
Veesaar returning would have put them as a top-20 roster.
Matt Sexton, MD, MBA retweeted
BREAKING: The University of Kentucky announces that Mitch Barnhart will no longer step into his new role after retiring as athletic director on June 30.
The move comes amid mounting pressure on the university's management and decision-making.
on3.com/teams/kentucky-wildc…
Matt Sexton, MD, MBA retweeted
The 2026 AHA/ACC Guideline for the management of acute pulmonary embolism (PE).
This guideline replaces traditional "massive" and "submassive" labels with five clinical categories (A–E) to more precisely guide therapeutic decisions based on clinical severity, biomarkers, and hemodynamic stability.
instagram.com/p/DXZn1rljz9x/…
Matt Sexton, MD, MBA retweeted
🧠 AKI is not just creatinine.
And KDIGO 2026 makes that very clear.
🚨 Big shift in thinking
Acute Kidney Injury (AKI):
👉 Is no longer defined only by creatinine rise
Now includes:
✔️ Serum creatinine
✔️ Urine output
✔️ Biomarkers of kidney damage/stress
👉 Even structural injury alone can define AKI
⚠️ The clinical reality
Creatinine is:
▪️ Late
▪️ Diluted by fluids
▪️ Affected by muscle mass
▪️ Misleading in ICU
👉 Meaning:
We diagnose AKI too late
🧬 New paradigm: function + damage
KDIGO 2026 introduces a 3-axis model:
🟠 Functional decline (SCr, urine output)
🔵 Structural injury (biomarkers)
🟣 Time (AKI → AKD → CKD continuum)
👉 This is a major conceptual upgrade
📊 New AKI definition
AKI is present if ANY of the following:
✔️ ↑ SCr ≥0.3 mg/dL in 48h
✔️ ↑ SCr ≥1.5x baseline in 7 days
✔️ ↓ urine output <0.5 ml/kg/h ≥6h
✔️ Positive kidney damage biomarker
🧠 Staging is now multidimensional
Not just creatinine anymore:
▪️ C → Creatinine
▪️ U → Urine output
▪️ B → Biomarkers
👉 A patient can be:
➡️ C0 U0 B1 = subclinical AKI
🔥 Why this matters in ICU
This explains what we see daily:
✔️ “Normal creatinine”
✔️ But worsening outcomes
✔️ Especially in sepsis, surgery, shock
👉 Because injury precedes dysfunction
⚡ Key clinical implications
1. Earlier diagnosis → before irreversible damage
2. Better risk stratification → biomarkers + clinical models
3. Targeted prevention → not one-size-fits-all
4. Dynamic monitoring → AKI is a trajectory, not a moment
🫀 Hemodynamic connection
KDIGO reinforces:
👉 Kidney = perfusion-dependent organ
✔️ MAP ≥65 mmHg as baseline target but Individualized for chronic HTN patients
✔️ Avoid dopamine (finally dead for renal protection) 🙏🏼
👉 Cardio-renal integration is central
💧 Fluid strategy update
✔️ Prefer crystalloids over colloids
✔️ Prefer buffered solutions over saline
✔️ Avoid both overload AND hypovolemia
👉 “More fluids” ≠ better kidneys
🚀 Future direction
KDIGO 2026 is clearly moving toward:
▪️ Biomarker-guided care
▪️ Early phenotyping
▪️ Personalized kidney protection strategies
▪️ Continuum thinking (AKI → AKD → CKD)
🎯 Take-home
AKI is not a number.
👉 It is a dynamic, multidimensional syndrome
And if you wait for creatinine:
👉 You are already late
📚 Reference
Kidney Disease: Improving Global Outcomes (KDIGO). Kidney Int. 2026 Jan;109(1S):S1-S99. doi: 10.1016/j.kint.2025.06.006.
ALT
Matt Sexton, MD, MBA retweeted
DID WE JUST SEE THAT?????!!!!
FRESHMAN @Braxton_VC WITH A WALK-OFF, TWO OUT GRAND SLAM!!!!!!!!!!!!!!!!
VICTORY, KENTUCKY!!!!!!!!!
Matt Sexton, MD, MBA retweeted
We are excited to announce Dr. Marissa Kauss has been selected as the new chair of CV anesthesia! 👏
#CardiacAnesthesia
Matt Sexton, MD, MBA retweeted
New Testament scholar Jeremiah Johnston explains why he believes the Shroud of Turin is authentic, tells story about how Jewish technical photographer Barrie Schwortz became convinced it was authentic.
"If you're a medieval forger, how are you gonna know about AB blood?"
"I believe that based on the evidence in the 102 academic disciplines that have studied over 600,000 research hours in it... I believe that because I'm not irrational."
"I went from skeptic to believing in it based on the science..."
"It is an itemized receipt of how much Jesus loves you."
Remarkable.
Video: @ShawnRyan762
Matt Sexton, MD, MBA retweeted
Needs to cut expenses but doles out $950K plus $120 + $30 million bridge loan?? This is utterly ridiculous and who are the 30 people to date?? Credentials??
WATCH: @UKYpres shares an update on the future of @UKAthletics. Hear what he’s learned from his listening tour and what’s ahead.
As a reminder, you can follow the progress on this process at go.uky.edu/BusinessOfUKY.
youtube.com/watch?v=bG7DT2x_…
