A compendium of critical appraisals in Intensive Care Medicine research and related specialties
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?
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In patients with sepsis-induced hypotension does a restrictive fluid strategy (with early vasopressor usage) compared to a liberal fluid strategy result in lower mortality before discharge by day 90?
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In adults with an expected ICU stay of > 72 hours, does the provision of enteral melatonin compared to placebo increase the number of delirium-free assessments within 14 days or before ICU discharge?
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Early Active Mobilization during Mechanical Ventilation in the ICU @chodgsonANZICRC @TEAMtrialICU. NEJM 2022; 387:1747-58 doi:10.1056/NEJMoa2209083 Clinical Question In mechanically ventilated adult patients does the provision of early mobilisation when compared to standard care increase the number of days alive and out of hospital at 180 days? Background ICU Acquired weakness (ICUAW) is common with one systematic review reporting a median […]
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Oxygen-Saturation Targets for Critically Ill Adults Receiving Mechanical Ventilation Semler. N Engl J Med 2022; 387:1759-1769. DOI: 10.1056/NEJMoa2208415 Clinical Question In patients receiving invasive mechanical ventilation, does a target oxygen saturation of 90%, 94%, or 98% increase days alive and free of mechanical ventilation at 28 days? Background Despite the ubiquity of oxygen therapy in the critical care setting, the […]
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Operative vs Nonoperative Treatment of Acute Unstable Chest Wall Injuries: A Randomised Clinical Trial Dehghan et al. JAMA Surg 2022 doi:10.1001/jamasurg.2022.4299 Background Blunt chest wall trauma has high associated rates of morbidity and mortality RCTs have shown a reduced ICU length of stay in those requiring mechanical ventilation, however this has not been replicated in non-ventilated patients What did they […]
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In mechanically ventilated adults, does the addition of selective decontamination of the digestive tract (SDD) compared to standard care reduce all-cause hospital mortality within 90 days?
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In patients with refractory VF, does Double Sequential External Defibrillation or Vector-change Defibrillation improve survival to hospital discharge?
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In comatose patients following cardiac arrest does a restrictive compared with a liberal oxygenation strategy, reduce death or survival at discharge with a poor neurological outcome?
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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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