Critical Care & Emergencies

Miracle medical machine ECMO makes heroic rescues, but leaves patients in limbo – Kaiser Health News / USA Today (free)

“ECMO is not designed to be a destination, but a bridge to somewhere – recovery, transplantation or an implanted heart device. But when patients are too sick to reach those goals, ECMO can become a “bridge to nowhere,” leaving the patient in limbo…”

 


Use of Peripherally Inserted Central Catheters in Patients With Advanced Chronic Kidney Disease: A Prospective Cohort Study – Annals of Internal Medicine (link to abstract – $ for full-text)

Commentaries: Peripherally inserted central catheters often used in CKD – HealthDay (free) AND Too Many CKD Patients Get Central Catheters Despite Warnings – Medscape (free registration required)

 

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Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Setting Positive End-Expiratory Pressure in Mechanically Ventilated Patients Undergoing Surgery (free)

 

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Diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome: review of acute decompensated diabetes in adult patients – The BMJ (free for a limited period)

 

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Commentary: Nebulized TXA for Hemoptysis

28 May, 2019 | 10:31h | UTC

Eosinophil-guided corticosteroid therapy in patients admitted to hospital with COPD exacerbation (CORTICO-COP): a multicentre, randomised, controlled, open-label, non-inferiority trial – The Lancet Respiratory Medicine (link to abstract – $ for full-text)

Commentary: 2 Minute Medicine Rewind May 20, 2019 (4th Summary)

See also: Video Summary – Medwire News (free audio)

 

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Extending thrombolysis to 4·5–9 h and wake-up stroke using perfusion imaging: a systematic review and meta-analysis of individual patient data – The Lancet (link to abstract – $ for full-text)

“Patients with ischemic stroke 4·5–9 h from stroke onset or wake-up stroke with salvageable brain tissue who were treated with alteplase achieved better functional outcomes than did patients given placebo. The rate of symptomatic intracerebral hemorrhage was higher with alteplase, but this increase did not negate the overall net benefit of thrombolysis.”

 

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Current Concepts in Acute Liver Failure

22 May, 2019 | 06:00h | UTC

Early Sedation with Dexmedetomidine in Critically Ill Patients – New England Journal of Medicine (link to abstract – $ for full-text)

Just Presented at the 2019 Meeting of the American Thoracic Society.

 


Early Neuromuscular Blockade in the Acute Respiratory Distress Syndrome – New England Journal of Medicine (link to abstract – $ for full-text)

Commentaries: Sedation and controlled paralysis do not improve survival of ICU patients with ARDS – University of Pittsburgh (free)

Just Presented at the 2019 Meeting of the American Thoracic Society.

 

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Decompensated congestive heart failure – treatment with levosimendan – Revista da Associação Brasileira de Medicina (free)

“In patients with dilated cardiomyopathy and ejection fraction < 30% (heart failure post-intervention or not), levosimendan does not reduce the risk of death.”

 


“The Case of the Magician’s Sleight” – EMNerd (free)

See also: EXTEND Alteplase Shenanigans! – Emergency Medicine Literature of Note (free)

Original Study: Randomized Trial: Thrombolysis Guided by Perfusion Imaging up to 9 Hours after Onset of Stroke (link to abstract and commentary)

Related Cochrane Review: Thrombolysis for acute ischaemic stroke (free)

Related Review: Thrombolytics for stroke: The evidence – First10Em (free)

 

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Vasopressin in septic shock: an individual patient data meta-analysis of randomised controlled trials – Intensive Care Medicine (free)

“Vasopressin therapy in septic shock had no effect on 28-day mortality”

 


Early Norepinephrine Has Potential in Septic Shock – Emergency Medicine News (free)

Original Study: Randomized Trial: Early Use of Norepinephrine in Septic Shock Resuscitation (link to abstract and commentary)

 

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A decade of progress in critical care echocardiography: a narrative review – Intensive Care Medicine (free)

 

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Review: Acute Management of Hyperkalemia

28 Apr, 2019 | 13:33h | UTC

Review: Hepatorenal Syndrome

24 Apr, 2019 | 06:21h | UTC

Why most diagnostic procedures aren’t beneficial – PulmCrit (free)

“when strict evidence-based medicine is applied to procedures, they are often less impressive”.

 


Update in Neurocritical Care

17 Apr, 2019 | 06:25h | UTC

Review: Cardiogenic Shock

8 Apr, 2019 | 01:06h | UTC

In-Hospital Cardiac Arrest: A Review

28 Mar, 2019 | 07:31h | UTC

In-Hospital Cardiac Arrest: A Review – JAMA (free for a limited period)

 


Management of acute upper gastrointestinal bleeding – The BMJ (free for a limited period)

 

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Thyrotoxicosis: Diagnosis and Management

26 Mar, 2019 | 01:43h | UTC

Diagnostic Accuracy of Point-of-Care Lung Ultrasonography and Chest Radiography in Adults With Symptoms Suggestive of Acute Decompensated Heart Failure: A Systematic Review and Meta-analysis – JAMA Network Open (free)

“The findings suggest that Lung Ultrasonography is more sensitive than Chest Radiography in detecting pulmonary edema in ADHF”.

