A compendium of critical appraisals in Intensive Care Medicine research and related specialties
In trauma patients with exsanguinating haemorrhage, does the use of the REBOA (resuscitative endovascular balloon occlusion of the aorta) device with standard care in the emergency department, compared with standard care alone, impact 90-day-mortality?
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In patients with trauma and critical bleeding who require activation of a major haemorrhage protocol, does the empiric administration of 3 pools of cryoprecipitate (6g fibrinogen) within 90 minutes of randomisation (and no more than 3 hours after injury) improve survival, compared to standard care?
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In adult patients with major trauma, who are at risk for trauma-induced coagulopathy does early administration of 1g of tranexamic acid (TXA) followed by an infusion of 1g over 8 hours, compared with placebo, increase survival with a favourable functional outcome at 6 months?
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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 patients admitted to ICU with severe diffuse traumatic brain injury (TBI) and refractory raised intracranial pressure (ICP), does early decompressive craniectomy improve functional outcomes when compared with continued medical management?
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In patients with trauma-related haemorrhagic shock does prehospital administration of packed red cells and lyophilised plasma (Lyo-Plas) compared with normal saline reduce the composite outcome of mortality and failure to reach lactate clearance?
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In adult patients with moderate to severe traumatic brain injury, does a continuous infusion of 20% saline, compared with standard care along, improve neurological outcomes at six months?
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In adult trauma patients with major haemorrhage and hypofibrinogenaemia does the use fibrinogen concentrate (FC) compared to cryoprecipitate (cryo) result in a shorter time to administration?
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In adult trauma patients presenting with signs of haemorrhagic shock does the utilisation of a viscoelastic haemostatic assay (VHA) augmented transfusion strategy compared to a strategy augmented by conventional coagulation tests (CCT) result in an increased number of patients alive and free of massive transfusion at 24 hours?
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Beta-Blocker Therapy in Severe Traumatic Brain Injury: A Prospective Randomised Controlled trial Hosseinali Khalili. World J Surgery 2020; 44:1844-1853. https://doi.org/10.1007/s00268-020-05391-8 Clinical Question In patients with severe traumatic brain injury, does the administration of Beta-Blockade, compared with standard care alone, improve in-hospital mortality? Background The main aim of neurocritical in the management of traumatic brain injury is to mitigate the burden […]
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