Critical Care Evidence Updates – October 2023

Randomised Controlled Trials

Adjunctive Dexamethasone for Tuberculous Meningitis in HIV-Positive Adults  NEJM

Antimicrobial Multidrug Resistance: Clinical Implications for Infection Management in Critically Ill Patients   Microorganisms

Catheter Ablation in End-Stage Heart Failure with Atrial Fibrillation  NEJM

Cefepime vs Piperacillin-Tazobactam in Adults Hospitalized With Acute Infection – The ACORN Randomized Clinical Trial  JAMA

Ceftobiprole for Treatment of Complicated Staphylococcus aureus Bacteremia  NEJM

Convalescent Plasma for Covid-19–Induced ARDS in Mechanically Ventilated Patients  NEJM

Early and Empirical High-Dose Cryoprecipitate for Hemorrhage After Traumatic Injury – The CRYOSTAT-2 Randomized Clinical Trial   JAMA

Early Left Ventricular Unloading or Conventional Approach After Venoarterial Extracorporeal Membrane Oxygenation: The EARLY-UNLOAD Randomized Clinical Trial  Circulation

Effects of an online information tool on post-traumatic stress disorder in relatives of intensive care unit patients: a multicenter double-blind, randomized, placebo-controlled trial (ICU-Families-Study)  Intensive Care Medicine

Effects of CPAP and FiO2 on respiratory effort and lung stress in early COVID-19 pneumonia: a randomized, crossover study  Annals of Intensive Care

Effect of Glutamine Administration After Cardiac Surgery on Kidney Damage in Patients at High Risk for Acute Kidney Injury: A Randomized Controlled Trial  Anesthesia & Analgesia

Efficacy and Safety of Reparixin in Patients with Severe COVID-19 Pneumonia: A Phase 3, Randomized, Double-Blind Placebo-Controlled Study  Infectious Diseases and Therapy

Efficacy of haloperidol to decrease the burden of delirium in adult critically ill patients: the EuRIDICE randomized clinical trial  Critical Care

Endovascular thrombectomy for acute ischaemic stroke with established large infarct: multicentre, open-label, randomised trial  The Lancet

Enteral citrulline supplementation versus placebo on SOFA score on day 7 in mechanically ventilated critically ill patients: the IMMUNOCITRE randomized clinical trial  Critical Care

GlideScope versus C-MAC D-blade videolaryngoscope for double-lumen tube intubation in patients with anticipated difficult airways: A multi-center, prospective, randomized, controlled trial  Journal of Clinical Anaesthesia

Inhaled Amikacin to Prevent Ventilator-Associated Pneumonia  NEJM

Initiation of continuous renal replacement therapy versus intermittent hemodialysis in critically ill patients with severe acute kidney injury: a secondary analysis of STARRT-AKI trial  Intensive Care Medicine

Intracranial pressure monitoring with and without brain tissue oxygen pressure monitoring for severe traumatic brain injury in France (OXY-TC): an open-label, randomised controlled superiority trial  The Lancet Neurology

Intravenous Vitamin C for Patients Hospitalized With COVID-19 – Two Harmonized Randomized Clinical Trials  JAMA

Intraventricular Lavage vs External Ventricular Drainage for Intraventricular Hemorrhage – A Randomized Clinical Trial  Neurology

Landiolol and Organ Failure in Patients With Septic Shock – The STRESS-L Randomized Clinical Trial  JAMA

Magnesium sulphate in patients with thrombotic thrombocytopenic purpura (MAGMAT): a randomised, double-blind, superiority trial  Intensive Care Medicine

Mega-dose sodium ascorbate: a pilot, single-dose, physiological effect, double-blind, randomized, controlled trial  Critical Care

Nasal Iodophor Antiseptic vs Nasal Mupirocin Antibiotic in the Setting of Chlorhexidine Bathing to Prevent Infections in Adult ICUs – A Randomized Clinical Trial  JAMA

Physiological effects of high-flow nasal cannula oxygen therapy after extubation: a randomized crossover study  Annals of Intensive Care

Piloting an ICU follow-up clinic to improve health-related quality of life in ICU survivors after a prolonged intensive care stay (PINA): feasibility of a pragmatic randomised controlled trial  BMC Anesthesiology

Remote Ischemic Conditioning for Acute Stroke – The RESIST Randomized Clinical Trial  JAMA

Sigh Ventilation in Patients With Trauma – The SiVent Randomized Clinical Trial  JAMA

Simvastatin in Critically Ill Patients with Covid-19  NEJM

Small-Volume Blood Collection Tubes to Reduce Transfusions in Intensive Care – The STRATUS Randomized Clinical Trial  JAMA

Temporary Mechanical Circulatory Support in Cardiogenic Shock Patients after Cardiac Procedures: Selection Algorithm and Weaning Strategies  Life

Timing of Complete Revascularization with Multivessel PCI for Myocardial Infarction  NEJM



