Category: Summaries

A category to collect all the summaries, so that they can be used in menus and widgets. Please don’t expand this – “Specialties” and “Special Topics” have been created as a custom category sets for the clinical topics.

RSI: Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults

Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults Casey. NEJM. 2025. doi: 10.1056/NEJMoa2511420 Clinical Question Among adults with non‑traumatic critical illness undergoing emergency tracheal intubation in the ED or ICU, how does induction with ketamine (1–2 mg/kg IV, dosed by actual body weight) versus etomidate (0.2–0.3 mg/kg IV, dosed by actual body weight) affect 28‑day mortality? Background Peri-intubation […]

ANDROMEDA-SHOCK2 – Personalized Hemodynamic Resuscitation

Personalized Hemodynamic Resuscitation Targeting Capillary Refill Time in Early Septic Shock ANDROMEDA SHOCK 2 Investigators @ShockAndromeda2. JAMA 2025. doi:10.1001/jama.2025.20402 Clinical Question In adult patients with early septic shock, does a personalised haemodynamic resuscitation protocol targeting capillary refill time (CRT) normalisation improve outcomes compared to usual care? Background In septic shock, the pathophysiological mechanisms contributing to the development of a shocked […]

Individualized Perioperative Blood Pressure Management in Patients Undergoing Major Abdominal Surgery

28 November 2025 Jake Reeve Peri-operative Medicine Leave a comment

Individualized Perioperative Blood Pressure Management in Patients Undergoing Major Abdominal Surgery: The IMPROVE-multi Randomized Clinical Trial B Saugel. JAMA 2025; doi: 10.1001/jama.2025.17235 Clinical Question In patients undergoing major intra-abdominal surgery, does an individualised blood pressure target, compared to standard care, improve rates of acute kidney injury, acute myocardial infarction, non-fatal cardiac arrest or death within the first 7 days? Background […]

BICARICU-2: NaHCO3 for Metabolic Acidemia

11 November 2025 George Walker Intensive Care Medicine Leave a comment

Sodium Bicarbonate for Severe Metabolic Acidemia and Acute Kidney Injury Jung et al. JAMA 2025. doi: 10.1001/jama.2025.20231 Clinical Question In patients with severe metabolic acidosis (pH ≤7.20) and moderate to severe AKI does the administration of sodium bicarbonate (NaHCO3) compared to placebo reduce 90-day mortality? Background Multiple cardiac, respiratory, renal and neurological pathophysiological consequences of severe academia have been reported […]

Collaborative VLS – Video vs Direct Laryngoscopy for Endotracheal Intubation in the OT

19 September 2025 Daniel Chung Intensive Care Medicine, Summaries Leave a comment

Video Laryngoscopy vs Direct Laryngoscopy for Endotracheal Intubation in the Operating Room A Cluster Randomized Clinical Trial Ruetzler et al. JAMA 2024;331;(15):1279-1286. doi:10.1001/jama.2024.0762 Clinical Question In patients being intubated for cardiac, thoracic or vascular surgery, does initial video laryngoscopy (VL) with a hyperangulated blade or direct laryngoscopy (DL) effect the number of intubation attempts? Background Endotracheal intubation is integral to the […]

REMAP CAP: Corticosteroids

1 September 2025 Generic Contributor Intensive Care Medicine Leave a comment

Effect of hydrocortisone on mortality in patients with severe community-acquired pneumonia: The REMAP-CAP Corticosteroid Domain Randomized Clinical Trial Angus. ICM 2025; doi: https://doi.org/10.1007/s00134-025-07861-w Clinical Question In adult patients with severe community acquired pneumonia (CAP) requiring ICU admission, does a 7-day course of intravenous hydrocortisone reduce 90-day mortality? Background Community-acquired pneumonia (CAP) remains a leading cause of ICU admissions and mortality […]

Target Protein – Augmented Enteral Protein During Critical Illness

31 July 2025 George Walker Intensive Care Medicine Leave a comment

Augmented Enteral Protein During Critical Illness MJ Summers. JAMA 2025; doi: 10.1001/jama.2025.9110 Clinical Question In critically ill patients receiving enteral nutrition does the augmentation of protein delivery compared to standard care result in an increased number of days free of the index hospital and alive at day 90? Background Critical illness weakness is a common complication within the ICU population […]

Shared Decision Making in Resuscitation Decisions

11 July 2025 Generic Contributor Intensive Care Medicine, Peri-operative Medicine Leave a comment

A Randomized Trial of Shared Decision-Making in Code Status Discussions Becker. NEJM Evidence 2025; doi:10.1056/EVIDoa2400422 Clinical Question In hospitalized adults requiring code status discussions, does a shared decision-making approach (including a checklist and decision aid) compared to usual care increase the proportion of patients choosing a DNR status? Background In-hospital cardiac arrest outcomes are poor (<20% survival; ~40% with neurologic […]

UK-ROX Trial

27 June 2025 Celia Bradford Intensive Care Medicine Leave a comment

Conservative Oxygen Therapy in Mechanically Ventilated Critically Ill Adult Patients Martin. JAMA June 12 2025; doi:10.1001/jama.2025.9663 Clinical Question In mechanically ventilated adult patients in the ICU, does a strategy of conservative oxygen therapy, targeting a SpO2 of 90% (Range 88-92%) compared with usual care, reduce mortality at 90 days? Background In the United Kingdom, around 184,000 adults are admitted to […]

Fluid – Hospital Wide Lactated Ringer’s versus Normal Saline

19 June 2025 George Walker Emergency Medicine, Intensive Care Medicine, Peri-operative Medicine Leave a comment

A Crossover Trial of Hospital-Wide Lactated Ringer’s Solution versus Normal Saline L McIntyre. NEJM 2025; DOI: 10.1056/NEJMoa2416761 Clinical Question In hospitalised patients, does the use of Lactated Ringers (LR) vs Normal Saline (NS) lower the incidence of death or readmission to the hospital within 90 days after the index admission? Background Fluid choice (balanced solutions vs NS) has been widely […]

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