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Critical Care & Emergencies (all articles)

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

https://twitter.com/cochraneINJ/status/1473667822542888964

 

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

 

Another study showed neutralizing monoclonal antibody therapies are not effective when given after the patient is already hospitalized.

13 Jan, 2022 | 08:48h | UTC

Efficacy and safety of two neutralising monoclonal antibody therapies, sotrovimab and BRII-196 plus BRII-198, for adults hospitalised with COVID-19 (TICO): a randomised controlled trial – The Lancet Infectious Diseases

Invited Commentary: Time to knock monoclonal antibodies off the platform for patients hospitalised with COVID-19

 

Cohort Study: Patient factors associated with appendectomy within 30 days of initiating antibiotic treatment for appendicitis – the presence of an appendicolith was associated with a nearly 2-fold increased risk of undergoing appendectomy within 30 days.

13 Jan, 2022 | 08:39h | UTC

Patient Factors Associated With Appendectomy Within 30 Days of Initiating Antibiotic Treatment for Appendicitis – JAMA Surgery (free for a limited period)

Invited commentary: Appendicoliths, Antibiotic Treatment Failure, and Appendectomy—Is the Glass Half Full or Half Empty? – JAMA Surgery

 

The COVID-19 Treatment Guidelines Panel’s Statement on Anticoagulation in Hospitalized Patients With COVID-19 – in the absence of contraindications, use therapeutic-dose anticoagulation with low molecular weight heparin for hospitalized patients not in the ICU who have a D-dimer above the upper limit of normal.

12 Jan, 2022 | 09:11h | UTC

The COVID-19 Treatment Guidelines Panel’s Statement on Anticoagulation in Hospitalized Patients With COVID-19 – NIH COVID-19 Treatment Guidelines

 

Statement on potential drug-drug interactions between Ritonavir-boosted Nirmatrelvir (Paxlovid) and concomitant medications; antiarrhythmics, oral anticoagulants, immunosuppressants, anticonvulsants, antineoplastics, and neuropsychiatric drugs are among the drugs of concern.

12 Jan, 2022 | 09:09h | UTC

The COVID-19 Treatment Guidelines Panel’s Statement on Potential Drug-Drug Interactions Between Ritonavir-Boosted Nirmatrelvir (Paxlovid) and Concomitant Medications – NIH COVID-19 Treatment Guidelines Panel

Commentaries:

Pfizer antiviral pills may be risky with other medications – NBC News

The New COVID-19 Pill, Paxlovid, Interacts with Many Medications: Cardiac Patients Take Note – The Skeptical Cardiologist

See also: What’s New in the Guidelines – NIH COVID-19 Treatment Guidelines

 

German Guideline: Oxygen therapy in the acute care of adult patients.

12 Jan, 2022 | 08:57h | UTC

German S3 Guideline: Oxygen Therapy in the Acute Care of Adult Patients – Respiration

 

RCT: Among patients younger than 21 years of age with provoked thromboembolism, anticoagulation for 6 weeks was non-inferior vs. 12 weeks on the risk of recurrence and bleeding events.

12 Jan, 2022 | 08:53h | UTC

Effect of Anticoagulant Therapy for 6 Weeks vs 3 Months on Recurrence and Bleeding Events in Patients Younger Than 21 Years of Age With Provoked Venous Thromboembolism: The Kids-DOTT Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Duration of Anticoagulant Treatment for Acute Provoked Venous Thromboembolism in Pediatric Patients – JAMA (free for a limited period)

 

Review: Management of coagulopathy in bleeding patients.

12 Jan, 2022 | 08:34h | UTC

Management of Coagulopathy in Bleeding Patients – Journal of Clinical Medicine

 

Clinical Guideline: Acute-on-chronic liver failure.

11 Jan, 2022 | 02:43h | UTC

Acute-on-Chronic Liver Failure Clinical Guidelines – American Journal of Gastroenterology

Related: Guidelines for the Management of Adult Acute and Acute-on-Chronic Liver Failure in the ICU

 

Commentary on Twitter

 

Position Statement: Prehospital surgical airway management.

11 Jan, 2022 | 02:39h | UTC

Prehospital Surgical Airway Management: An NAEMSP Position Statement and Resource Document – Prehospital Emergency Care

 

Special Issue: Peri‐operative and critical care management of the brain ‐ current evidence.

