STRESS-L: Landiolol and Organ Failure in Patients With Septic Shock

Landiolol and Organ Failure in Patients With Septic Shock Whitehouse. JAMA Published online October 25, 2023. doi:10.1001/jama.2023.20134 Clinical Question In patients with tachycardia and septic shock who are treated with high dose norepinephrine does the use of β-blockade for up to 14 days reduce organ failure compared to standard care? Background Many view the use of β-blockade as contentious in […]

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ECLS-Shock – Extracorporeal Life Support in Infarct-Related Cardiogenic Shock

Extracorporeal Life Support in Infarct-Related Cardiogenic Shock Thiele H. NEJM 2023; Online ahead of print. doi:10.1056/NEJMoa2307227 Clinical Question In patients presenting with acute myocardial infarction complicated by cardiogenic shock undergoing revascularisation, does the early unselected application of extracorporeal life support reduce mortality from any cause at day 30? Background The use of venoarterial extracorporeal membrane oxygenation (VA ECMO), which is […]

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BOX Trial: Blood Pressure

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 target  (>63mmHg) reduce death or survival at discharge with a poor neurological status? Background Manipulation […]

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Ferrari

Diuretics Versus Volume Expansion in the Initial Management of Acute Intermediate High‐Risk Pulmonary Embolism Ferrari E. Lung (2022); DOI:10.1007/s00408-022-00530-5 Clinical Question In adult patients with acute pulmonary embolism and right heart strain does a strategy of volume expansion or early diuretic therapy result in a more rapid resolution of troponin levels? Background Acute pulmonary embolism (PE) is a common cause […]

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Terminal QRS distortion

Terminal QRS distortion is present in anterior myocardial infarction but absent in early repolarization Lee. @smithECGBlog. The American Journal of Emergency Medicine;2016;34(11):2182-2185 Clinical Question In patients with benign early repolarisation, is there the absence of terminal QRS distortion on the ECG? Background For patients who present with chest pain, it can be difficult to distinguish between ECG findings of benign […]

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