Category: Intensive Care Medicine

A collection of TBL summaries relevant to Intensive Care Medicine

Quetiapine Versus Haloperidol for Delirium

22 November 2024 Hrishee Vaidya Intensive Care Medicine, Summaries Leave a comment

Quetiapine Versus Haloperidol in the Management of Hyperactive Delirium: Randomized Controlled Trial Zakhary et al. Neurocritical Care; Oct;41(2):550-557. doi:10.1007/s12028-024-01948-w Clinical Question In critically ill patients with delirium, does quetiapine in comparison to haloperidol, reduce the severity of delirium? Background Delirium affects 30-50% of adult ICU patients Haloperidol is licensed for the treatment of acute delirium in the UK Previous RCTs […]

Pupillometry Thresholds for Neuroprognostication

22 November 2024 stephen.waite2@nhs.scot Intensive Care Medicine, Summaries Leave a comment

Validating quantitative pupillometry thresholds for neuroprognostication after out‑of‑hospital cardiac arrest. A predefined substudy of the Blood Pressure and Oxygenations Targets After Cardiac Arrest (BOX)‑trial Nyholm. Intensive Care Med 2024; 50:1484–1495. doi.org/10.1007/s00134-024-07574-6 Clinical Question In adult out-of-hospital cardiac arrest (OHCA) survivors of presumed cardiac cause who are comatose post-admission, do automated pupillometry thresholds of quantitatively assessed pupillary light reflex (qPLR) < […]

Flexible vs Restrictive Visiting in the ICU

22 November 2024 Roland Amoah Intensive Care Medicine, Summaries Leave a comment

Long-term effects of flexible visitation in the intensive care unit on family members’ mental health: 12-month results from a randomized clinical trial JMB de Souza et al. Intensive Care Med (2024); 50:1614–1621. DOI: 10.1007/s00134-024-07577-3 Clinical Question In family members of intensive care patients, does a flexible visiting policy, compared to a restrictive one, improve the prevalence of depression, anxiety and […]

TRAIN – Transfusion Strategies in Acute Brain Injured Patients

26 October 2024 andrew.achilleos@nhs.net Intensive Care Medicine, Summaries Leave a comment

Restrictive vs Liberal Transfusion Strategy in Patients With Acute Brain Injury @fabio_taccone. JAMA. 2024. PMID: 39382241 Clinical Question In patients with acute brain injury, does a liberal, compared to a restrictive strategy of blood transfusion, improve neurological outcomes at 180 days? Background The TRICC study, published over 20 years go, led to the widespread adoption of restrictive thresholds for blood […]

TIGHT K: Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery

14 October 2024 George Walker Intensive Care Medicine, Peri-operative Medicine Leave a comment

Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery: The TIGHT K Randomized Clinical Trial O’Brien. JAMA 2024; 332:979 – 988. doi:10.1001/jama.2024.17888 Clinical Question In adult patients undergoing coronary artery bypass surgery (CABG) is supplementing potassium when serum concentration is ≤ 3.5 mEq/L non-inferior to supplementation when serum concentration is ≤ 4.5 mEq/L to reduce the frequency of new […]

BLING III – Continuous vs Intermittent Antibiotics

15 August 2024 Generic Contributor Intensive Care Medicine Leave a comment

In critically ill adult patients with presumed sepsis, does the administration of β-lactam antibiotics via a continuous infusion compared to an intermittent infusion reduce 90-day mortality?

PREOXI Trial – Noninvasive Ventilation for Preoxygenation

20 July 2024 Celia Bradford Emergency Medicine, Intensive Care Medicine Leave a comment

In critically ill patients undergoing tracheal intubation does pre-oxygenation with non-invasive ventilation compared with pre-oxygenation with an oxygen mask reduce the incidence of hypoxemia during intubation?

ENRICH: Early Minimally Invasive Removal of ICH

15 July 2024 Generic Contributor Intensive Care Medicine, Peri-operative Medicine Leave a comment

In patients with spontaneous intracranial haemorrhage (ICH), does the use of early minimally invasive surgery + standard management compared to standard management alone, result in better functional outcomes at 180 days?

REVISE – Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation

12 July 2024 Celia Bradford Intensive Care Medicine Leave a comment

Stress Ulcer Prophylaxis during Invasive Mechanical Ventilation (REVISE) D. Cook. NEJM 2024. DOI: 10.1056/NEJMoa2404245 Clinical Question In mechanically ventilated adults, does stress ulcer prophylaxis with intravenous pantoprazole (40 mg daily), compared with placebo (0.9% saline), reduce the occurrence of clinically important upper gastrointestinal bleeding at 90 days? Background Critical illness is associated with an increased risk of gastrointestinal (GI) stress […]

ANNEXA-I – Andexanet for Factor Xa Inhibitor–Associated ICH

10 July 2024 George Walker Emergency Medicine, Intensive Care Medicine One comment

In patients who have recently taken factor Xa inhibitors with an intracerebral haemorrhage (ICH) did the administration of Andexanet result in better haemostatic efficacy compared to standard care?

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