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In patients with sepsis-induced hypotension does a restrictive fluid strategy (with early vasopressor usage) compared to a liberal fluid strategy result in lower mortality before discharge by day 90?
Continue reading »A compendium of critical appraisals in Intensive Care Medicine research and related specialties
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In patients with sepsis-induced hypotension does a restrictive fluid strategy (with early vasopressor usage) compared to a liberal fluid strategy result in lower mortality before discharge by day 90?
Continue reading »Effect of Fluid Bolus Administration on Cardiovascular Collapse Among Critically Ill Patients Undergoing Tracheal Intubation @DerekRussellMD. JAMA; 328(3):270-279. doi:10.1001/jama.2022.9792 Clinical Question In critically ill adult patients undergoing tracheal intubation and positive pressure ventilation, does intravenous infusion of a 500ml fluid bolus vs no fluid bolus, decrease the incidence of cardiovascular collapse during, or shortly after the procedure? Background Tracheal intubation […]
Continue reading »In adults with an expected ICU stay of > 72 hours, does the provision of enteral melatonin compared to placebo increase the number of delirium-free assessments within 14 days or before ICU discharge?
Continue reading »Early Active Mobilization during Mechanical Ventilation in the ICU @chodgsonANZICRC @TEAMtrialICU. NEJM 2022; 387:1747-58 doi:10.1056/NEJMoa2209083 Clinical Question In mechanically ventilated adult patients does the provision of early mobilisation when compared to standard care increase the number of days alive and out of hospital at 180 days? Background ICU Acquired weakness (ICUAW) is common with one systematic review reporting a median […]
Continue reading »Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation Semler. N Engl J Med 2022; 387:1759-1769. DOI: 10.1056/NEJMoa2208415 Clinical Question In patients receiving invasive mechanical ventilation, does a target oxygen saturation of 90%, 94%, or 98% increase days alive and free of mechanical ventilation at 28 days? Background Despite the ubiquity of oxygen therapy in the critical care setting, the […]
Continue reading »Operative vs Nonoperative Treatment of Acute Unstable Chest Wall Injuries: A Randomised Clinical TrialĀ Dehghan et al. JAMA Surg 2022 doi:10.1001/jamasurg.2022.4299 Background Blunt chest wall trauma has high associated rates of morbidity and mortality RCTs have shown a reduced ICU length of stay in those requiring mechanical ventilation, however this has not been replicated in non-ventilated patients What did they […]
Continue reading »In mechanically ventilated adults, does the addition of selective decontamination of the digestive tract (SDD) compared to standard care reduce all-cause hospital mortality within 90 days?
Continue reading »In patients with refractory VF, does Double Sequential External Defibrillation or Vector-change Defibrillation improve survival to hospital discharge?
Continue reading »In comatose patients following cardiac arrest does a restrictive compared with a liberal oxygenation strategy, reduce death or survival at discharge with a poor neurological outcome?
Continue reading »Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest Kjaergaard et al | New England Journal of Medicine| August 2022 DOI: 10.1056/NEJMoa2208687 Clinical Question In patients with return of spontaneous circulation (ROSC) after cardiac arrest does a higher MAP target (> 77mmHg) compared to a standard targetĀ (>63mmHg) reduce death or survival at discharge with a poor neurological status? Background Manipulation […]
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