11 Jan, 2022 | 02:36h | UTC

Homepage: Special Issue:Peri‐operative and critical care management of the brain ‐ current evidence – Anaesthesia

Editorials:

In search of the perfect outcome in neuroanaesthesia and neurocritical care

Anaesthesia and the older brain: what should we do?

Review Articles:

Implications of nocebo in anaesthesia care

Chronic subdural haematoma: the role of peri-operative medicine in a common form of reversible brain injury

Acute peri-operative neurocognitive disorders: a narrative review

Pragmatic sedation strategies to prevent secondary brain injury in low-resource settings

Delirium and COVID-19: a narrative review of emerging evidence

Anaesthesia for mechanical thrombectomy: a narrative review

Clinical applications of point-of-care ultrasound in brain injury: a narrative review

Management of status epilepticus: a narrative review

Evidence-based strategies to reduce the incidence of postoperative delirium: a narrative review

Management of traumatic brain injury: a narrative review of current evidence

Peri-operative neurological monitoring with electroencephalography and cerebral oximetry: a narrative review

Peri-operative management of patients with Parkinson’s disease

 

Review: Rapid diagnostic testing for SARS-CoV-2.

11 Jan, 2022 | 01:34h | UTC

Rapid Diagnostic Testing for SARS-CoV-2 – New England Journal of Medicine

 

Clinical Practice Guideline Summary: Recommended Drugs and Biologics in Adult Patients with COVID-19.

11 Jan, 2022 | 01:26h | UTC

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

 

Commentary on Twitter

 

New CDC Guidance shortens isolation and quarantine period for Covid-19; patients that tested positive should isolate for 5 days and, if asymptomatic after this period, can leave isolation if they can continue to mask for 5 days to minimize the risk of infecting others.

9 Jan, 2022 | 01:13h | UTC

CDC Updates and Shortens Recommended Isolation and Quarantine Period for General Population – Centers for Disease Control and Prevention

See also: Quarantine and Isolation – Centers for Disease Control and Prevention

Commentaries:

Facing criticism, CDC updates Covid-19 isolation recommendations with guidance on testing – CNN

CDC posts rationale for shorter isolation, quarantine – Associated Press

Covid-19: CDC shortens isolation period as US cases hit record high – The BMJ

Shortened CDC COVID isolation guide draws sharply mixed reviews – CIDRAP

New CDC isolation guidelines raise concerns among health experts – NPR

CDC Reduces Recommended Isolation Time for People With COVID-19 – HealthDay

COVID isolation and quarantine period for general population shortened by CDC – News Medical

CDC shortens recommended Covid-19 isolation and quarantine time – CNN

CDC cuts the recommended isolation and quarantine periods for coronavirus infections – NPR

US officials recommend shorter COVID isolation, quarantine – Associated Press

See new recommendations from other countries:

France cuts isolation times and plans crackdown on unvaccinated amid record surge in Covid cases – CNN

Covid: Self-isolation cut from 10 days to seven with negative tests – BBC

 

[Preprint] RCT: In symptomatic adults above 18 years positive for SARS-CoV-2, early outpatient treatment with high-titer convalescent plasma significantly reduced hospitalizations.

8 Jan, 2022 | 23:28h | UTC

Randomized Controlled Trial of Early Outpatient COVID-19 Treatment with High-Titer Convalescent Plasma – medRxiv

News release: Early Use of Convalescent Plasma May Help Outpatients with COVID-19 Avoid Hospitalization – Johns Hopkins Medicine

Commentary: Convalescent plasma shows renewed promise for COVID-19 in outpatient trial – Science

 

RCT: Among patients hospitalized with COVID-19 at increased risk for venous thromboembolism, post-discharge thromboprophylaxis with Rivaroxaban for 35 days may improve outcomes.

17 Dec, 2021 | 09:50h | UTC

Rivaroxaban versus no anticoagulation for post-discharge thromboprophylaxis after hospitalisation for COVID-19 (MICHELLE): an open-label, multicentre, randomised, controlled trial – The Lancet

Invited commentary: Anticoagulation in COVID-19 – The Lancet

 

Commentary on Twitter

 

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