Critical Care & Emergencies (all articles)
Fluid-induced harm in the hospital: look beyond volume and start considering sodium. From physiology towards recommendations for daily practice in hospitalized adults.
19 May, 2021 | 08:32h | UTC
[Preprint] Practice Changing RCT: Therapeutic-dose anticoagulation with heparin (LMWH or unfractionated heparin) improves outcomes in non-critically ill patients with Covid-19 – the superiority of therapeutic-dose anticoagulation was seen in both high and low D-dimer groups.
18 May, 2021 | 08:04h | UTCTherapeutic Anticoagulation in Non-Critically Ill Patients with Covid-19 – medRxiv
Commentary on Twitter
Final results of the mpRCT now on preprint server. In non-critically ill patients with COVID-19 (n=2219), therapeutic-dose anticoagulation with heparins increases survival to hospital discharge with reduced use of organ support. https://t.co/TkhGs5qow5
— Ryan Zarychanski (@RZarychanski) May 17, 2021
#ACC21 – [Not published yet] RCT: Among hospitalized patients with Covid-19 and elevated D-Dimer, therapeutic anticoagulation with Rivaroxaban 20 mg was not associated with improved outcomes and resulted in increased major bleeding.
18 May, 2021 | 08:01h | UTCAntiCoagulaTIon cOroNavirus – ACTION – American College of Cardiology
Commentary: ACTION: Full-Dose Rivaroxaban Doesn’t Help in Hospitalized COVID-19 – TCTMD
M-A: Incidence and mortality of COVID‐19‐associated pulmonary aspergillosis – The incidence and mortality in the ICU were estimated to be 10.2% and 54.9%, respectively.
18 May, 2021 | 07:50h | UTC
Expert consensus on peri-operative myocardial injury screening in noncardiac surgery.
18 May, 2021 | 07:12h | UTCInvited Commentary: Expert consensus on peri-operative myocardial injury screening in noncardiac surgery
WSES-AAST guidelines: Management of inflammatory bowel disease in the emergency setting.
18 May, 2021 | 07:15h | UTC
RECOVERY Trial: No benefit from convalescent plasma in patients admitted to hospital with COVID-19.
17 May, 2021 | 08:56h | UTCInvited commentary: Convalescent plasma in patients hospitalised with COVID-19
Commentaries on Twitter
Convalescent plasma:
Yet another example of
Don’t guess, don’t gamble
Randomize… and learn
I’ve heard it said that it was deemed “too difficult” to do a randomised controlled trial. Really? If that’s the case, we must (and can) fix that problem. Pts deserve better. https://t.co/zxIiK5U63v
— Martin Landray (@MartinLandray) May 15, 2021
NEW #COVID19 research—In patients hospitalised with COVID-19, high-titre convalescent plasma did not improve survival or other prespecified clinical outcomes. Read https://t.co/7Sbe8V9THp. #RECOVERY #RECOVERYtrial pic.twitter.com/D0OLZKxZc4
— The Lancet (@TheLancet) May 16, 2021
#ACC21 – [Not published yet] RCT: DARE-19: Dapagliflozin is safe, but did not significantly improve outcomes among high-risk patients hospitalized with COVID-19.
17 May, 2021 | 08:49h | UTC
Commentaries on Twitter
DARE-19 trial #ACC21 @ACCinTouch
Dapa did not reduce clinical endpoints in #COVID19, but excellent safety profile
? Do not discontinue SGLT2i in ? for #COVID19
Full slideset available in ?https://t.co/RPi5mpPbbN pic.twitter.com/B9VQdSSAFu
— Enrique Santas (@SantasEnrique) May 16, 2021
DARE-19 findings presented at #ACC21 show #dapagliflozin didn’t significantly ⬇️ risk of organ failure or death or improve recovery in patients hospitalized w/ #COVID19. However, data suggest the SGLT2 inhibitor was well tolerated in acutely ill patients. https://t.co/YjYxbuc952 pic.twitter.com/J4PqwvGpLJ
— American College of Cardiology (@ACCinTouch) May 16, 2021
#ACC21 – RCT: In patients with STEMI undergoing complete revascularization, an FFR-guided strategy did not improve outcomes compared to an angiography-guided strategy.
17 May, 2021 | 08:26h | UTCMultivessel PCI Guided by FFR or Angiography for Myocardial Infarction – New England Journal of Medicine (link to abstract – $ for full-text)
#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