Critical Care Evidence Updates – April 2023

Randomised Controlled Trials

A randomized-controlled trial (TARGET-C) of high vs. low target mean arterial pressure in patients with cirrhosis and septic shock  Journal of Hepatology

biomArker-guided Duration of Antibiotic treatment in hospitalised Patients with suspecTed Sepsis (ADAPT-Sepsis): A protocol for a multicentre randomised controlled trial  Journal of the Intensive Care Society

Early non-invasive ventilation and high-flow nasal oxygen therapy for preventing endotracheal intubation in hypoxemic blunt chest trauma patients: the OptiTHO randomized trial  Critical Care

Effect of Angiotensin-Converting Enzyme Inhibitor and Angiotensin Receptor Blocker Initiation on Organ Support–Free Days in Patients Hospitalized With COVID-19 – A Randomized Clinical Trial  JAMA

Endovascular treatment versus no endovascular treatment after 6–24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands: a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial  The Lancet

Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial  The Lancet

Interferon gamma-1b for the prevention of hospital-acquired pneumonia in critically ill patients: a phase 2, placebo-controlled randomized clinical trial  Intensive Care Medicine

IV Vitamin C in Adults With Sepsis: A Bayesian Reanalysis of a Randomized Controlled Trial  Critical Care Medicine

One-lung ventilation and postoperative pulmonary complications after major lung resection surgery. A multicenter randomized controlled trial.  Journal of Cardiothoracic and Vascular Anesthesia

Peri-Intubation Hypoxia After Delayed Versus Rapid Sequence Intubation in Critically Injured Patients on Arrival to Trauma Triage: A Randomized Controlled Trial  Anesthesia & Analgesia

Prolonged higher dose methylprednisolone versus conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)  European Respiratory Journal

Renin-Angiotensin System Modulation With Synthetic Angiotensin (1-7) and Angiotensin II Type 1 Receptor–Biased Ligand in Adults With COVID-19 – Two Randomized Clinical Trials  JAMA

Safety, tolerability, pharmacokinetics, and efficacy of kukoamine B in patients with sepsis: A randomized phase IIa trial  Journal of Critical Care

The effectiveness of early surgical stabilization for multiple rib fractures: a multicenter randomized controlled trial  Journal of Cardiothoracic Surgery

Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct  NEJM

Trial of Endovascular Thrombectomy for Large Ischemic Strokes  NEJM

Utilization of mechanical power and associations with clinical outcomes in brain injured patients: a secondary analysis of the extubation strategies in neuro-intensive care unit patients and associations with outcome (ENIO) trial  Critical Care

Other Guidance/Reports

Causes, Consequences, and Treatments of Sleep and Circadian Disruption in the ICU: An Official American Thoracic Society Research Statement  American Journal of Respiratory and Critical Care Medicine

ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia  Intensive Care Medicine

ESTES recommendation on thoracolumbar spine fractures  European Journal of Trauma and Emergency Surgery

Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU: Neurology, Peri-Transplant Medicine, Infectious Disease, and Gastroenterology Considerations  Critical Care Medicine

Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care  European Journal of Anaesthesiology

Management of vagus nerve stimulation therapy in the peri-operative period  Anaesthesia

Preparing internal medicine trainees for their intensive care rotations: What are we doing across the UK?  Journal of the Intensive Care Society

Society of Anesthesia and Sleep Medicine Position Paper on Patient Sleep During Hospitalization  Anesthesia & Analgesia

Symptom Assessment for Mechanically Ventilated Patients: Principles and Priorities: An Official American Thoracic Society Workshop Report  Annals of the American Thoracic Society

Primary Research

A Comparison of Long-Term Outcomes in Patients Managed With Venovenous Extracorporeal Membrane Oxygenation in the First and Second Waves of the COVID-19 Pandemic in the United Kingdom  Critical Care Medicine

Association Between Levels of Intensive Care and In-Hospital Mortality in Patients Hospitalized for Sepsis Stratified by Sequential Organ Failure Assessment Scores  Critical Care Medicine

Association between prolonged corticosteroids use in COVID-19 and increased mortality in hospitalized patients: a retrospective study with inverse probability of treatment weighting analysis  Critical Care

Association between the timing of ICU admission and mortality in patients with hospital-onset sepsis: a nationwide prospective cohort study  Journal of Intensive Care

Association of lung recruitment and change in recruitment-to-inflation ratio from supine to prone position in acute respiratory distress syndrome  Critical Care

Atrial Fibrillation (AFIB) in the ICU: Incidence, Risk Factors, and Outcomes: The International AFIB-ICU Cohort Study  Critical Care Medicine

Bridging gut microbiota composition with extended-spectrum beta-lactamase Enterobacteriales faecal carriage in critically ill patients (microbe cohort study)  Annals of Intensive Care

Can carotid artery Doppler variations induced by the end-expiratory occlusion maneuver predict fluid responsiveness in septic shock patients?  Critical Care

Cerebrovascular Complications of COVID-19 on Venovenous Extracorporeal Membrane Oxygenation  Critical Care Medicine

Change of target temperature from 36 °C to strict fever avoidance only in comatose cardiac arrest survivors – A before and after study  Resuscitation

