Emergency Medicine Evidence Updates – January 2022
What’s new in the Critical Care literature – monthly updates
Continue reading »Category: Summaries
A category to collect all the summaries, so that they can be used in menus and widgets. Please don’t expand this – “Specialties” and “Special Topics” have been created as a custom category sets for the clinical topics.
SUBCLAVIAN LINES
In patients undergoing elective neurosurgery, is a supraclavicular in-plane ultrasound guided approach, compared with an infra-clavicular out-of-plane ultrasound guided approach, non-inferior for catheterisation-related complication?
Continue reading »PLUS Study
Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults Finfer S, NEJM, 2022; DOI: 10.1056/NEJMoa2114464 Clinical Question In critically ill adults does the use of a balanced multielectrolyte solution (BMES, Plasmalyte 148), as opposed to 0.9% Sodium Chloride, for fluid resuscitation and therapy result in reduced 90 day mortality? Background Fluid administration is a key component of critical care therapy […]
Continue reading »PALACS
Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery Mario Gaudino, The Lancet Dec 4 2021; 398: 2075–83 https://doi.org/10.1016/S0140-6736(21)02490-9 Clinical Question In selected patients undergoing cardiac surgery, does posterior left pericardiotomy compared with usual care, reduce the incidence of postoperative atrial fibrillation? Background Atrial fibrillation is common following cardiac surgery with approximately one-third of patients developing […]
Continue reading »CONTROLING
Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study—a randomized clinical trial Bohé. Intensive Care Medicine 2021. https://doi.org/10.1007/s00134-021-06526-8 Clinical Question In critically unwell adults does targeting individualised glycaemic control compared to glycaemia < 180 mg/dL improve 90 day mortality? Background Hyperglycaemia has been shown to result in worse outcomes in the critically ill, especially in non-diabetic patients In […]
Continue reading »COMBAT-COVID
In mechanically ventilated patients with COVID-19 and severe endotheliopathy, does prostacylin compared with placebo, improve days alive without ventilation by day 28?
Continue reading »COCA
In patients with out-of-hospital cardiac arrest, does calcium compared with placebo, improve sustained return of spontaneous circulation?
Continue reading »SILENCE
In patients near end of life, does subcutaneous scopolamine butylbromide compared with placebo, reduce the incidence of death rattle?
Continue reading »SNOCAT
Effect of Out-of-Hospital Sodium Nitrite on Survival to Hospital Admission After Cardiac Arrest: A Randomized Clinical Trial Kim @uwcardiology. JAMA. 2021 January 12;325(2):138-145. doi: 10.1001/jama.2020.24326. Clinical Question In patients with out-of-hospital cardiac arrest, does sodium nitrite, compared with placebo, improve survival to hospital admission? Background Out-of-hospital cardiac arrest continues to have a high risk of morbidity and mortality Nitrate therapy […]
Continue reading »VAM-IHCA
Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial Anderson et al. JAMA 2021. doi:10.1001/jama.2021.16628 Clinical Question In adult patients suffering an in-hospital cardiac arrest (IHCA) does the use of vasopressin and methylprednisolone compared to a placebo result in increased rates of return of spontaneous circulation (ROSC)? […]
Continue reading »