Critical Care
#ACC21 – [Not published yet] RCT: PARADISE-MI: Sacubitril/Valsartan did not outperform ACE inhibitor after myocardial infarction with new onset heart failure.
17 May, 2021 | 08:17h | UTC
2 recent meta-analysis highlight the benefits of short term (30 days) dual antiplatelet therapy with aspirin + clopidogrel in patients within 24 hours of high-risk transient ischemic attack or mild-moderate ischemic stroke.
17 May, 2021 | 08:16h | UTCMeta-analysis 1: Dual Antiplatelet Therapy Versus Aspirin in Patients With Stroke or Transient Ischemic Attack: Meta-Analysis of Randomized Controlled Trials – Stroke
Meta-analysis 2: Efficacy and Safety of Using Dual Versus Monotherapy Antiplatelet Agents in Secondary Stroke Prevention: Systematic Review and Meta-Analysis of Randomized Controlled Clinical Trials – Circulation (link to abstract – $ for full-text)
Commentary: Dual vs. Monotherapy Antiplatelet Agents in Secondary Stroke Prevention – American College of Cardiology
Related Guideline: Dual antiplatelet therapy with aspirin and clopidogrel for acute high risk transient ischaemic attack and minor ischaemic stroke – The BMJ
Opinion | Reconceptualizing how to support surrogates making medical decisions for critically ill patients.
17 May, 2021 | 08:08h | UTCReconceptualizing How to Support Surrogates Making Medical Decisions for Critically Ill Patients – JAMA (free for a limited period)
What is mucormycosis, the fungal infection affecting COVID patients in India?
14 May, 2021 | 08:35h | UTCWhat is mucormycosis, the fungal infection affecting COVID patients in India? – The Conversation
Related: What Is ‘Black Fungus’? And Why Is It Spreading Among India’s COVID Patients? – NPR AND Mucormycosis: The ‘black fungus’ maiming Covid patients in India
[Preprint] The Emergence of COVID-19 Associated Mucormycosis: Analysis of Cases From 18 Countries.
14 May, 2021 | 08:34h | UTCThe Emergence of COVID-19 Associated Mucormycosis: Analysis of Cases From 18 Countries – The Lancet
Review: Diagnosis and treatment of unruptured intracranial aneurysms and aneurysmal subarachnoid hemorrhage
13 May, 2021 | 05:53h | UTC
Study: More nurses lead to fewer patient deaths & readmissions, shorter hospital stays, and savings
13 May, 2021 | 05:55h | UTCNews release: More nurses lead to fewer patient deaths & readmissions, shorter hospital stays, and savings – The Lancet
Original study: Effects of nurse-to-patient ratio legislation on nurse staffing and patient mortality, readmissions, and length of stay: a prospective study in a panel of hospitals (free registration required)
Commentary on Twitter
NEW—More nurses lead to fewer patient deaths and readmissions, shorter hospital stays, and cost-savings for hospitals, suggests study of recent Australian state policy to introduce a minimum ratio of one nurse to four patients for day shifts. Read https://t.co/zTZNt8viPU. pic.twitter.com/B812I0P6N2
— The Lancet (@TheLancet) May 12, 2021
[Preprint] Meta-analysis of risk of vaccine-induced immune thrombotic thrombocytopenia following ChAdOx1-S recombinant vaccine – Overall risk is 1 in 139,000; for age 65 and over, about 1 in 1,000,000; for age under 55, between 1 in 20,000 to 60,000.
12 May, 2021 | 08:45h | UTC
Perspective | 12 things to do to improve wellbeing in the ICU.
12 May, 2021 | 08:30h | UTC12 Things to Do to Improve Wellbeing in the ICU – ICU Management & Practice
Perspective | Top five priorities for a new ICU director during the first year.
12 May, 2021 | 08:33h | UTCTop Five Priorities for a New ICU Director During the First Year – ICU Management & Practice
Review: Neurologic assessment of the neurocritical care patient.
12 May, 2021 | 08:24h | UTCNeurologic Assessment of the Neurocritical Care Patient – Frontiers in Neurology
Review: The incidence, risk, presentation, pathophysiology, treatment, and effects of perioperative acute kidney injury.
12 May, 2021 | 08:27h | UTC
Perspective | The essentials for a humanized ICU.
