Critical Care
Brief Review | In search of the Holy Grail: identifying the best PEEP in ventilated patients.
9 May, 2022 | 01:50h | UTC
Commentary on Twitter
Best PEEP on MV?? Individual-specific providing oxygenation (SpO2 >90%/no excessive FiO2 + acceptable PaCO2 (<50/55 mmHg) & minimal need for fluids/cardioactives. Start at 10-12 but stay alert to hemodynamic impact & as set, serially asses need/adequacy.
🖇https://t.co/wdK92bs8B9 pic.twitter.com/NlTzoxfwa5— Intensive Care Medicine (@yourICM) May 5, 2022
Brief Review | Oxygen targets.
9 May, 2022 | 01:48h | UTCOxygen targets – Intensive Care Medicine (if the link is paywalled, try this one)
Related:
Commentary on Twitter
Oxygen targets in #ICU?? Supplemental O2 often required in critically ill, but balancing opposing risks hypo/hyperxaemia required to choose right amount to give. Hyperoxaemia associated with negative cellular/physiological effects: O2 can harm!#FOAMcc
🫧 https://t.co/F4r3Qg7hXg pic.twitter.com/EizwMNjjnc— Intensive Care Medicine (@yourICM) May 7, 2022
Systematic Review: Outpatient versus inpatient treatment for acute pulmonary embolism.
9 May, 2022 | 01:47h | UTCOutpatient versus inpatient treatment for acute pulmonary embolism – Cochrane Library
Commentary: Is home or hospital treatment better for people with blood clots in the lungs? – Cochrane Library
Commentary on Twitter
#CochraneEvidence updated – Is home or hospital treatment better for people with blood clots in the lungs? #VTE #PE #CLOT https://t.co/6tubeADzUY @CochraneLibrary @CochraneUK @NIHRresearch @VSGBI @PERTConsortium @isth @APPTGThrombosis @accpchest @EuropeanTHA @ThrombosisCan pic.twitter.com/JDTio2KC1N
— Vascular Evidence (@Vasc_Evidence) May 6, 2022
Clinical challenges treating Stenotrophomonas maltophilia infections: an update.
9 May, 2022 | 01:32h | UTCRelated:
Derivation and validation of a score for predicting poor neurocognitive outcomes in acute carbon monoxide poisoning.
9 May, 2022 | 01:20h | UTC
RCT: Effect of early vs. standard approach to tracheostomy on functional outcome at 6 months among patients with severe stroke receiving mechanical ventilation.
6 May, 2022 | 11:13h | UTCEffect of Early vs Standard Approach to Tracheostomy on Functional Outcome at 6 Months Among Patients With Severe Stroke Receiving Mechanical Ventilation: The SETPOINT2 Randomized Clinical Trial – JAMA (free for a limited period)
Commentary on Twitter
In this study, among patients with severe stroke receiving mechanical ventilation, a strategy of early tracheostomy, compared with a standard approach to tracheostomy, did not significantly improve functional outcome at 6 months. https://t.co/bLZ4b6hBxr
— JAMA (@JAMA_current) May 4, 2022
Position statement on acute oxygen use in adults: ‘swimming between the flags’.
6 May, 2022 | 10:56h | UTCRelated:
Guideline Summary: New guidance on the perioperative management of diabetes.
6 May, 2022 | 10:55h | UTCNew guidance on the perioperative management of diabetes – Clinical Medicine Journal
Original Guideline: Perioperative Care of People with Diabetes Undergoing Surgery
Related:
Perioperative Evaluation and Management of Endocrine Disorders – Mayo Clinic Proceedings
M-A: Body position for preventing ventilator-associated pneumonia for critically ill patients.
6 May, 2022 | 10:23h | UTC
Ten tips to optimize vasopressors use in the critically ill patient with hypotension.
5 May, 2022 | 11:07h | UTCTen tips to optimize vasopressors use in the critically ill patient with hypotension – Intensive Care Medicine (if the link is paywalled, try this one)
Commentary on Twitter
Vasopressors in #ICU
1️⃣set MAP/DBP goals
2️⃣individualize
3️⃣may⬇️+ve fluid balance
4️⃣reassess fluid status/CO
5️⃣change mechanism as 2 line
6️⃣high doses?? hydrocortisone
7️⃣vasopressin in RV failure
8️⃣no MAX dose
9️⃣EN can be initiated
🔟can be safe in PVC
🖇 https://t.co/v6Q9nfy5KY pic.twitter.com/8YEDaOQBOQ— Intensive Care Medicine (@yourICM) May 4, 2022
Venovenous extracorporeal membrane oxygenation in patients with acute covid-19 associated respiratory failure: comparative effectiveness study.
5 May, 2022 | 11:02h | UTC
Commentary on Twitter
In this international, registry based cohort study of patients with covid-19 associated acute respiratory failure, extracorporeal membrane oxygenation was associated with a reduction in mortality by 7.1% compared with conventional mechanical ventilation https://t.co/VkNFeRDQ3j
— The BMJ (@bmj_latest) May 4, 2022
M-A: Effect of inclined positioning on first-pass success during endotracheal intubation.
