A collection of TBL summaries relevant to Intensive Care Medicine

BigPAK-2 – preventive care strategy to reduce acute kidney injury after major surgery

A preventive care strategy to reduce moderate or severe acute kidney injury after major surgery (BigpAK-2); a multinational, randomised clinical trial Zarbock. The Lancet 2025. doi: 10.1016/S0140-6736(25)01717-9 Clinical Question In patients at high risk of AKI undergoing major surgery, does a preventative care strategy based on KDIGO guidelines, compared to standard care lead to a reduction in moderate/severe AKI within […]

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ACTiVE – Automated Closed-Loop Ventilation vs Protocolized Conventional Ventilation

Effect of Automated Closed-Loop Ventilation vs Protocolized Conventional Ventilation on Ventilator-Free Days in Critically Ill Adults: A Randomized Clinical Trial Sinnige J. JAMA 2025. doi:10.1001/jama.2025.24384 Clinical Question Among critically ill mechanically ventilated adults, does early use of an automated closed-loop ventilation system (INTELLiVENT-ASV) increase ventilator-free days at day 28 (VFD-28) compared with protocolled conventional ventilation (CV)? Background Mechanical ventilation carries […]

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VENT-AVOID – Extracorporeal Carbon Dioxide Removal to Avoid Invasive Ventilation During COPD Exacerbations

Extracorporeal Carbon Dioxide Removal to Avoid Invasive Ventilation During Exacerbations of Chronic Obstructive Pulmonary Disease: VENT-AVOID Trial – A Randomized Clinical Trial Duggal et al. 2024; American Journal of Respiratory and Critical Care Medicine March 1, 2024 Pages xv-616 Clinical Question In patients with acute exacerbations of COPD who are either failing noninvasive ventilation (NIV) or failing to wean from […]

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IPC for prevention of upper limb venous thrombosis with PICCs

Intermittent pneumatic compression can reduce the incidence of upper extremity venous thrombosis after peripherally inserted central catheter placement in traumatic brain injury patients: A randomised control trial Liang et al. Australian Critical Care 2025; 38(6). doi:10.1016/j.aucc.2025.101308 Clinical Question In patients with traumatic brain injury (TBI) on neurointensive care with peripherally-inserted central catheters (PICC), does the use of upper-limb intermittent pneumatic […]

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Positive communication for decreasing burnout in intensive‑care‑unit staff: a cluster‑randomized trial

Positive communication for decreasing burnout in intensive‑care‑unit staff: a cluster‑randomized trial Azoulay @ElieAzoulay5. Intensive Care Med, 2025; 51:2031-2041. doi.org/10.1007/s00134-025-08134-2 Clinical Question In ICU healthcare professionals, does a multicomponent positive communication intervention, compared with usual care, reduce the prevalence of occupational burnout? Background Burnout prevalence in healthcare professionals in ICU is high Recent international reports have prioritised targeting burnout Observational studies […]

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Delirium Reduction via Scripted Family Voice Recordings in Critically Ill Patients Receiving Mechanical Ventilation

Delirium Reduction via Scripted Family Voice Recordings in Critically Ill Patients Receiving Mechanical Ventilation CL Munro. Am J Crit Care. 2025; Nov 1;34(6):429-437. doi: 10.4037/ajcc2025486 Clinical Question In mechanically ventilated adult ICU patients, does a structured voice reorientation intervention recorded by family members, compared to usual care, reduce delirium? Background Delirium affects a significant proportion of patients receiving mechanical ventilation. […]

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TAVR vs SAVR for severe aortic stenosis

Clinical Question In adults with asymptomatic severe aortic stenosis and low surgical risk, should transcatheter aortic-valve replacement (TAVR) or surgical aortic-valve replacement (SAVR) be recommended as the preferred initial strategy? Background Management of severe aortic stenosis has evolved rapidly over the past decade, driven largely by the expansion of transcatheter aortic-valve replacement into lower- risk and younger patient populations. While […]

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Immunosep – Precision Immunotherapy to Improve Sepsis Outcomes

Precision Immunotherapy to Improve Sepsis Outcomes Giamarellos-Bourboulis. JAMA 2025. doi:10.001/jama.2025.24175 Clinical Question In patients with sepsis, does immunotherapy (using either anakinra or human interferon gamma) that is tailored to the type of immune dysregulation lead to a reduction in organ dysfunction at day 9? Background Sepsis can involve a dysregulated immune response to an infection (SIDP, sepsis induced immune dysfunction) […]

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CLIPII – Cryopreserved vs Liquid-Stored Platelets

Cryopreserved vs Liquid-Stored Platelets for the Treatment of Surgical Bleeding: The CLIP-II Randomized Noninferiority Clinical Trial Reade. JAMA, 2025. doi: 10.1001/jama.2025.23355 Clinical Question In adult cardiac surgery patients at high risk of bleeding, is the transfusion of cryopreserved platelets, compared with conventional liquid-stored platelets, non-inferior in reducing postoperative bleeding within the first 24 hours after ICU admission? Background Platelet transfusion […]

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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 […]

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