Critical Care Evidence Updates – July 2021

Randomised Controlled Trials

Dexamethasone 12 mg versus 6 mg for patients with COVID-19 and severe hypoxia: an international, randomized, blinded trial. MedRxiv 2021;epublished July 24th

Use of a High-Protein Enteral Nutrition Formula to Increase Protein Delivery to Critically Ill Patients: A Randomized, Blinded, Parallel-Group, Feasibility Trial. JPEN J Parenter Enteral Nutr 2021;45(4):699-709

Induced hypernatremia in patients with moderate-to-severe ARDS: a randomized controlled study. ICMx 2021;9:33

In case you missed it..

Treatment of Multisystem Inflammatory Syndrome in Children. N Engl J Med 2021; 385:11-22 DOI: 10.1056/NEJMoa2102968


Clostridioides difficile infection: antimicrobial prescribing : guidance (NG199)

COVID-19 rapid guideline: vaccine-induced immune thrombocytopenia and thrombosis (VITT) : guidance (NG200)

Acumen IQ sensor for predicting hypotension risk – medtech innovation briefing (MIB266)

Other Guidance/Reports

Clinical guidance for managing COVID-19: Information for RCN members. Updated 06 July 2021 Royal College of Nursing

Catheter Care (PDF) Royal College of Nursing

Better Together: Collaborative working between emergency medicine and critical care: A framework for improved collaborative working between Emergency Medicine (EM) and Intensive Care Medicine (ICM) (PDF) Royal College of Emergency Medicine

Best Practice Standards for the delivery of NHS infection services in the uk Royal College of Pathologists

Physician-assisted dying survey British Medical Association

Continuous Positive Airway Pressure (CPAP) and Bi-level PAP: Clinical risk stratification tool British Thoracic Society


Ivermectin for preventing and treating COVID‐19

Systematic Reviews & Meta-analyses

The WHO Rapid Evidence Appraisal for COVID-19 Therapies (REACT) Working Group. Association Between Administration of IL-6 Antagonists and Mortality Among Patients Hospitalized for COVID-19A Meta-analysis. JAMA 2021;epublished July 6th

Transmission of Severe Acute Respiratory Syndrome Coronavirus 1 and Severe Acute Respiratory Syndrome Coronavirus 2 During Aerosol-Generating Procedures in Critical Care: A Systematic Review and Meta-Analysis of Observational Studies. Crit Care Med 2021;49(7):1159-1168

Effect of dexmedetomidine on delirium during sedation in adult patients in intensive care units: A systematic review and meta-analysis. J Clin Anesth 2021;69:110157

Accuracy and precision of continuous non-invasive arterial pressure monitoring in critical care: A systematic review and meta-analysis. Intensive & Critical Care Nursing

Factors contributing to poor sleep in critically ill patients: A systematic review and meta-synthesis of qualitative studies. Intensive & Critical Care Nursing

The relationship between sensory stimuli and the physical environment in complex healthcare settings: A systematic literature review. Intensive & Critical Care Nursing

Outcomes sensitive to critical care nurse staffing levels: A systematic review. Intensive & Critical Care Nursing

Experiences and needs of families with a relative admitted to an adult intensive care unit: a systematic review of qualitative studies Joanna Briggs Institute

The negative impact of obesity on the occurrence and prognosis of the 2019 novel coronavirus (COVID-19) disease: a systematic review and meta-analysis. Eating and Weight Disorders

Venoarterial extracorporeal membrane oxygenation as mechanical circulatory support in adult septic shock: a systematic review and meta-analysis with individual participant data meta-regression analysis. Critical Care

Mental disorders and risk of COVID-19-related mortality, hospitalisation, and intensive care unit admission: a systematic review and meta-analysis. The Lancet Psychiatry

Cochrane Clinical Answers

What are the effects of alternative reactive support surfaces (non‐foam and non‐air‐filled) for preventing pressure ulcers?