5 May, 2022 | 10:06h | UTCEffect of inclined positioning on first-pass success during endotracheal intubation: a systematic review and meta-analysis – Emergency Medicine Journal (link to abstract – $ for full-text)
Cluster RCT: Algorithm-based care vs. usual care for the early recognition and management of complications after pancreatic resection.
4 May, 2022 | 10:55h | UTCAlgorithm-based care versus usual care for the early recognition and management of complications after pancreatic resection in the Netherlands: an open-label, nationwide, stepped-wedge cluster-randomised trial – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter
New research @TheLancet – Smits et al – Algorithm-based care vs usual care for early recognition and management of complications after pancreatic resection in the Netherlands: a stepped-wedge, cluster-randomised trialhttps://t.co/8BeKhtk0mV#SoMe4Surgery #pancsm @DPCG_official pic.twitter.com/atPcJk4O8r
— The Lancet Gastroenterology & Hepatology (@LancetGastroHep) April 29, 2022
Review: Diagnostic management of pregnant women with suspected pulmonary embolism.
4 May, 2022 | 10:28h | UTC
Remdesivir and three other drugs for hospitalized patients with COVID-19: final results of the WHO Solidarity randomized trial and updated meta-analyses.
3 May, 2022 | 11:18h | UTCInvited Commentary: When and which patients should receive remdesivir? – The Lancet
Point/Counterpoint: Should therapeutic heparin be administered to acutely ill hospitalized patients with COVID-19?
3 May, 2022 | 11:04h | UTCCOUNTERPOINT: Should Therapeutic Heparin Be Administered to Acutely Ill Hospitalized Patients With COVID-19? No – CHEST
See also: Rebuttal From Dr Tritschler et al – CHEST
Related:
Anticoagulants for people hospitalised with COVID‐19 – Cochrane Library
SUNBURN: a protocol for delivering bad news in trauma and acute care surgery.
3 May, 2022 | 10:53h | UTC
Commentary on Twitter
Delivery of bad news can be a challenging tasks for practicing surgeons
Protocol-based delivery can provide support to help guide these difficult conversations
S-U-N-B-U-R-N protocol by @DrMentorA provides a framework
Read more: https://t.co/3H5AyT6125 pic.twitter.com/imJ9HuUQJ3
— Trauma Surgery & Acute Care Open (TSACO) (@TSACO_AAST) February 15, 2022
Perspective: Less pharmacotherapy is more in delirium.
3 May, 2022 | 10:56h | UTCLess pharmacotherapy is more in delirium – Intensive Care Medicine (if the link is paywalled, try this one)
Related:
Effectiveness of Bundle Interventions on ICU Delirium: A Meta-Analysis – Critical Care Medicine
Commentary on Twitter
⬇️ 💉Less medications (& ⬆️ awareness of behavioural interventions) is more in #delirium, common, challenging/costly (but often preventable) in #ICU. Despite lacking evidence, medications widely used.
Prevent/minimize addressing suspected contributors!
📎 https://t.co/fYWAsIcuiZ pic.twitter.com/DyC3agSP7w— Intensive Care Medicine (@yourICM) April 30, 2022
Review | Glycemic control in the critically ill: Less is more.
3 May, 2022 | 10:50h | UTCGlycemic control in the critically ill: Less is more – Cleveland Clinic Journal of Medicine
Editorial: Glycemic targets in the ICU: A look back, and ahead – Cleveland Clinic Journal of Medicine
Brief Review: Lung recruitment.
3 May, 2022 | 10:49h | UTCLung recruitment – Intensive Care Medicine
Commentary on Twitter
Lung recruitment
💨 what's it?
💨 how to explain variability in recruitability among pts?
💨 how can recruitment be measured? Directly &/or indirectly?
Knowing potential recruitability crucial to optimize MV: lot of questions, answers #FOAMcc on @yourICM
📎https://t.co/y3LizTsWWZ pic.twitter.com/9CNS382O9H— Intensive Care Medicine (@yourICM) May 2, 2022
Review: Integrating palliative care into the modern cardiac intensive care unit.
3 May, 2022 | 10:45h | UTC
Systematic Review: Antiepileptic drugs for the primary and secondary prevention of seizures after stroke.
29 Apr, 2022 | 10:45h | UTC
Sodium-glucose Co-transporter 2 Inhibitors in acute heart failure: A review of the available evidence and practical guidance on clinical use.
28 Apr, 2022 | 08:15h | UTC
Commentary on Twitter
#RCM – Vol. 23 No. 4
📑Review
Sodium-glucose Co-transporter 2 Inhibitors in Acute Heart Failure: A Review of the Available Evidence and Practical Guidance on Clinical Use#SGLT2Inhibitor #HeartFailureFulltext:https://t.co/Y997Js75GG pic.twitter.com/61gieE7Mcv
— Reviews in Cardiovascular Medicine (@RCMjournal) April 27, 2022
M-A: Risk factors for acquired Stenotrophomonas maltophilia pneumonia in intensive care unit.
28 Apr, 2022 | 08:01h | UTC
Cohort Study: Ischemic injury of the upper gastrointestinal tract after out-of-hospital cardiac arrest.
28 Apr, 2022 | 07:57h | UTC