A compendium of critical appraisals in Intensive Care Medicine research and related specialties
Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults Finfer S, NEJM, 2022; DOI: 10.1056/NEJMoa2114464 Clinical Question In critically ill adults does the use of a balanced multielectrolyte solution (BMES, Plasmalyte 148), as opposed to 0.9% Sodium Chloride, for fluid resuscitation and therapy result in reduced 90 day mortality? Background Fluid administration is a key component of critical care therapy […]
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Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study—a randomized clinical trial Bohé. Intensive Care Medicine 2021. https://doi.org/10.1007/s00134-021-06526-8 Clinical Question In critically unwell adults does targeting individualised glycaemic control compared to glycaemia < 180 mg/dL improve 90 day mortality? Background Hyperglycaemia has been shown to result in worse outcomes in the critically ill, especially in non-diabetic patients In […]
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Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial Anderson et al. JAMA 2021. doi:10.1001/jama.2021.16628 Clinical Question In adult patients suffering an in-hospital cardiac arrest (IHCA) does the use of vasopressin and methylprednisolone compared to a placebo result in increased rates of return of spontaneous circulation (ROSC)? […]
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Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation Desch S et al. NEJM 2021. DOI: 10.1056/NEJMoa2101909 Clinical Question In adults > 30 years old suffering out-of-hospital cardiac arrest (OOHCA) without ST elevation on their ECG does routine immediate coronary angiography compared to a delayed or selective approach to coronary angiography improve 30-day all-cause mortality? Background The DISCO pilot study showed […]
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In adult intensive care patients does the use of a balanced crystalloid compared to 0.9% saline reduce 90-day all-cause mortality?
In adult intensive care patients needing administration of resuscitation fluids, does the slow infusion compared to a fast infusion of a fluid boluses reduce 90-day all-cause mortality?
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In patients undergoing caesarean section (CS) does the administration of tranexamic acid (TXA) when compared to placebo result in a lower incidence of calculated estimated blood loss of red blood cell transfusion by day 2?
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In adult trauma patients with major haemorrhage and hypofibrinogenaemia does the use fibrinogen concentrate (FC) compared to cryoprecipitate (cryo) result in a shorter time to administration?
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In adults suffering out of hospital cardiac arrest (OHCA) presenting with an initial rhythm of VF or pulseless VT, does the implementation of early ECMO facilitated resuscitation compared to standard ACLS resuscitation improve survival to hospital discharge?
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In adult trauma patients presenting with signs of haemorrhagic shock does the utilisation of a viscoelastic haemostatic assay (VHA) augmented transfusion strategy compared to a strategy augmented by conventional coagulation tests (CCT) result in an increased number of patients alive and free of massive transfusion at 24 hours?
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In patients aged > 18 years who were unable to be liberated from vasopressors for 24 hours, did the addition of midodrine when compared to a placebo result in the earlier discontinuation of vasopressors?
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