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Critical Care

The Role of the Nephrologist in Management of Poisoning and Intoxication: Core Curriculum 2022.

9 Feb, 2022 | 08:46h | UTC

The Role of the Nephrologist in Management of Poisoning and Intoxication: Core Curriculum 2022 – American Journal of Kidney Diseases

 

Review | Emergency blood transfusion for trauma and perioperative resuscitation.

9 Feb, 2022 | 08:22h | UTC

Emergency Blood Transfusion for Trauma and Perioperative Resuscitation: Standard of Care – Transfusion Medicine and Hemotherapy

 

Clinical update on COVID-19 for the emergency clinician: Presentation and evaluation.

7 Feb, 2022 | 08:56h | UTC

Clinical update on COVID-19 for the emergency clinician: Presentation and evaluation – The American Journal of Emergency Medicine

 

ERC-ESICM guidelines on temperature control after cardiac arrest in adults.

7 Feb, 2022 | 08:44h | UTC

ERC-ESICM guidelines on temperature control after cardiac arrest in adults – Intensive Care Medicine (if the link is paywalled, try this one)

Related:

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

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.

 

Commentary on Twitter

 

M-A: Tranexamic acid in aneurysmal subarachnoid hemorrhage does not improve clinical outcomes or mortality.

7 Feb, 2022 | 08:26h | UTC

Efficacy and safety of tranexamic acid in aneurysmal subarachnoid hemorrhage: A meta-analysis of randomized controlled trials – The American Journal of Emergency Medicine (link to abstract – $ for full-text)

 

M-A: The effect of Dexmedetomidine as a sedative agent for mechanically ventilated patients with sepsis.

7 Feb, 2022 | 08:15h | UTC

The Effect of Dexmedetomidine as a Sedative Agent for Mechanically Ventilated Patients With Sepsis: A Systematic Review and Meta-Analysis – Frontiers in Medicine

 

Consensus Statement: Preoperative Management of Medications for Neurologic Diseases.

4 Feb, 2022 | 10:00h | UTC

Preoperative Management of Medications for Neurologic Diseases – Mayo Clinic Proceedings

Related: Consensus Statement: Preoperative management of medications for psychiatric diseases.

 

Podcast: Infective Endocarditis Pearls.

4 Feb, 2022 | 08:27h | UTC

Infective Endocarditis Pearls – The Curbsiders

 

Perspective: The origins, development, and context of the Lancet Commission on the Value of Death – “Death has turned from being a family, social, and cultural event to primarily a medical event”.

3 Feb, 2022 | 08:51h | UTC

The origins, development, and context of the Lancet Commission on the Value of Death – The BMJ

Related: The Lancet Commission: Experts warn of the increasing overmedicalization of death, call for radical rethink of how society cares for dying people.

 

Cluster randomized controlled trial: An innovative telemedical network to improve infectious disease management in critically ill patients and outpatients.

3 Feb, 2022 | 08:53h | UTC

An innovative telemedical network to improve infectious disease management in critically ill patients and outpatients: a stepped-wedge, cluster randomized controlled trial (TELnet@NRW) – Journal of Medical Internet Research

Related:

The “Choosing Wisely” initiative in infectious diseases – German Society of Infectious Diseases (link to abstract – $ for full-text)

Infectious Diseases Society of America: Five Things Physicians and Patients Should Question

 

Evaluation and management of traumatic pneumothorax: A Western Trauma Association critical decisions algorithm.

3 Feb, 2022 | 08:46h | UTC

Evaluation and management of traumatic pneumothorax: A Western Trauma Association critical decisions algorithm – Journal of Trauma and Acute Care Surgery

 

M-A: Impact of Ketamine on analgosedative consumption in critically ill patients.

2 Feb, 2022 | 08:44h | UTC

Impact of Ketamine on Analgosedative Consumption in Critically Ill Patients: A Systematic Review and Meta-Analysis – Annals of Pharmacotherapy

Related:

RCT: Fentanyl vs. placebo with ketamine and rocuronium for patients undergoing rapid sequence intubation in the emergency department.

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).

 

Perspective: The ongoing saga of normal saline vs. balanced fluids.

2 Feb, 2022 | 08:43h | UTC

The ongoing saga of normal saline versus balanced fluids – First10EM

Original studies:

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.

Balanced Crystalloids versus Saline in Critically Ill Adults — A Systematic Review with Meta-Analysis – NEJM Evidence

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

 

Takotsubo Syndrome: A review of presentation, diagnosis and management.

2 Feb, 2022 | 08:25h | UTC

Takotsubo Syndrome: A Review of Presentation, Diagnosis and Management – Clinical Medicine Insights: Cardiology

Related:

Middle-aged and older women are being diagnosed with Takotsubo Syndrome more frequently, up to 10 times more often, than younger women or men of any age.

International Expert Consensus Document on Takotsubo Syndrome

International Registry: 16.6% of Patients with Takotsubo Syndrome Have Underlying Malignancy

Systematic Review: Long-Term Prognosis and Outcome Predictors in Takotsubo Syndrome

Cohort Study: Hospital Readmission Following Takotsubo Syndrome

 

DIC in Pregnancy: Pathophysiology, clinical characteristics, diagnostic scores, and treatments.