Pneumonia in adults: diagnosis and management CG191


Other Guidance/Reports

Cardiovascular-Kidney-Metabolic Health: A Presidential Advisory From the American Heart Association  – Circulation

Definition of factor Xa inhibitor–related, life-threatening gastrointestinal bleeding and guidance on when to use reversal therapy: A Delphi panel  –  Journal of the American College of Emergency Physicians Open

European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis and treatment of Guillain–Barré syndrome  –  European Journal of Neurology

Red Blood Cell Transfusion – 2023 AABB International Guidelines  –  JAMA

Society of Critical Care Medicine and the Infectious Diseases Society of America Guidelines for Evaluating New Fever in Adult Patients in the ICU  –  Critical Care Medicine

The role of beta-blocker drugs in critically ill patients: a SIAARTI expert consensus statement  –  Journal of Anesthesia, Analgesia and Critical Care



Cerebrolysin for acute ischaemic stroke

Erector spinae plane block for postoperative pain

Immediate versus delayed versus no antibiotics for respiratory infections


Primary Research

Age and associated outcomes among patients receiving venoarterial extracorporeal membrane oxygenation–analysis of the Extracorporeal Life Support Organization registry  Intensive Care Medicine

Airway Pressure Release Ventilation in COVID-19-Associated Acute Respiratory Distress Syndrome—A Multicenter Propensity Score–Matched Analysis  Journal of Intensive Care Medicine

Assessing neutrophil-derived ROS production at the bedside: a potential prognostic tool in severe COVID-19 cases  Intensive Care Medicine Experimental

Association Between Nurse Copatient Illness Severity and Mortality in the ICU  Critical Care Medicine

Association of language concordance and restraint use in adults receiving mechanical ventilation  Intensive Care Medicine

Association of pronounced elevation of NET formation and nucleosome biomarkers with mortality in patients with septic shock  Annals of Intensive Care

Characteristics of pulmonary artery catheter use in multicenter ICUs in Japan and the association with mortality: a multicenter cohort study using the Japanese Intensive care PAtient Database  Critical Care

Clinical Warburg effect in lymphoma patients admitted to intensive care unit  Annals of Intensive Care

Clinician views on actionable processes of care for prolonged stay intensive care patients and families: A descriptive qualitative study  Intensive and Critical Care Nursing

Cognitive impairment and psychopathology in sudden out-of-hospital cardiac arrest survivors: Results from the REVIVAL cohort study  Resuscitation

Comparison of communication interfaces for mechanically ventilated patients in intensive care  Intensive and Critical Care Nursing

Comparison of whole blood cytokine immunoassays for rapid, functional immune phenotyping in critically ill patients with sepsis  Intensive Care Medicine Experimental

Correlation analysis between lung ultrasound scores and pulmonary arterial systolic pressure in patients with acute heart failure admitted to the emergency intensive care unit  Journal of Intensive Medicine

Correlation of Sedation Depth During Critical Care Transport and Hospitalization  Journal of Intensive Care Medicine

Creating the ICU of the future: patient-centred design to optimise recovery  Critical Care

Delirium During Critical Illness and Subsequent Change of Treatment in Patients With Cancer: A Mediation Analysis  Critical Care Medicine

Diaphragm excursions as proxy for tidal volume during spontaneous breathing in invasively ventilated ICU patients  Intensive Care Medicine Experimental

Dying to be better: Outlining the growing benefits of palliative care training in intensive care medicine  Journal of the Intensive Care Society

Echocardiography Does not Reduce Mortality in Sepsis: A Re-Evaluation Using the Medical Information Mart for Intensive Care IV Dataset  Critical Care Medicine

Elevated circulating PCSK9 level is associated with 28-day mortality in patients with sepsis: a prospective cohort study  BMC Emergency Medicine

Facilitators and barriers to evidence-based practice in central venous access device insertion and management in an intensive care unit: A qualitative study  Intensive and Critical Care Nursing

First and final farewells, disrupted family connections and loss: A collective case study exploring the impact of COVID-19 visitor restrictions in critical care  Intensive and Critical Care Nursing

Human cytomegalovirus seropositivity is associated with reduced patient survival during sepsis  Critical Care

Impact of a cumulative positive fluid balance during the first three ICU days in patients with sepsis: a propensity score-matched cohort study  Annals of Intensive Care

Impact of Standardized Multidisciplinary Critical Care Training on Confidence with Critical Illness and Attitudes Towards Interprofessional Education and Multidisciplinary Care  Journal of Intensive Care Medicine

Impact of Using Blood Warmer During Continuous Kidney Replacement Therapy in Patients With Acute Kidney Injury  Journal of Intensive Care Medicine

Implementation of a Pressure Injury Prevention Protocol for Intensive Care Unit Patients Undergoing Prone Positioning  Critical Care Nurse

Improved 30-Day Survival Estimation in ICU Patients: A Comparative Analysis of Different Approaches With Real-World Data  Critical Care Medicine

