Year: 2025

OVISS: Optimal Vasopressin Initiation in Septic Shock with Reinforcement Learning

13 June 2025 Hrishee Vaidya Intensive Care Medicine Leave a comment

OVISS: Optimal Vasopressin Initiation in Septic Shock Kalimouttou et al. for the OVISS Study group, JAMA 2025. doi:10.1001/jama.2025.3046 Clinical Question In patients with septic shock, does a reinforcement learning model identify a strategy for vasopressin initiation that improves mortality? Background Vasopressin is a non-catecholamine vasoconstrictor that is currently recommended as a secondary agent to be considered alongside noradrenaline if mean […]

FARES II: PCC vs FFP in Cardiac Surgery

23 May 2025 Aniket Nadkarni Intensive Care Medicine, Summaries Leave a comment

Prothrombin Complex Concentrate vs Frozen Plasma for Coagulopathic Bleeding in Cardiac Surgery The FARES-II Multicenter Randomized Clinical Trial Karkouthi. JAMA 2025; doi:10.1001/jama.2025.3501 Clinical Question In adults undergoing cardiac surgery with cardiopulmonary bypass, is the use of a 4-factor prothrombin complex concentrate (PCC), compared to fresh frozen plasma (FFP), safe and efficacious in treating active or anticipated bleeding? Background Bleeding post […]

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 […]

NIV vs HFNC to prevent re-intubation in patients with obesity

26 March 2025 George Walker Intensive Care Medicine Leave a comment

Humidified Non-Invasive Ventilation versus High-Flow Therapy to Prevent Reintubation in Patients with Obesity Hernández et al. AJRCCM 2025. DOI: 10.1164/rccm.202403-0523OC Clinical Question In obese adult patients at intermediate risk for hypoxaemic extubation failure, does non-invasive ventilation (NIV) therapy with active humidification compared to use of high-flow nasal oxygen (HFNO or HFNC) reduce all-cause reintubation within 7 days after extubation? Background […]

NAVIGATE: Early noninvasive ventilation in general wards for acute respiratory failure

28 February 2025 Hrishee Vaidya Emergency Medicine, Intensive Care Medicine, Summaries Leave a comment

NAVIGATE: Early noninvasive ventilation in general wards for acute respiratory failure Monti et al. for the NAVIGATE Study Group, BJA Feb 2025. doi:10.1016/j.bja.2024.11.023 Clinical Question In adult patients with mild acute respiratory failure (ARF), does a regime of 2-hour cycles of noninvasive ventilation (NIV), delivered on general wards every 8 hours, reduce the progression to severe acute respiratory failure (defined […]