 


Presented at the American College of Cardiology (ACC) 2019 Scientific Session.

Coronary Angiography after Cardiac Arrest without ST-Segment Elevation – New England Journal of Medicine (free for a limited period)

Editorial: Coronary Angiography after Cardiac Arrest — The Right Timing or the Right Patients? (free for a limited period)

Commentaries: Angiography timing does not impact survival after cardiac arrest for NSTEMI patients – American College of Cardiology (free) AND COACT: Delayed Angiography Does Not Compromise Survival in Cardiac Arrest Patients Without STEMI – TCTMD (free)

 

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Presented at the European Heart Rhythm Association 2019 Congress.

Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation – New England Journal of Medicine (free for a limited period)

Editorial: The RACE to Treat Atrial Fibrillation in the Emergency Department (free for a limited period)

Commentary: For Acute A-fib, Wait-and-See Approach May Spare Many Patients from Cardioversion – TCTMD (free)

 

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Guidelines for Antibiotic Prescription in Intensive Care Unit – Indian Journal of Critical Care Medicine (free PDF)

Source: Critical Care Reviews Newsletter

Comprehensive guideline covering many common conditions in the Critical Care Unit.

 


Acute Respiratory Distress Syndrome – Nature Reviews Disease Primer (free PDF)

 

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Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis – Journal of the American Board of Family Medicine (free)

Adults with an acute respiratory infection who have normal vital signs (temperature < 37,8 / respiratory rate < 20 / heart rate < 100) and a normal pulmonary examination are very unlikely to have CAP.

 


Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study – the BMJ (free)

Commentary: ECG rhythm and airway management make all the difference during a heart attack – Osaka University (free)

 

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Review: Glucose Control in the ICU

6 Mar, 2019 | 01:27h | UTC

The Difficult Airway Trolley: A Narrative Review and Practical Guide – Anesthesiology Research and Practice (free)

Related Guidelines: Difficult Airway Society 2015 guidelines for management of unanticipated difficult intubation in adults – British Journal of Anaesthesia (free) AND Practice Guidelines for Management of the Difficult Airway: An Updated Report by the American Society of Anesthesiologists Task Force on Management of the Difficult Airway – Anesthesiology (free)

“Despite several national guidelines on management of the anticipated and unanticipated difficult airway, with separate guidelines for pediatric, obstetric, and intensive care settings, only limited effort has been directed towards developing specific suggestions regarding the contents of a Difficult Airway Trolley”

 


Early Use of Norepinephrine in Septic Shock Resuscitation (CENSER) : A Randomized Trial – American Journal of Respiratory and Critical Care Medicine (link to abstract – $ for full-text)

See Commentary by Wellington ICU

“This is a promising result, and more and larger studies are needed to confirm the findings.” (from Wellington ICU)

 


Fever control in critically ill adults. An individual patient data meta-analysis of randomised controlled trials – Intensive Care Medicine (free)

Note: if the above link is not working, try this one

“Our findings do not support the hypothesis that more active fever management increases survival compared with less active fever management overall or in patients with limited physiological reserves.”

 


Fluid administration for acute circulatory dysfunction using basic monitoring: narrative review and expert panel recommendations from an ESICM task force – Intensive Care Medicine (free for a limited period)

Note: if the above link is paywalled, try this one

 

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Podcast: Hyperkalemia Master Class

6 Feb, 2019 | 00:52h | UTC

International Consensus Guidelines for the Optimal Use of the Polymyxins – Pharmacotherapy (free)

Endorsed by the American College of Clinical Pharmacy (ACCP), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), Infectious Diseases Society of America (IDSA), International Society for Anti‐infective Pharmacology (ISAP), Society of Critical Care Medicine (SCCM), and Society of Infectious Diseases Pharmacists (SIDP).

 


Humanizing the intensive care unit – Critical Care (free)

 

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10 Myths About Frusemide

30 Jan, 2019 | 23:31h | UTC

10 myths about frusemide – Intensive Care Medicine (free)

Note: if the above link is paywalled, try this one

 


Perspective: Debates in Sepsis

30 Jan, 2019 | 23:20h | UTC

Patient-reported complications related to peripherally inserted central catheters: a multicentre prospective cohort study – BMJ Quality & Safety (free)

 

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Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization – European Heart Journal (free)

Summary: Angina After PCI – American College of Cardiology (free)

 

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