Critical Care & Emergencies (all articles)
Review: Cardiac device troubleshooting in the intensive care unit.
16 Nov, 2021 | 08:21h | UTC
Commentary on Twitter
Cardiac device troubleshooting in the intensive care unit: an educational review by @JeroenDauw et al. in #EHJACVC on how to deal with common issues of pacemakers, implantable cardioverter-defibrillators, & cardiac resynchronization devices in the CICU https://t.co/CISh3QVH2E pic.twitter.com/vHnfGdq6gU
— European Society of Cardiology Journals (@ESC_Journals) November 15, 2021
Cohort study suggests low-dose vs. standard radiation dose CT have similar diagnostic accuracy in suspected acute appendicitis.
14 Nov, 2021 | 19:37h | UTCNews release: Doctors can use CT scans with less radiation to diagnose appendicitis – Oxford University
Original study: Diagnostic accuracy using low-dose versus standard radiation dose CT in suspected acute appendicitis: prospective cohort study – British Journal of Surgery (link to abstract – $ for full-text)
Observational Study: In patients with shockable in-hospital cardiac arrest, epinephrine before defibrillation was associated with worse survival.
14 Nov, 2021 | 19:33h | UTC
Commentary on Twitter
Despite guidelines suggesting otherwise, 27% of patients with an in-hospital cardiac arrest with a shockable rhythm received epinephrine before defibrillation
– and had a lower survival rate
– were defibrillated later-> dont do that!https://t.co/BGtNW02hav pic.twitter.com/WCJd7vtnEc
— Konstantin Krychtiuk (@krychtiukmd) November 13, 2021
Infection control in the intensive care unit: expert consensus statements for SARS-CoV-2 using a Delphi method.
12 Nov, 2021 | 10:41h | UTC
Commentary from the author on Twitter (thread – click for more)
Honoured to lead this Delphi on Infection Control in ICU for SARS-CoV-2 with global experts https://t.co/39NTHgfyZR @Drnasap @ElieAzoulay5 @jigidivatia @AlhazzaniW @NaomiHammond @criticcaredoc @YaseenarabiYa @Laura_Evans_206 @FlaviaSepsis @AndersPerner @jlvincen @TheLancetInfDis pic.twitter.com/RWw6vXcHb0
— Sheila Myatra (@SheilaMyatra) November 11, 2021
ERS Guidelines: High-flow nasal cannula in acute respiratory failure.
12 Nov, 2021 | 10:29h | UTC
2022 ASA Guidelines for Management of the Difficult Airway.
12 Nov, 2021 | 10:31h | UTCRelated:
Consensus Guideline: Pediatric Airway Management in COVID-19 Patients
Guidelines for Awake Tracheal Intubation in Adults
Position Paper: Management of Unanticipated Difficult Airways in Children in Anesthetic Practice
Review: Difficult Airway Management Algorithms (several resources on the subject)
The Difficult Airway Trolley: A Narrative Review and Practical Guide
Estimating daily antibiotic harms: an umbrella review with individual study meta-analysis – “Each day of antibiotic therapy was associated with 4% increased odds of experiencing an adverse event”.
12 Nov, 2021 | 09:47h | UTC
Commentary on Twitter
Each additional day of antibiotic therapy is associated with measurable antibiotic harm, particularly adverse events
🆕💥💥 @CMIJournal @BRxAD et Al
Estimating daily antibiotic harms: an umbrella review with individual study meta-analysis #IDTwitter https://t.co/ERlUZ1ict6 pic.twitter.com/KOWU4PhSzK— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) November 11, 2021
COVID antiviral pills: what scientists still want to know – “Drugs like Molnupiravir and Paxlovid could change the course of the pandemic if clinical trial results hold up in the real world”.
11 Nov, 2021 | 08:59h | UTCCOVID antiviral pills: what scientists still want to know – Nature
Related:
The U.K. approves Merck’s COVID-19 antiviral pill, calling it a world first.
Merck to allow other nations to produce new COVID-19 antiviral.
Video: Merck’s Covid pill could transform treatment. Here’s how it works.
How antiviral pill Molnupiravir shot ahead in the COVID drug hunt.
What we know — and don’t know — about Merck’s new Covid-19 pill.
