Critical Care
Editorial | Selective digestive decontamination – Pro
22 May, 2023 | 13:34h | UTCSelective digestive decontamination – Pro – Intensive Care Medicine (free for a limited period)
Commentary on Twitter
#SDD? One of few areas in critical care where large RCTs/SRs demonstrate consistent advantage, without evident side effects. Pivotal
? standardized formulation/protocols
? education
? ABT stewardship + rigorous IPC strategies, monitoring ABTs use/AMR
?️ https://t.co/VOqudX6E6k pic.twitter.com/YN5DuXknDL— Intensive Care Medicine (@yourICM) May 21, 2023
Practice Guidance | Differential diagnosis of suspected COPD exacerbations in the acute care setting
15 May, 2023 | 13:26h | UTC
Commentary on Twitter
Differential Diagnosis of Suspected Chronic Obstructive Pulmonary Disease Exacerbations in the Acute Care Setting: Best Practice
? Open Access
? https://t.co/aPiT06E2g4 pic.twitter.com/kF40aSS7Oo— ATS Blue Journal (@ATSBlueEditor) May 12, 2023
RCT | Prophylactic antibiotics show no statistically significant survival improvement in severe alcohol-related hepatitis
15 May, 2023 | 13:21h | UTCSummary: This multicenter, randomized, double-blind clinical trial aimed to determine the efficacy of amoxicillin-clavulanate combined with prednisolone compared to placebo combined with prednisolone on mortality in patients hospitalized with severe alcohol-related hepatitis. The study involved 284 patients from 25 centers in France and Belgium with biopsy-proven severe alcohol-related hepatitis, who were followed up for 180 days.
The primary outcome was all-cause mortality at 60 days, while secondary outcomes included mortality at 90 and 180 days, infection rates, hepatorenal syndrome, and changes in Model for End-stage Liver Disease (MELD) and Lille scores. The results showed no statistically significant difference in 60-day mortality between the two groups, with 17.3% in the amoxicillin-clavulanate group and 21.3% in the placebo group. However, infection rates at 60 days were significantly lower in the amoxicillin-clavulanate group compared to the placebo group.
It is worth noting that the study may have been underpowered, as the absolute risk difference of 4% did not achieve statistical significance. In conclusion, the combination of amoxicillin-clavulanate and prednisolone did not show a statistically significant improvement in 2-month survival in patients hospitalized with severe alcohol-related hepatitis compared to prednisolone alone. These findings do not support the use of prophylactic antibiotics to improve survival in this patient population, but the potential underpowered nature of the study should be considered.
Article: Effect of Prophylactic Antibiotics on Mortality in Severe Alcohol-Related Hepatitis: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)
Commentary on Twitter
Among patients with severe alcohol-related #hepatitis receiving prednisolone, amoxicillin-clavulanate did not improve survival at 60-day follow-up compared with placebo. https://t.co/4XkVL2CTsP #DDW pic.twitter.com/9sh5vennkK
— JAMA (@JAMA_current) May 9, 2023
Therapeutic plasma exchange: Core curriculum 2023
15 May, 2023 | 13:14h | UTCTherapeutic Plasma Exchange: Core Curriculum 2023 – American Journal of Kidney Diseases
Commentary on Twitter
Therapeutic Plasma Exchange: Core Curriculum 2023 https://t.co/6IoHXeAzyO (FREE)@Elena_Cervants @JohnSperati pic.twitter.com/3OVgAhXjCv
— AJKD (@AJKDonline) May 7, 2023
Review | Intensive care unit–acquired weakness in patients with acute kidney injury
15 May, 2023 | 13:12h | UTC
Commentary on Twitter
Intensive Care Unit–Acquired Weakness in Patients With Acute Kidney Injury: A Contemporary Review https://t.co/I7JXcb11VY (FREE) @NephCrit_NM @KirbyMayerDPT @Ben_Griffin_MD @NRG3000 @njenkinsphd @FGonzalezSeguel @javo_neyra #AKI pic.twitter.com/8nDSSQFMwa
— AJKD (@AJKDonline) May 13, 2023
Brief Review | Coagulation support during perioperative bleeding management
15 May, 2023 | 13:01h | UTCCoagulation support during perioperative bleeding management – Intensive Care Medicine
Commentary on Twitter
Coagulation & perioperative bleeding
?fibrinogen source/dose/time
?Ca++: just vs citrated blood products?
?PCCs/factor concentrates
?TXA
?plasma: volume or coagulation?