2 Feb, 2022 | 08:27h | UTC

DIC in Pregnancy – Pathophysiology, Clinical Characteristics, Diagnostic Scores, and Treatments – Journal of Blood Medicine

 

Observational study suggests Ceftaroline has comparable efficacy vs. Daptomycin for the treatment of Methicillin-Resistant Staphylococcus aureus bloodstream infection.

2 Feb, 2022 | 08:07h | UTC

Multicenter Cohort Study of Ceftaroline versus Daptomycin for Treatment of Methicillin-Resistant Staphylococcus aureus Bloodstream Infection – Open Forum Infectious Diseases

 

Commentary on Twitter

 

SCAI SHOCK Cardiogenic Shock Classification Expert Consensus Update.

1 Feb, 2022 | 09:53h | UTC

SCAI SHOCK Stage Classification Expert Consensus Update: A Review and Incorporation of Validation Studies: This statement was endorsed by the American College of Cardiology (ACC), American College of Emergency Physicians (ACEP), American Heart Association (AHA), European Society of Cardiology (ESC) Association for Acute Cardiovascular Care (ACVC), International Society for Heart and Lung Transplantation (ISHLT), Society of Critical Care Medicine (SCCM), and Society of Thoracic Surgeons (STS) in December 2021 – JSCAI

News Release: SCAI releases updated expert consensus to SCAI SHOCK classification – Society for Cardiovascular Angiography and Interventions

Commentaries:

SCAI SHOCK: Update Refines Cardiogenic Shock Classification – TCTMD

SCAI Releases Updated Expert Consensus to SCAI SHOCK Classification – American College of Cardiology

 

Commentaries on Twitter

 

The Lancet Commission: Experts warn of the increasing overmedicalization of death, call for radical rethink of how society cares for dying people.

1 Feb, 2022 | 09:55h | UTC

News Release: THE LANCET: Experts warn of the increasing overmedicalization of death, call for radical rethink of how society cares for dying people

Homepage: Lancet Commission on the Value of Death (free registration required for all articles)

Report of the Lancet Commission on the Value of Death: bringing death back into life

The precariousness of balancing life and death

Ros Taylor: seeing palliative care as relational

Related: What would it take to die well? A systematic review of systematic reviews on the conditions for a good death – The Lancet Health Longevity

 

Commentary on Twitter (thread – click for more)

 

Observational study: Pharmacist involvement in the care of critically ill patients may reduce resource utilization, adverse drug events, and medical costs.

1 Feb, 2022 | 09:47h | UTC

PHarmacist Avoidance or Reductions in Medical Costs in CRITically Ill Adults: PHARM-CRIT Study – Critical Care Explorations

 

Commentary from the author on Twitter (thread – click for more)

 

Consensus: Nephrotoxins and acute kidney injury.

1 Feb, 2022 | 08:46h | UTC

Nephrotoxins and acute kidney injury – The consensus of the Taiwan acute kidney injury Task Force – Journal of the Formosan Medical Association

 

M-A: Vasopressin and glucocorticoids for in-hospital cardiac arrest.

1 Feb, 2022 | 08:43h | UTC

Vasopressin and glucocorticoids for in-hospital cardiac arrest: A systematic review and meta-analysis of individual participant data – Resuscitation

Related: RCT: Vasopressin + Methylprednisolone increase the likelihood of return of spontaneous circulation compared to placebo in patients with in-hospital cardiac arrest.

 

Commentary on Twitter

 

Review: Multidisciplinary management of tracheobronchial injury.

1 Feb, 2022 | 08:17h | UTC

Multidisciplinary management of tracheobronchial injury – European Respiratory Review

 

FDA halts use of antibody drugs that don’t work vs. Omicron.

30 Jan, 2022 | 14:35h | UTC

FDA halts use of antibody drugs that don’t work vs. omicron – Associated Press

Related: Lab study shows new antiviral pills maintain efficacy against Omicron, but antibody drugs are substantially less effective.

 

ELSO Guidelines for adult and pediatric extracorporeal membrane oxygenation circuits.

30 Jan, 2022 | 14:25h | UTC

ELSO Guidelines for Adult and Pediatric Extracorporeal Membrane Oxygenation Circuits – ASAIO Journal

Related: ELSO Guidelines for anticoagulation in adult and pediatric patients using extracorporeal membrane oxygenation (ECMO).

 

Commentary on Twitter

 

Guideline Summary: Management of the top 10 most common immune-related adverse events in patients treated with immune checkpoint inhibitor therapy.

30 Jan, 2022 | 14:11h | UTC

Management of the Top 10 Most Common Immune-Related Adverse Events in Patients Treated With Immune Checkpoint Inhibitor Therapy – JCO Oncology Practice

Original Article: ASCO Guideline Update: Management of immune-related adverse events in patients treated with immune checkpoint inhibitor therapy.

Related:

Clinical practice guideline on immune checkpoint inhibitor-related adverse events.

NCCN Guidelines Insights: Management of Immunotherapy-Related Toxicities (several resources on the subject)

 

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