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Critical Care & Emergencies (all articles)

Updated Guideline: Recommended drugs and biologics in adult patients with COVID-19.

24 Jan, 2022 | 08:52h | UTC

Clinical Practice Guideline Summary: Recommended Drugs and Biologics in Adult Patients with COVID-19 – Covid-19 Advisory for Ontario

 

Commentary on Twitter (thread – click for more)

 


A guide to immunotherapy for COVID-19.

24 Jan, 2022 | 08:29h | UTC

A guide to immunotherapy for COVID-19 – Nature Medicine

 


The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly.

24 Jan, 2022 | 08:24h | UTC

The WSES/SICG/ACOI/SICUT/AcEMC/SIFIPAC guidelines for diagnosis and treatment of acute left colonic diverticulitis in the elderly – World Journal of Emergency Surgery

Related:

ACP Guideline: Diagnosis and management of acute left-sided colonic diverticulitis.

Review: Changing paradigms in the management of acute uncomplicated diverticulitis.

RCT: Another study shows that non-antibiotic outpatient treatment in mild acute diverticulitis is safe.

Review: Elective surgical management of diverticulitis

State of the Art Review | Management of colonic diverticulitis

Drains, germs, or steel: Multidisciplinary management of acute colonic diverticulitis

Diverticulitis: Observational study in outpatients suggests amoxicillin-clavulanate is a safe and effective option compared with metronidazole-fluoroquinolone

Randomized trial: Laparoscopic lavage vs. primary resection for perforated purulent diverticulitis; similar long-term results, but recurrence was more common after laparoscopic lavage

Randomized trial: In patients with recurrent, complicated, or persistent painful diverticulitis, sigmoid resection improved quality of life but was associated with a small but significant risk of major complications

Systematic review: Management of colonic diverticulitis

WSES Guidelines for the Management of Acute Colonic Diverticulitis

ASCRS Guidelines for the Treatment of Left-Sided Colonic Diverticulitis

 


Perioperative guidelines on antiplatelet and anticoagulant agents: 2022 Update.

21 Jan, 2022 | 09:53h | UTC

Perioperative Guidelines on Antiplatelet and Anticoagulant Agents: 2022 Update – Current Anesthesiology Reports

 


M-A: No difference in outcomes with Beta-lactam monotherapy vs. combination therapy for bloodstream infections or pneumonia due to P. aeruginosa.

21 Jan, 2022 | 09:37h | UTC

Beta-lactam monotherapy or combination therapy for bloodstream infections or pneumonia due to P. aeruginosa: a meta-analysis – International Journal of Antimicrobial Agents (link to abstract – $ for full-text)

 


M-A: In comatose survivors of cardiac arrest, targeted hypothermia is not associated with improved survival or better neurological outcomes vs. targeted normothermia.

21 Jan, 2022 | 09:29h | UTC

Targeted Hypothermia Versus Targeted Normothermia In Survivors of Cardiac Arrest: A Systematic Review and Meta-Analysis of Randomized Trials – American Journal of Medicine

Related:

RCT: In comatose survivors of out-of-hospital cardiac arrest, there was no difference in mortality and neurologic outcomes with mild (target temperature of 34 °C) vs. moderate therapeutic hypothermia (target temperature of 31 °C).

M-A: Targeted temperature management following out-of-hospital cardiac arrest – “Routine use of moderate or deep hypothermia in comatose survivors of OHCA may potentially be associated with more harm than benefit”.

RCT: In patients with coma after out-of-hospital cardiac arrest, targeted hypothermia did not improve outcomes.

 


Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis.

20 Jan, 2022 | 09:17h | UTC

Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis – The Lancet

News Release: An estimated 1.2 million people died in 2019 from antibiotic-resistant bacterial infections, more deaths than HIV/AIDS or malaria – The Lancet

Editorial: Antimicrobial resistance: time to repurpose the Global Fund – The Lancet

Commentary: Antimicrobial resistance now a leading cause of death worldwide, study finds – The Guardian

 

Commentary on Twitter

 


RCT: In non–critically ill hospitalized patients with COVID-19, the use of a P2Y12 Inhibitor (ticagrelor in 63% of patients and clopidogrel in 37%) in addition to a therapeutic dose of heparin did not improve survival free of organ support compared to therapeutic heparin alone.

