A compendium of critical appraisals in Intensive Care Medicine research and related specialties
In critically ill patients undergoing tracheal intubation does pre-oxygenation with non-invasive ventilation compared with pre-oxygenation with an oxygen mask reduce the incidence of hypoxemia during intubation?
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Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation (REVISE) D. Cook. NEJM 2024. DOI: 10.1056/NEJMoa2404245 Clinical Question In mechanically ventilated adults, does stress ulcer prophylaxis with intravenous pantoprazole (40 mg daily), compared with placebo (0.9% saline), reduce the occurrence of clinically important upper gastrointestinal bleeding at 90 days? Background Critical illness is associated with an increased risk of gastrointestinal (GI) stress […]
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In adult patients scheduled for cardiac surgery with cardiopulmonary bypass does infusion of a balanced solution of amino acids, commencing at the time of surgery, compared with balanced crystalloid alone (Ringer’s Lactate) reduce the incidence of acute kidney injury (AKI)?
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Liberal or Restrictive Transfusion Strategy in Patients with Traumatic Brain Injury Turgeon AF. NEJM June 13 2024; doi:10.1056/NEJMoa240360 Clinical Question In adult patients with moderate or severe traumatic brain injury, does a liberal transfusion strategy (transfusion if haemoglobin <10g/dl) compared to a restrictive strategy (transfusion if haemoglobin <7g/dl) reduce the rate of an unfavourable Glasgow Outcome Scale – Extended, at […]
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In trauma patients with exsanguinating haemorrhage, does the use of the REBOA (resuscitative endovascular balloon occlusion of the aorta) device with standard care in the emergency department, compared with standard care alone, impact 90-day-mortality?
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In patients with trauma and critical bleeding who require activation of a major haemorrhage protocol, does the empiric administration of 3 pools of cryoprecipitate (6g fibrinogen) within 90 minutes of randomisation (and no more than 3 hours after injury) improve survival, compared to standard care?
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In adult patients with major trauma, who are at risk for trauma-induced coagulopathy does early administration of 1g of tranexamic acid (TXA) followed by an infusion of 1g over 8 hours, compared with placebo, increase survival with a favourable functional outcome at 6 months?
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In patients with trauma-related haemorrhagic shock does prehospital administration of packed red cells and lyophilised plasma (Lyo-Plas) compared with normal saline reduce the composite outcome of mortality and failure to reach lactate clearance?
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In comatose survivors of cardiac arrest does the treatment of rhythmic and periodic electroencephalographic (EEG) patterns improve neurological outcome compared with standard care?
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Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery Mario Gaudino, The Lancet Dec 4 2021; 398: 2075–83 https://doi.org/10.1016/S0140-6736(21)02490-9 Clinical Question In selected patients undergoing cardiac surgery, does posterior left pericardiotomy compared with usual care, reduce the incidence of postoperative atrial fibrillation? Background Atrial fibrillation is common following cardiac surgery with approximately one-third of patients developing […]
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