Merck’s Covid-19 pill is great news but may not be a game-changer.
Video | A Pill For COVID? A Doctor Explains Molnupiravir.
RCT: In patients with acute stroke eligible for intravenous alteplase and endovascular treatment, intravenous alteplase before endovascular treatment did not improve outcomes compared to endovascular treatment alone.
11 Nov, 2021 | 08:43h | UTCA Randomized Trial of Intravenous Alteplase before Endovascular Treatment for Stroke – New England Journal of Medicine (link to abstract – $ for full-text)
RCT: In patients with acute myocardial infarction complicated by a reduced left ventricular ejection fraction, pulmonary congestion, or both, Sacubitril–valsartan was not associated with improved outcomes compared to Ramipril.
11 Nov, 2021 | 08:44h | UTCAngiotensin Receptor–Neprilysin Inhibition in Acute Myocardial Infarction – New England Journal of Medicine (link to abstract – $ for full-text)
[Preprint] RCT: In hypoxic but not critically ill patients with COVID-19, an intervention to increase prone positioning did not improve outcomes.
10 Nov, 2021 | 07:20h | UTCRCT: Prone positioning of patients with moderate hypoxia due to COVID-19 – medRxiv
Related:
RCT: Awake prone positioning reduces the need for intubation in patients with COVID-19.
Commentary from the author on Twitter (thread – click for more)
The results from the COVID-PRONE pragmatic RCT are available @medRxiv! This was a massive team effort with my co-PIs @AmolAVerma, @drfahadrazak. Our goal was to evaluate the effectiveness of prone positioning for pts hospitalized with COVID19. https://t.co/6SpjdPvT2U 🧵 1/5 pic.twitter.com/WH10ciBn4w
— Michael Fralick (@FralickMike) November 8, 2021
Review: Cardiogenic shock after acute myocardial infarction.
10 Nov, 2021 | 07:03h | UTCCardiogenic Shock After Acute Myocardial Infarction: A Review – JAMA (free for a limited period)
Perspective: Life lessons after a career in intensive care medicine.
10 Nov, 2021 | 06:54h | UTCLife lessons after a career in intensive care medicine – Intensive Care Medicine
Commentary on Twitter
Reflections/lessons from a life in #ICU:
1⃣work with people you like/love
2⃣take sabbaticals to recharge
3⃣prioritize family = those you love most
4⃣live every day as having terminal disease: focus on what most important@JRandallCurtis1 #ICMfromtheInsidehttps://t.co/X2GKXRM3rf pic.twitter.com/ytx1eMLkMW— Intensive Care Medicine (@yourICM) November 8, 2021
M-A: Among patients with acute intracerebral hemorrhage, interventions to lower blood pressure within 7 days of the onset had no overall benefit on functional recovery, despite reducing bleeding.
10 Nov, 2021 | 06:55h | UTC
Review: Uremic Encephalopathy.
10 Nov, 2021 | 06:49h | UTCUremic Encephalopathy – Kidney International
M-A: In adults with sepsis or septic shock, metabolic resuscitation with vitamin C, glucocorticoids, vitamin B1, or combinations of these drugs was not associated with decreased long-term mortality. Adding glucocorticoid to other treatments shortened the duration of vasopressor therapy and ICU stay.
10 Nov, 2021 | 06:52h | UTCRelated:
Commentary on Twitter
Metabolic resuscitation in sepsis/septic shock with
💉vitamin C
💉glucocorticoids
💉vitamin B1
or their combinations not proven to⬇️long-term mortality.
NMA suggests association high dose/very high dose vit C & decreased mortality (low certainty).#FOAMcc https://t.co/tB2KKRjtzc pic.twitter.com/uns9rcmDbA— Intensive Care Medicine (@yourICM) November 9, 2021
Practice Review: COVID-19 rapid diagnostics.
9 Nov, 2021 | 01:52h | UTCCOVID-19 rapid diagnostics: practice review – Emergency Medicine Journal
[Press release – not published yet] RCT: Pfizer’s novel Covid-19 oral antiviral treatment candidate reduced risk of hospitalization or death by 89% in interim analysis of phase 2/3 EPIC-HR study.
