Critical Care Evidence Updates – May 2025
What’s new in the Critical Care literature – monthly updates
Continue reading »Year: 2025
Emergency Evidence Updates – May 2025
What’s new in the Critical Care literature – monthly updates
Continue reading »Fluid – Hospital Wide Lactated Ringer’s versus Normal Saline
A Crossover Trial of Hospital-Wide Lactated Ringer’s Solution versus Normal Saline L McIntyre. NEJM 2025; DOI: 10.1056/NEJMoa2416761 Clinical Question In hospitalised patients, does the use of Lactated Ringers (LR) vs Normal Saline (NS) lower the incidence of death or readmission to the hospital within 90 days after the index admission? Background Fluid choice (balanced solutions vs NS) has been widely […]
Continue reading »OVISS: Optimal Vasopressin Initiation in Septic Shock with Reinforcement Learning
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 […]
Continue reading »FARES II: PCC vs FFP in Cardiac Surgery
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 […]
Continue reading »Clinical Decisions on Beta Blockers After MI
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 […]
Continue reading »NIV vs HFNC to prevent re-intubation in patients with obesity
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 […]
Continue reading »NAVIGATE: Early noninvasive ventilation in general wards for acute respiratory failure
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 […]
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