Clinical and Electroencephalographic Predictors of Seizures and Status Epilepticus in 12,450 Critically Ill Adults: A Retrospective Cohort Study  Critical Care Medicine

Clinical features, etiologies, and outcomes in adult patients with meningoencephalitis requiring intensive care (EURECA): an international prospective multicenter cohort study  Intensive Care Medicine

Clinical risk factors for increased respiratory drive in intubated hypoxemic patients  Critical Care

Comparison of cardiac index measurements in intensive care patients using continuous wave vs. pulsed wave echo-Doppler compared to pulse contour cardiac output  Intensive Care Medicine Experimental

Early Bacterial Coinfections in Patients Admitted to the ICU With COVID-19 or Influenza: A Retrospective Cohort Study  Critical Care Explorations

Effect of intravenous fluid volume on biomarkers of endothelial glycocalyx shedding and inflammation during initial resuscitation of sepsis  Intensive Care Medicine Experimental

Effects of an asymmetrical high flow nasal cannula interface in hypoxemic patients  Critical Care

Effects of sleep disturbance on dyspnoea and impaired lung function following hospital admission due to COVID-19 in the UK: a prospective multicentre cohort study  The Lancet Respiratory Medicine

External validation of the PROLOGUE score to predict neurological outcome in adult patients after cardiac arrest: a prospective cohort study  Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

First non-invasive magnetic phrenic nerve and diaphragm stimulation in anaesthetized patients: a proof-of-concept study  Intensive Care Medicine Experimental

Hyperoxia for accidental hypothermia and increased mortality: a post-hoc analysis of a multicenter prospective observational study  Critical Care

Hypertonic sodium lactate infusion reduces vasopressor requirements and biomarkers of brain and cardiac injury after experimental cardiac arrest  Critical Care

ICU admission for solid cancer patients treated with immune checkpoint inhibitors  Annals of Intensive Care

ICU Bereaved Surrogates’ Transition Through States of Co-Occurring Prolonged Grief Disorder, Posttraumatic Stress Disorder, and Depression Symptoms  Critical Care Medicine

Identification of a sub-group of critically ill patients with high risk of intensive care unit-acquired infections and poor clinical course using a transcriptomic score  Critical Care

Impact of Radial Arterial Location on Catheter Lifetime in ICU Surgical Intensive Care  Critical Care Explorations

Implementing a Unit-Based Alarm Management Bundle for Critical Care Nurses  Critical Care Nurse

Incidence of Hyponatremia Among Critically Ill Patients With and Without COVID-19 Infection at a Community Teaching Hospital  Journal of Intensive Care Medicine

Major adverse cardiovascular events are associated with necroptosis during severe COVID-19  Critical Care

Mechanical power and 30-day mortality in mechanically ventilated, critically ill patients with and without Coronavirus Disease-2019: a hospital registry study  Journal of Intensive Care

Monitoring the Resolution of Acute Exacerbation of Airway Bronchoconstriction in an Asthma Attack Using Capnogram Waveforms  Critical Care Explorations

Multiple-site decontamination to prevent acquired infection in patients with veno-venous ECMO support  Annals of Intensive Care

Necrotizing soft tissue infections in critically ill neutropenic patients: a French multicentre retrospective cohort study  Annals of Intensive Care

Pathogen-based target attainment of optimized continuous infusion dosing regimens of piperacillin-tazobactam and meropenem in surgical ICU patients: a prospective single center observational study  Annals of Intensive Care

Patient Safety: Cognitive Assessment at Intensive Care Unit Discharge  Critical Care Nurse

Personalized ventilatory strategy based on lung recruitablity in COVID-19-associated acute respiratory distress syndrome: a prospective clinical study  Critical Care

Phenobarbital-Based Protocol for Alcohol Withdrawal Syndrome in a Medical ICU: Pre-Post Implementation Study  Critical Care Explorations

Preoxygenation with standard facemask combining apnoeic oxygenation using high flow nasal cannula versuss standard facemask alone in patients with and without obesity: the OPTIMASK international study  Annals of Intensive Care

Pressure Injury Prevention in Patients in Prone Position With Acute Respiratory Distress Syndrome and COVID-19  Critical Care Nurse

Prognostic Value of Diaphragm Diameter, Muscle Volume, and Bone Mineral Density in Critically Ill COVID-19 Patients  Journal of Intensive Care Medicine

Subjective and objective survival prediction in mechanically ventilated critically ill patients: a prospective cohort study  Critical Care

The impact of unexpected intensive care unit admission after cancer surgery on long-term symptom burden among older adults: a population-based longitudinal analysis  Critical Care

The increase in cardiac output induced by a decrease in positive end-expiratory pressure reliably detects volume responsiveness: the PEEP-test study  Critical Care

Thromboelastometry-guided haemostatic resuscitation in severely injured patients: a propensity score-matched study  Critical Care

Tranexamic Acid vs Adrenaline for Controlling Iatrogenic Bleeding During Flexible Bronchoscopy  Chest Journal

What’s new in reducing the impact of tracheostomy on communication and swallowing in the ICU  Intensive Care Medicine


Summary author: Rebecca Howes @ClinicalLibsPHU
Summary date:
Picture by: Ehimetalor Akhere Unuabona on Unsplash

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