12 May, 2021 | 08:28h | UTCThe Essentials for a Humanised Intensive Care Unit (H-ICU) – ICU Management & Practice
Mucormycosis: The ‘black fungus’ maiming Covid patients in India
11 May, 2021 | 09:14h | UTCMucormycosis: The ‘black fungus’ maiming Covid patients in India – BBC
See also: Potentially fatal ‘black fungus’ infections on the rise in India’s COVID-19 patients – LiveScience AND A potentially fatal fungal infection is cropping up among India’s Covid patients. – The New York Times AND WHO says virus strain in India a ‘variant of concern’ as Europe eases curbs – MedicalXpress
Commentary on Twitter (thread – click for more)
Doctors in India are concerned about an increase in a highly fatal fungal infection affecting cases & recently recovered from #COVID19. Mucormycosis, is a mold that attacks the respiratory tract, potentially eroding facial structures & harming the brain.🧵https://t.co/1rHU2nM346
— Eric Feigl-Ding (@DrEricDing) May 10, 2021
Observational study suggests an early head‐to‐pelvis computed tomography can expedite the diagnosis of potential causes in patients with out‐of‐hospital circulatory arrest without obvious etiology
11 May, 2021 | 09:10h | UTCEarly head‐to‐pelvis computed tomography in out‐of‐hospital circulatory arrest without obvious etiology – Academic Emergency Medicine (link to abstract – $ for full-text)
Commentary: Early Head-to-Pelvis CT for OHCA – Journal Feed
New WHO Online Course: Initial approach to the acutely ill patient with COVID-19.
10 May, 2021 | 01:21h | UTC
A restrictive fluid management strategy shows promise for acute kidney injury in a pilot randomized controlled trial.
10 May, 2021 | 00:57h | UTC
Commentary on Twitter
REVERSE-AKI restrictive fluid management vs usual care among critically ill pts with #AKI (proper initial fluid resus), multicenter feasibility RCT:
restriction? ⬇️cumulative fluid balance#RRT ➡️13% vs 30%
diuretics ↔️
usual care? ⬆️adverse events#FOAMcc https://t.co/JdKDo1XeIf pic.twitter.com/P1sOCHjkCS— Intensive Care Medicine (@yourICM) May 7, 2021
Guideline: Diagnosis and treatment of neurogenic dysphagia.
6 May, 2021 | 08:51h | UTC
ATS Guideline: Nucleic acid–based testing for noninfluenza viral pathogens in adults with suspected community-acquired pneumonia – Testing should be considered only in patients with severe CAP and in immunocompromised patients
5 May, 2021 | 08:28h | UTCNews Release: New clinical practice guideline on community acquired pneumonia – American Thoracic Society
Opinion | Manual in‐line stabilization during tracheal intubation: effective protection or harmful dogma?
5 May, 2021 | 08:18h | UTC
M-A: Prone positioning of nonintubated patients with Covid-19 improve oxygenation variables without any reported serious adverse events – randomized trials with patient-relevant outcomes such as the need for intubation or mortality rates are required
4 May, 2021 | 08:52h | UTCProne Positioning of Nonintubated Patients With Coronavirus Disease 2019—A Systematic Review and Meta-Analysis – Critical Care Medicine (link to abstract – $ for full-text)
[Preprint] Preventing disproportionate mortality in ICU overload situations: Empirical evidence from the first COVID-19 wave in Europe – “transferring patients proactively out of developing hotspots to less affected regions, well before high ICU workload situations emerge, will improve patient outcomes”
4 May, 2021 | 08:42h | UTC
ISCHEMIA trial – days alive out of hospital endpoint was higher in the conservative management group vs. invasive management group at 1 month (30.8 vs 28.4 days), 1 year (362.2 vs 355.9 days), and 2 years (718.4 vs 712.1 days)
4 May, 2021 | 08:41h | UTCComparison of Days Alive Out of Hospital With Initial Invasive vs Conservative Management: A Prespecified Analysis of the ISCHEMIA Trial – JAMA Cardiology (free for a limited period)
Original study: ISCHEMIA Trial: Health-Status Outcomes with Initial Invasive vs. Conservative Care in Stable Coronary Disease AND ISCHEMIA Trial: Initial Invasive vs. Conservative Strategy for Stable Coronary Disease AND ISCHEMIA Trial: Health Status after Invasive or Conservative Care in Coronary and Advanced Kidney Disease AND ISCHEMIA Trial: Management of Coronary Disease in Patients with Advanced Kidney Disease
Study: Most patients who develop a non-IgE-mediated hypersensitivity reaction to nafcillin can be safely treated with cefazolin
4 May, 2021 | 08:36h | UTC
Commentary on Twitter
New case series found 90% tolerated switching to cefazolin out of 80 patients who experienced non-IgE hypersensitivity reactions to nafcillin.https://t.co/YbFeWS4n4k
Our previous metas-analysis https://t.co/sJBjrx4a3r found higher odds of these reactions with nafcillin. pic.twitter.com/SIWcSuPcct— Antibiotic Tweets (@khalideljaaly) April 28, 2021
M-A: Tocilizumab reduces the need for mechanical ventilation in COVID-19 patients, but the randomized trials included in the analysis showed it has no significant effect on the risk of mortality or adverse events
3 May, 2021 | 05:44h | UTC