A compendium of critical appraisals in Intensive Care Medicine research and related specialties
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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Bayesian Statistics “Under Bayes’ Theorem, no theory is perfect. Rather it is a work in progress, always subject to refinement and further testing” Nate Silver Introduction With the recent publication of the REMAP-CAP steroid arm and the Bayesian post-hoc re-analysis of the EOLIA trial, it appears Bayesian statistics are appearing more frequently in critical care trials. The purpose of this […]
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In patients with severe COVID-19, does intravenous hydrocortisone (either as a fixed dose or restricted to when shock is clinically evident) compared with standard care, improve 21-day organ support free days?
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In patients with acute upper GI (UGI) bleeding and a Glasgow-Blatchford score ≥ 12, does endoscopy performed within 6 hours of gastroenterological consultation, compared with endoscopy performed within 6 – 24 hours have a lower 30 day mortality?
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