Year: 2024

ADAPT-Sepsis: PCT or CRP Guided Antibiotic Duration

24 January 2025 Hrishee Vaidya Intensive Care Medicine, Summaries Leave a comment

ADAPT-Sepsis: PCT or CRP-guided Antibiotic Duration for Patients with suspected Sepsis Dark et al. JAMA Dec 9 2024. doi:10.1001/jama.2024.26458 Clinical Question For critically ill adults with suspected sepsis, does a procalcitonin (PCT) guided or C-reactive protein (CRP) guided antibiotic discontinuation prompt, compared with usual care, reduce the total duration of antibiotics without increasing all-cause 28-day mortality? Background Shorter antibiotic durations […]

Continued enteral nutrition until extubation compared with fasting before extubation

17 January 2025 Jody Ede Intensive Care Medicine, Summaries Leave a comment

Continued enteral nutrition until extubation compared with fasting before extubation in patients in the intensive care unit: an open-label, cluster-randomised, parallel-group, non-inferiority trial Landais et al. The Lancet Respiratory Medicine 2023. 11:319-28. doi://10.1016/ S2213-2600(22)00413-1 Clinical Question In patients ventilated for more than 48h in the Intensive Care Unit, is continued enteral nutrition compared with fasting prior to extubation, non-inferior with […]

Critical Care Evidence Updates – December 2024

16 January 2025 Rebecca Howes Blog, Evidence-based Medicine Leave a comment

What’s new in the Critical Care literature – monthly updates

ASTER – Acetaminophen in Sepsis

9 January 2025 Generic Contributor Intensive Care Medicine Leave a comment

Acetaminophen for Prevention and Treatment of Organ Dysfunction in Critically Ill Patients With Sepsis Ware. JAMA 2024. doi:10.1001/jama.2024.8772 Clinical Question In critically ill adult patients with sepsis does the administration of acetaminophen compared to placebo increase the number of days alive and free of organ support to day 28? Background Acetaminophen is a potent and specific haemoprotein reductant that can […]

RENOVATE – High-Flow vs NIV

18 December 2024 Generic Contributor Emergency Medicine, Intensive Care Medicine Leave a comment

High-Flow Nasal Oxygen vs Noninvasive Ventilation in Patients with Acute Respiratory Failure RENOVATE and BRICNet Authors. JAMA 2024. doi: 10.1001/jama.2024.26244 Clinical Question In adult patients with acute respiratory failure does the use of high-flow nasal oxygen compared to noninvasive ventilation reduce the rate of endotracheal intubation or death at 7 days? Background Both high-flow nasal oxygen (HFNO) and noninvasive ventilation […]

SAHARA – Liberal vs Restrictive Transfusion Targets in SAH

18 December 2024 Celia Bradford Intensive Care Medicine Leave a comment

Liberal versus Restrictive Transfusion in Aneurysmal Subarachnoid Haemorrhage English S. NEJM 2024 DOI:10.1056/NEJMoa2410962 Clinical Question In patients following acute aneurysmal subarachnoid haemorrhage, does a liberal strategy of blood transfusion compared with a restrictive strategy of blood transfusion reduce unfavourable neurological outcome? SubArachnoid Haemorrhage Red-cell transfusion And Outcome (SAHaRA) Background Anaemia is common following aneurysmal subarachnoid haemorrhage with an incidence of approximately 50% during the […]

TRAUMOX2 – Early Restrictive vs Liberal Oxygen for Trauma Patients

15 December 2024 George Walker Emergency Medicine, Intensive Care Medicine Leave a comment

Early Restrictive vs Liberal Oxygen for Trauma Patients Arleth. JAMA 2024. doi: 10.1001/jama.2024.25786 Clinical Question In adult patients experiencing blunt or penetrating trauma does an early restrictive oxygen strategy compared to a liberal oxygen strategy reduce death and/or major respiratory complications within 30 days? Background ATLS guidelines recommend that all severely injured patients should receive supplemental oxygen in the initial […]

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 […]

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