19 Jan, 2022 | 08:56h | UTC

Effect of P2Y12 Inhibitors on Survival Free of Organ Support Among Non–Critically Ill Hospitalized Patients With COVID-19: A Randomized Clinical Trial – JAMA

Editorial: Antiplatelet Therapy in Patients With COVID-19—More Is Less? – JAMA

Commentary: Adding a P2Y12 Inhibitor Does Not Improve Outcomes in COVID-19 – HealthDay

 


RCT: In critically ill adults, using a balanced multielectrolyte solution did not lower the risk of death or acute kidney injury compared to standard saline.

19 Jan, 2022 | 08:41h | UTC

Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Australian study set to guide the treatment of critically ill patients worldwide – George Institute for Global Health

Related:

BaSICS RCT: Among critically ill patients requiring fluid therapy, treatment with a balanced solution did not lead to reduced mortality compared to a 0.9% saline solution.

BaSICS RCT: Among critically ill patients requiring fluid therapy, there was no difference in mortality with slower (333 mL/h) vs. faster (999 mL/h) intravenous fluid bolus rates.

Cochrane Review: Buffered Solutions Do Not Improve Mortality in Critically Ill Adults and Children Compared to 0,9% Saline

 

Commentary on Twitter

 


Clinical practice guidelines for therapeutic drug monitoring of teicoplanin.

19 Jan, 2022 | 08:27h | UTC

Clinical practice guidelines for therapeutic drug monitoring of teicoplanin: a consensus review by the Japanese Society of Chemotherapy and the Japanese Society of Therapeutic Drug Monitoring – Journal of Antimicrobial Chemotherapy

 


M-A: Evaluation of interventions to reduce opioid prescribing for patients discharged from the emergency department.

19 Jan, 2022 | 08:13h | UTC

Evaluation of Interventions to Reduce Opioid Prescribing for Patients Discharged From the Emergency Department: A Systematic Review and Meta-analysis – JAMA Network Open

Invited commentary: Optimizing Opioid Prescriptions for Patients in the Emergency Department—How Much Is Almost Never? – JAMA Network Open

 

Commentary on Twitter

 


COVID-19 updated evidence: a Cochrane round-up.

18 Jan, 2022 | 09:53h | UTC

COVID-19 evidence: a Cochrane round-up – Cochrane Library

 


ACP Guideline: Diagnosis and management of acute left-sided colonic diverticulitis.

18 Jan, 2022 | 09:38h | UTC

Diagnosis and Management of Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine

Related Guideline: Colonoscopy for Diagnostic Evaluation and Interventions to Prevent Recurrence After Acute Left-Sided Colonic Diverticulitis: A Clinical Guideline From the American College of Physicians – Annals of Internal Medicine

Related Systematic Reviews:

Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Evaluation and Management After Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

Annals Video Summary: Diagnostic Imaging and Medical Management of Acute Left-Sided Colonic Diverticulitis: A Systematic Review – Annals of Internal Medicine

News Release: ACP releases two new clinical guidelines on the diagnosis and management of diverticulitis – American College of Physicians

 


Pro-Con Debate: Cardiac Troponin measurement as part of routine follow-up of myocardial damage following noncardiac surgery.

18 Jan, 2022 | 09:36h | UTC

Pro-Con Debate: Cardiac Troponin Measurement as Part of Routine Follow-up of Myocardial Damage Following Noncardiac Surgery – Anesthesia & Analgesia

 


Cluster-randomized trial: Antiseptic bathing with 2% chlorhexidine-impregnated cloths and 0.08% octenidine wash mitts were not effective for preventing central-line associated bloodstream infections in intensive care patients.

18 Jan, 2022 | 09:18h | UTC

Effect of antiseptic bathing with chlorhexidine or octenidine on central-line associated bloodstream infections in intensive care patients: a cluster-randomised controlled trial – Clinical Microbiology and Infection

 


WHO recommends two new drugs (Baricitinib and Sotrovimab) to treat COVID-19.

17 Jan, 2022 | 00:48h | UTC

News release: WHO recommends two new drugs to treat COVID-19 – World Health Organization

Infographic with the updated recommendations: A living WHO guideline on drugs for covid-19 – The BMJ

Commentaries:

WHO Recommends Two New COVID-19 Treatments – Cost and Availability Likely Barriers – Health Policy Watch

Expert reaction to WHO recommending two drugs, sotrovimab and baricitinib, to treat patients with COVID-19 – Science Media Centre

 

Commentary on Twitter (thread – click for more)

 


Viewpoint: COVID-19 therapeutics for nonhospitalized patients.