Incidence of asymptomatic catheter-related thrombosis in intensive care unit patients: a prospective cohort study  Annals of Intensive Care

Insulin Use Is Associated With Improved Outcomes in Critically Ill Patients With Acute Pancreatitis: A Retrospective Matched Cohort Study  Journal of Intensive Care Medicine

Limiting life-sustaining treatment for very old ICU patients: cultural challenges and diverse practices  Annals of Intensive Care

Long-term prognostic significance of gasping in out-of-hospital cardiac arrest patients undergoing extracorporeal cardiopulmonary resuscitation: a post hoc analysis of a multi-center prospective cohort study  Journal of Intensive Care

Low levels of small HDL particles predict but do not influence risk of sepsis  Critical Care

Lung abscess following ventilator-associated pneumonia during COVID-19: a retrospective multicenter cohort study  Critical Care

Mortality, incidence, and microbiological documentation of ventilated acquired pneumonia (VAP) in critically ill patients with COVID-19 or influenza  Annals of Intensive Care

Nomogram model on estimating the risk of pressure injuries for hospitalized patients in the intensive care unit  Intensive and Critical Care Nursing

Oxygen Debt as Predictor of Mortality and Multiple Organ Dysfunction Syndrome in Severe COVID-19 Patients: A Retrospective Study  Journal of Intensive Care Medicine

Outcome of comatose patients following cardiac arrest: When mRS completes CPC  Resuscitation

Polymyxin B-immobilised fibre column treatment for acute exacerbation of idiopathic pulmonary fibrosis patients with mechanical ventilation: a nationwide observational study  Journal of Intensive Care

Prediction of mechanical ventilation outcome by early abdominal-visceral-blood-flow-and-function score in critically ill patients after cardiopulmonary bypass in the ICU: A prospective observational study  Journal of Intensive Medicine

Prevalence and predictors of shared decision-making in goals-of-care clinician-family meetings for critically ill neurologic patients: a multi-center mixed-methods study  Critical Care

Prognosis of critically ill immunocompromised patients with virus-detected acute respiratory failure  Annals of Intensive Care

Prognostic value of time-varying dead space estimates in mechanically ventilated patients with acute respiratory distress syndrome  Journal of Intensive Medicine

Prospective comparison of prognostic scores for prediction of outcome after out-of-hospital cardiac arrest: results of the AfterROSC1 multicentric study  Annals of Intensive Care

Protein-S-100 Beta, a marker of blood–brain barrier dysfunction, is increased in patients with decompensated cirrhosis admitted to the intensive care unit  Journal of Intensive Medicine

Safety and Outcome of High-Flow Nasal Oxygen Therapy Outside ICU Setting in Hypoxemic Patients With COVID-19  Critical Care Medicine

Self-reported symptoms experienced by intensive care unit patients: a prospective observational multicenter study  Intensive Care Medicine

Serial assessments of cardiac output and mixed venous oxygen saturation in comatose patients after out-of-hospital cardiac arrest  Critical Care

Severe Acute Respiratory Syndrome Coronavirus 2 Pneumonia in Critically Ill Patients: A Cluster Analysis According to Baseline Characteristics, Biological Features, and Chest CT Scan on Admission  Critical Care Medicine

Sex Differences in Vital Organ Support Provided to ICU Patients  Critical Care Medicine

The diverse invitations to participate in early rehabilitation – A qualitative study of nurse-patient interactions in the intensive care unit  Intensive and Critical Care Nursing

The effect of audiobooks on sleep quality and vital signs in intensive care patients  Intensive and Critical Care Nursing

The impact of higher protein dosing on outcomes in critically ill patients with acute kidney injury: a post hoc analysis of the EFFORT protein trial  Critical Care

The impact of religion on changes in end-of-life practices in European intensive care units: a comparative analysis over 16 years  Intensive Care Medicine

The intensive care unit diary as a valuable care tool: A qualitative study of patients’ experiences  Intensive and Critical Care Nursing

The Predictive Validity of the Berlin Definition of Acute Respiratory Distress Syndrome for Patients With COVID-19-Related Respiratory Failure Treated With High-Flow Nasal Oxygen: A Multicenter, Prospective Cohort Study  Critical Care Medicine

The role of beta-blocker drugs in critically ill patients: a SIAARTI expert consensus statement  Journal of Anesthesia, Analgesia and Critical Care

Thrombocytopenia and platelet transfusions in ICU patients: an international inception cohort study (PLOT-ICU)   Intensive Care Medicine

Utilization of spontaneous breathing trial, objective cough test, and diaphragmatic ultrasound results to predict extubation success: COBRE-US trial  Critical Care

Validity of the total SOFA score in patients ≥ 80 years old acutely admitted to intensive care units: a post-hoc analysis of the VIP2 prospective, international cohort study  Annals of Intensive Care


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

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