Year: 2025

OVISS: Optimal Vasopressin Initiation in Septic Shock with Reinforcement Learning

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OVISS: Optimal Vasopressin Initiation in Septic Shock Kalimouttou et al. for the OVISS Study group, JAMA 2025. doi:10.1001/jama.2025.3046 Clinical Question In patients with septic shock, does a reinforcement learning model identify a strategy for vasopressin initiation that improves mortality? Background  Vasopressin is a non-catecholamine vasoconstrictor that is currently recommended as a secondary agent to be considered alongside noradrenaline if mean […]

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TGC-Fast: Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU

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Tight Blood-Glucose Control without Early Parenteral Nutrition in the ICU Gunst et al. N Engl J Med 2023;389:1180-1190 DOI: 10.1056/NEJMoa2304855 Clinical Question In ICU patients not receiving early parenteral nutrition, does liberal glucose control (initiating insulin when blood glucose level [BGL] >11.9 mmol per liter [>215 mg per deciliter]) or tight glucose control (commencing insulin at BGL 4.4 to 6.1 […]

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MINT – Restrictive or Liberal Transfusion Strategy in Myocardial Infarction

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Restrictive or Liberal Transfusion Strategy in Myocardial Infarction and Anemia Carson et al. NEJM 2023 DOI: 10.1056/NEJMoa2307983   Clinical Question In patients with myocardial infarction and anaemia, does a restrictive or liberal transfusion strategy decrease myocardial ischaemia or death at 30 days?  Myocardial Ischemia and Transfusion (MINT) Trial  Background Anaemia is common in patients with acute myocardial infarction and may exacerbate […]

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FARES II: PCC vs FFP in Cardiac Surgery

Intensive Care Medicine, Summaries Leave a comment

Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery The FARES-II Multicenter Randomized Clinical Trial Karkouthi. JAMA 2025; doi:10.1001/jama.2025.3501 Clinical Question In adults undergoing cardiac surgery with cardiopulmonary bypass, is the use of a 4-factor prothrombin complex concentrate (PCC), compared to fresh frozen plasma (FFP), safe and efficacious in treating active or anticipated bleeding? Background Bleeding post […]

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Clinical Decisions on Beta Blockers After MI

Blog, Evidence-based Medicine Leave a comment

Clinical Question In adults with acute myocardial infarction and preserved left ventricular ejection fraction (LVEF), does initiating beta-blocker therapy at discharge, compared with no beta-blocker therapy, reduce the risk of death or recurrent myocardial infarction?   Background Beta-blockers have long been a cornerstone of post–myocardial infarction care, largely based on trials conducted in the pre-reperfusion era. However, with modern advances […]

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NIV vs HFNC to prevent re-intubation in patients with obesity

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Humidified Non-Invasive Ventilation versus High-Flow Therapy to Prevent Reintubation in Patients with Obesity Hernández et al. AJRCCM 2025. DOI: 10.1164/rccm.202403-0523OC Clinical Question In obese adult patients at intermediate risk for hypoxaemic extubation failure, does non-invasive ventilation (NIV) therapy with active humidification compared to use of high-flow nasal oxygen (HFNO or HFNC) reduce all-cause reintubation within 7 days after extubation? Background […]

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