7 Nov, 2021 | 20:35h | UTCCommentaries:
Pfizer’s Good News Is the World’s Good News – Science
Experimental Pfizer pill prevents Covid hospitalizations and deaths – STAT
Pfizer reports good results against severe COVID-19 for its antiviral pill – CIDRAP
Covid: Pfizer says antiviral pill 89% effective in high-risk cases – BBC
Pfizer says COVID-19 pill cut hospital, death risk by 90% – Associated Press
Commentary on Twitter (thread – click for more)
Pfizer’s oral protease inhibitor PF-07321332 for #COVID19 Reduced Risk of Hospitalization or Death from 6.7% (41/612) to 1.0% (6/607) when starting within 5 days of symptom onset.
10 vs 0 deaths. #idtwitter https://t.co/ZAIm6Y5mAt— David Boulware, MD MPH (@boulware_dr) November 5, 2021
New study challenges the idea that a coronary artery calcium score of 0 is enough for ruling out coronary stenosis in symptomatic patients, especially in young adults.
7 Nov, 2021 | 20:09h | UTCAssociation of Age With the Diagnostic Value of Coronary Artery Calcium Score for Ruling Out Coronary Stenosis in Symptomatic Patients – JAMA Cardiology (link to abstract – $ for full-text)
Commentary: Zero CAC Questionable for Ruling Out Obstructive CAD in Young Adults – TCTMD
Commentary from the author on Twitter (thread – click for more)
There has been a lot of discussion about our recent paper in JAMA Cardiology. In my opinion, much of the discussion is caused by a troublesome extrapolation of the results to the value of CAC in risk assessment in primary prevention. I will go through our findings in these tweets https://t.co/O0Rl12XYmV
— Martin Bødtker Mortensen (@MaBMortensen) November 1, 2021
Things We Do for No Reason: Prescribing Tramadol for Inpatients in Pain.
5 Nov, 2021 | 09:44h | UTCRelated:
Cohort Study: Chronic Use of Tramadol After Acute Pain Episode
ASH Guideline issued a conditional recommendation against routine use of outpatient anticoagulant prophylaxis in patients with COVID-19 being discharged from the hospital.
4 Nov, 2021 | 10:03h | UTC
Short Review: Cardiac injury in Covid-19.
3 Nov, 2021 | 10:04h | UTCCardiac injury in COVID-19 – Intensive Care Medicine
Commentary on Twitter
Myocardial injury in #COVID19, many potential mechanisms:
🫀myocardial DO2/VO2 imbalance
🫀ARDS & MV
🫀cytokine storm
🫀direct viral lesion.
Variable clinical presentations, with high complications rates, mortality & risk of long-term cardiac impairment.https://t.co/wxPDDrtEoY pic.twitter.com/vOx1B4cwY2— Intensive Care Medicine (@yourICM) November 2, 2021
Review: The role of chest imaging in the diagnosis, management, and monitoring of Covid-19.
3 Nov, 2021 | 10:05h | UTC
RCT: Among children with community-acquired pneumonia discharged within 48 hours from the ED or hospital, lower-dose outpatient oral amoxicillin was noninferior to a higher dose, and a 3-day duration course was noninferior to 7 days.
3 Nov, 2021 | 09:56h | UTCEffect of Amoxicillin Dose and Treatment Duration on the Need for Antibiotic Re-treatment in Children With Community-Acquired Pneumonia: The CAP-IT Randomized Clinical Trial – JAMA (free for a limited period)
Related:
ACP Guidance: Appropriate Use of Short-Course Antibiotics in Common Infections
RCT: 7 days of antibiotic therapy as good as 14 days for afebrile men with urinary tract infection.
Commentary on Twitter
🔥Just published🔥
CAP-IT RCT
Children w CAP discharged from ED or hospital (w/in48 hrs)
lower-dose outpatient oral amoxicillin was noninferior to higher dose& 3d was noninferior to 7 d, w regard to need for Abx re-treatment @BradSpellberg table update 🤔 https://t.co/VkxBmJaEeW pic.twitter.com/fKzpGp1XM7— Antibiotic Steward Bassam Ghanem 🅱️C🆔🅿️🌟 (@ABsteward) November 2, 2021
A comprehensive review of vascular complications in COVID-19.
2 Nov, 2021 | 03:01h | UTC