Primary Research

Transpulmonary thermodilution in patients treated with veno-venous extracorporeal membrane oxygenation Annals of Intensive Care

Mental health outcomes of ICU and non-ICU healthcare workers during the COVID-19 outbreak: a cross-sectional study Annals of Intensive Care

Prevalence and prognostic value of various types of right ventricular dysfunction in mechanically ventilated septic patients Annals of Intensive Care

Noninvasive ventilation vs. high-flow nasal cannula oxygen for preoxygenation before intubation in patients with obesity: a post hoc analysis of a randomized controlled trial Annals of Intensive Care

Outcomes of ICU patients with and without perceptions of excessive care: a comparison between cancer and non-cancer patients Annals of Intensive Care

Relationship between the Clinical Frailty Scale and short-term mortality in patients ≥ 80 years old acutely admitted to the ICU: a prospective cohort study Critical Care

Tracheostomy management in patients with severe acute respiratory distress syndrome receiving extracorporeal membrane oxygenation: an International Multicenter Retrospective Study Critical Care

Plasma glutamine status at intensive care unit admission: an independent risk factor for mortality in critical illness Critical Care

Longitudinal changes in compliance, oxygenation and ventilatory ratio in COVID-19 versus non-COVID-19 pulmonary acute respiratory distress syndrome Critical Care

Static compliance and driving pressure are associated with ICU mortality in intubated COVID-19 ARDS Critical Care

Ischemic and Hemorrhagic Stroke Among Critically Ill Patients With Coronavirus Disease 2019: An International Multicenter Coronavirus Disease 2019 Critical Care Consortium Study Critical Care Medicine

Palliative and End-of-Life Care: Prioritizing Compassion Within the ICU and Beyond Critical Care Medicine

Prediction of Postictal Delirium Following Status Epilepticus in the ICU: First Insights of an Observational Cohort Study Critical Care Medicine

A Locally Optimized Data-Driven Tool to Predict Sepsis-Associated Vasopressor Use in the ICU
Critical Care Medicine

Role and knowledge of critical care nurses in the assessment and management of hypophosphataemia and refeeding syndrome. A descriptive exploratory study Intensive and Critical Care Nursing

Early detection of intensive care needs and mortality risk by use of five early warning scores in patients with traumatic injuries: An observational study Intensive and Critical Care Nursing

Conditions and strategies to meet the challenges imposed by the COVID-19-related visiting restrictions in the ICU: a Scandinavian cross-sectional study Intensive and Critical Care Nursing

Healthcare personnel’s working conditions in relation to risk behaviours for organism transmission: A mixed-methods study Journal of Clinical Nursing

Practical view of the topical treatment of peripheral venous catheter-related phlebitis: A scoping review Journal of Clinical Nursing

Beyond the physical risk: Psychosocial impact and coping in healthcare professionals during the COVID-19 pandemic Journal of Clinical Nursing

Professional quality of life and caring behaviours among clinical nurses during the COVID-19 pandemic Journal of Clinical Nursing

Evaluating the impact on hospital acquired pressure injury/ulcer incidence in a United Kingdom NHS Acute Trust from use of sub-epidermal scanning technology Journal of Clinical Nursing

Adiponectin decrease was correlated with rising SOFA score and increased 28 days mortality: Beware of potential confounding factors! Journal of Critical Care

Comparison of three cisatracurium dosing strategies in acute respiratory distress syndrome: A focus on drug utilization and improvement in oxygenation Journal of Critical Care

Endothelium-associated biomarkers mid-regional proadrenomedullin and C-terminal proendothelin-1 have good ability to predict 28-day mortality in critically ill patients with SARS-CoV-2 pneumonia: A prospective cohort study Journal of Critical Care

Intensive Care Unit Volume of Sepsis Patients Does Not Affect Mortality: Results of a Nationwide Retrospective Analysis Journal of Intensive Care Medicine

Practices and Patterns of Hourly Neurochecks: Analysis of 8,936 Patients With Neurological Injury Journal of Intensive Care Medicine

Preoperative Vitamin D Deficiency Is Associated With Postoperative Delirium in Critically Ill Patients Journal of Intensive Care Medicine

Relationship Between Body Mass Index and Survival Among Critically Ill Patients With Cirrhosis Journal of Intensive Care Medicine

The Impact of Corticosteroids on Secondary Infection and Mortality in Critically Ill COVID-19 Patients Journal of Intensive Care Medicine

The Safety and Efficacy of Desmopressin in Patients With Intracranial Hemorrhage and a History of Alcohol Use Journal of Intensive Care Medicine

Tofacitinib in Patients Hospitalized with Covid-19 Pneumonia New England Journal of Medicine


Summary author: Rebecca Howes @ClinicalLibsPHU
Summary date: 2nd August 2021
Picture by: Ehimetalor Akhere Unuabona on Unsplash

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