?PLTs as primary components
?RBCs not just DO2
?targeted coagulation support
?️ https://t.co/lv1i5GoHBg pic.twitter.com/8BtuAE6gt8— Intensive Care Medicine (@yourICM) May 13, 2023
Review | Awake prone positioning in acute hypoxemic respiratory failure
15 May, 2023 | 12:56h | UTCAwake prone positioning in acute hypoxaemic respiratory failure – European Respiratory Review
M-A | Effectiveness of diaphragmatic ultrasound as a predictor of successful weaning from mechanical ventilation
15 May, 2023 | 12:46h | UTC
M-A | Endovascular therapy for stroke presenting beyond 24 hours
12 May, 2023 | 13:44h | UTC
Commentary on Twitter
Endovascular therapy for stroke presenting at >24 hours was associated with favorable clinical, safety, and procedural outcomes in this meta-analysis of 569 patients. https://t.co/DjoDDcr1mf
— JAMA Network Open (@JAMANetworkOpen) May 4, 2023
Review | Progress in the treatment of acute pulmonary embolism and chronic thrombo-embolic pulmonary hypertension/disease
12 May, 2023 | 13:24h | UTCSee all articles in the series here
Review | Takotsubo syndrome: more frequent in women, more dangerous in men
12 May, 2023 | 13:21h | UTCSee all articles in the series here
A review of bicarbonate use in common clinical scenarios
11 May, 2023 | 12:17h | UTCA Review of Bicarbonate Use in Common Clinical Scenarios – The Journal of Emergency Medicine
Review | Diagnosis and management of cirrhosis and its complications
10 May, 2023 | 16:06h | UTCDiagnosis and Management of Cirrhosis and Its Complications: A Review – JAMA (free for a limited period)
Author Interview: Management of Cirrhosis in 2023
RCT | Early NIV and HFNO therapy for preventing endotracheal intubation in hypoxemic blunt chest trauma patients
10 May, 2023 | 15:48h | UTC
ESTES recommendation on thoracolumbar spine fractures
10 May, 2023 | 15:40h | UTC
M-A | PCI vs. CABG in non–ST-elevation coronary syndromes and multivessel disease
10 May, 2023 | 15:35h | UTC
M-A | Effects of different types of early rehabilitation on ventilator weaning among patients in the ICU
10 May, 2023 | 15:34h | UTC
Guideline | Management of type B aortic dissection
10 May, 2023 | 15:32h | UTC
Cohort Study | Predicting the emergence of malignant brain edema in acute ischemic stroke
10 May, 2023 | 15:26h | UTC
M-A | Clinical profile and outcome of isolated pulmonary embolism
10 May, 2023 | 15:27h | UTC
Study shows unenhanced CT shows 30% lower diagnostic accuracy in abdominal pain evaluation
9 May, 2023 | 15:02h | UTCDiagnostic Accuracy of Unenhanced Computed Tomography for Evaluation of Acute Abdominal Pain in the Emergency Department – JAMA Surgery (free for a limited period)
Editorial: Intravenous Contrast in Computed Tomography Imaging for Acute Abdominal Pain – JAMA Surgery (free for a limited period)
Commentary: New data suggest clinicians should think twice before foregoing contrast-enhanced imaging – Health Imaging
Commentary on Twitter
In a general population of emergency department patients with abdominal pain, using unenhanced CT to avoid risks of intravenous contrast medium administration is associated with a large diagnostic penalty. https://t.co/CVg04763yd
— JAMA Surgery (@JAMASurgery) May 3, 2023
Review | Challenges in cardiology: diagnosis of native and prosthetic valve endocarditis
9 May, 2023 | 14:19h | UTCSee all articles in the series here
Review | Causes of sudden death
9 May, 2023 | 14:16h | UTCCauses of sudden death – European Heart Journal Supplements
See all articles in the series here
Consensus Paper | Strategies to prevent surgical site infections in acute-care hospitals
8 May, 2023 | 13:21h | UTCNews Release: New guidance: antibiotics should be halted upon closure of incisions – Society for Healthcare Epidemiology of America
Commentary: New guidance calls for stopping antibiotic prophylaxis immediately after surgery – CIDRAP
Related: Consensus Paper | Strategies to prevent Clostridioides difficile infections in acute-care hospitals
M-A | Lower vs higher fluid volumes in sepsis: no significant impact on mortality or serious adverse events
8 May, 2023 | 13:16h | UTC