Tag: Cardiology

Clinical Decisions on Beta Blockers After MI

23 April 2025 David Slessor Blog, Evidence-based Medicine Leave a comment

Clinical Question In adults with acute myocardial infarction and preserved left ventricular ejection fraction (LVEF), does initiating beta-blocker therapy at discharge, compared with no beta-blocker therapy, reduce the risk of death or recurrent myocardial infarction? Background Beta-blockers have long been a cornerstone of post–myocardial infarction care, largely based on trials conducted in the pre-reperfusion era. However, with modern advances […]

DanGer Shock – Microaxial Flow Pump in Infarct-Related Cardiogenic Shock

26 April 2024 George Walker Emergency Medicine, Intensive Care Medicine, Summaries Leave a comment

Microaxial Flow Pump or Standard Care in Infarct-Related Cardiogenic Shock Møller JE et al. 2024. NEJM. DOI: 10.1056/NEJMoa2312572 Clinical Question In adults presenting with STEMI and cardiogenic shock does the use of a microaxial flow pump (Impella CP) compared to standard care reduce death from any cause at day 180? Background Cardiogenic shock is a frequent complication of STEMI and […]

Validation of the MIRACLE 2 Score for Prognostication After OOHCA

22 March 2024 David Slessor Emergency Medicine, Intensive Care Medicine, Summaries Leave a comment

In patient with out-of-hospital cardiac arrest, how does the MIRACLE2 score compare with previously reporting scoring systems, for predicting poor neurological outcome at hospital discharge?

STRESS-L: Landiolol and Organ Failure in Patients With Septic Shock

29 October 2023 George Walker Intensive Care Medicine, Summaries Leave a comment

Landiolol and Organ Failure in Patients With Septic Shock Whitehouse. JAMA Published online October 25, 2023. doi:10.1001/jama.2023.20134 Clinical Question In patients with tachycardia and septic shock who are treated with high dose norepinephrine does the use of β-blockade for up to 14 days reduce organ failure compared to standard care? Background Many view the use of β-blockade as contentious in […]

ECLS-Shock – Extracorporeal Life Support in Infarct-Related Cardiogenic Shock

22 September 2023 Alastair Brown Emergency Medicine, Intensive Care Medicine, Summaries Leave a comment

Extracorporeal Life Support in Infarct-Related Cardiogenic Shock Thiele H. NEJM 2023; Online ahead of print. doi:10.1056/NEJMoa2307227 Clinical Question In patients presenting with acute myocardial infarction complicated by cardiogenic shock undergoing revascularisation, does the early unselected application of extracorporeal life support reduce mortality from any cause at day 30? Background The use of venoarterial extracorporeal membrane oxygenation (VA ECMO), which is […]

Expedited transfer to a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest (ARREST)

6 September 2023 andrew.achilleos@nhs.net Emergency Medicine, Intensive Care Medicine, Summaries Leave a comment

In patients with non-ST elevation out-of-hospital cardiac arrest, does expedited delivery of patients to a cardiac arrest centre, compared with delivery to the geographically closest hospital, improve all-cause mortality at 30 days?

Acetazolamide in Acute Decompensated Heart Failure with Volume Overload

4 August 2023 George Walker Intensive Care Medicine, Summaries Leave a comment

In adult patients with acute decompensated heart failure (ADHF), does the addition of acetazolamide to loop diuretics improve decongestion by day 3?

ECMO-CS

9 February 2023 Alastair Brown Intensive Care Medicine, Summaries Leave a comment

In patients with severe cardiogenic shock does immediate initiation of VA-ECMO, compared to a trial of conservative therapy and the possibility of rescue VA ECMO, reduce a composite outcome of death, resuscitated cardiac arrest or commencement of another mechanical circulatory support?

DOSEVF

10 November 2022 David Slessor Emergency Medicine, Intensive Care Medicine, Summaries Leave a comment

In patients with refractory VF, does Double Sequential External Defibrillation or Vector-change Defibrillation improve survival to hospital discharge?

BOX Trial: Blood Pressure

14 October 2022 Alastair Brown Intensive Care Medicine, Summaries Leave a comment

Blood-Pressure Targets in Comatose Survivors of Cardiac Arrest Kjaergaard et al | New England Journal of Medicine| August 2022 DOI: 10.1056/NEJMoa2208687 Clinical Question In patients with return of spontaneous circulation (ROSC) after cardiac arrest does a higher MAP target (> 77mmHg) compared to a standard target (>63mmHg) reduce death or survival at discharge with a poor neurological status? Background Manipulation […]

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