17 Jan, 2022 | 00:31h | UTC

COVID-19 Therapeutics for Nonhospitalized Patients – JAMA

Editorial: Realizing the Potential of Anti–SARS-CoV-2 Monoclonal Antibodies for COVID-19 Management – JAMA

 


Guidelines for the provision of nutrition support therapy in the adult critically ill patient.

16 Jan, 2022 | 23:19h | UTC

Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition – Journal of Parenteral and Enteral Nutrition

 


Multi-Disciplinary Guideline: Management of nephrolithiasis in pregnancy.

16 Jan, 2022 | 23:17h | UTC

Management of Nephrolithiasis in Pregnancy: Multi-Disciplinary Guidelines From an Academic Medical Center – Frontiers in Surgery

 

Commentary from the author on Twitter

 


RCT: In patients undergoing emergency endotracheal intubation, 7-day survival was significantly lower with etomidate vs. ketamine (77.3% versus 85.1%), but 28 survival rates were not significantly different (etomidate 64.1% vs. ketamine 66.8%, p = 0.294).

16 Jan, 2022 | 23:09h | UTC

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial – Intensive Care Medicine

Commentary: SGEM#356: Drugs are gonna knock you out – etomidate vs. ketamine for emergency endotracheal intubation – The Skeptics’ Guide to EM

 

Commentary on Twitter

 


Editorial: Towards evidence-based staffing: the promise and pitfalls of patient-to-intensivist ratios.

16 Jan, 2022 | 22:45h | UTC

Towards evidence-based staffing: the promise and pitfalls of patient-to-intensivist ratios – Intensive Care Medicine (free for a limited period)

Related Study: Association of patient-to-intensivist ratio with hospital mortality in Australia and New Zealand – Intensive Care Medicine

 

Commentary on Twitter

 


Fluvoxamine for Covid-19: What Prescribers and Pharmacists Need to Know.

14 Jan, 2022 | 08:37h | UTC

Fluvoxamine: What Prescribers and Pharmacists Need to Know – Covid-19 Advisory for Ontario

Related:

Fluvoxamine for the early treatment of SARS-CoV-2 Infection: a review of current evidence.

RCT: Early treatment with fluvoxamine reduced the risk of emergency care and hospitalization among patients with COVID-19.

[Preprint] RCT: Fluvoxamine reduced the risk for ER visits and hospitalization among patients with Covid-19.

Opinion | Could this be our first effective, inexpensive, widely available outpatient treatment for COVID-19? (It’s fluvoxamine).

Preliminary study shows fluvoxamine may reduce clinical deterioration in outpatients with symptomatic COVID-19

 

Commentary on Twitter

 


AAN Position Statement: Consent Issues in the Management of Acute Ischemic Stroke.

14 Jan, 2022 | 08:24h | UTC

Consent Issues in the Management of Acute Ischemic Stroke: AAN Position Statement – Neurology

News Release: Who gives consent for treatment when a person with stroke cannot? – American Academy of Neurology

 


Systematic Review: Restrictive transfusion thresholds can safely decrease transfusions by 41% across a broad range of clinical contexts.

14 Jan, 2022 | 08:18h | UTC

Transfusion thresholds for guiding red blood cell transfusion – Cochrane Library

Summary: Is it safe to use lower blood counts (haemoglobin levels) as a trigger for blood transfusion in order to give fewer blood transfusions? – Cochrane Library

Related:

RCT: Among patients with acute MI and anemia, a restrictive transfusion strategy resulted in a noninferior rate of major cardiovascular events compared to a liberal transfusion strategy

Randomized trial: Liberal vs. restrictive transfusion thresholds in extremely low-birth-weight infants

Meta-Analysis: Effects of Restrictive vs. Liberal Transfusion Strategies on Longer-term Outcomes After Cardiac Surgery

Randomized Trial: In Patients Undergoing Cardiac Surgery, A Restrictive Transfusion Approach Does Not Increase the Risk of Acute Kidney Injury

Effects of restrictive red blood cell transfusion on the prognoses of adult patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials – Critical Care

Research: Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

Transfusion Requirements After Cardiac Surgery: The TRACS Randomized Controlled Trial – JAMA

 

Commentary on Twitter

 


RCT: Early Remdesivir in outpatients can prevent progression to severe Covid-19.

13 Jan, 2022 | 08:54h | UTC

Early Remdesivir to Prevent Progression to Severe Covid-19 in Outpatients – New England Journal of Medicine

Editorial: The Goldilocks Time for Remdesivir — Is Any Indication Just Right?

Commentary: Three days of remdesivir cuts risk for severe COVID-19 in outpatients – MedicalXpress

 

Commentary on Twitter

 


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