July 2022
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Jul 15 2022
PREPARE II RCT – Does a Bolus Reduce Cardiovascular Collapse Post-Intubation?
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A 500mL fluid bolus does not reduce the incidence of cardiovascular collapse in critically ill patients undergoing endotracheal intubation.Source
Effect of Fluid Bolus Administration on Cardiovascular Collapse Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial. JAMA. 2022 Jun 16. doi: 10.1001/jama.2022.9792. Online ahead of print. -
Jul 14 2022
Back to BaSICS – First Fluid Choice Matters – A Reanalysis of the BaSICS RCT
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There have been multiple publications since the original SMART and SALT-ED trials, including this Brazilian RCT that initially said fluid choice didn’t matter in critically ill patients. However, a secondary analysis of the BaSICS RCT suggests otherwise.Source
Association between Type of Fluid Received Prior to Enrollment, Type of Admission, and the Effect of Balanced Crystalloid in Critically Ill Adults. Am J Respir Crit Care Med. 2022;205(12):1419-1428. Doi:10.1164/rccm.202111-2484OC -
Jul 13 2022
Top Ten Tips to Optimize Vasopressor Use
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Here are the top 10 points for optimizing vasopressor use in critically ill patients. -
Jul 12 2022
Don’t Drown Them Babies – Does 30 mL/kg Reduce Pediatric Septic Shock Mortality?
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In children with hypotensive septic shock, there was no 30-day mortality benefit to receiving ≥30 mL/kg isotonic fluid within the first hour.Source
Association Between the First-Hour Intravenous Fluid Volume and Mortality in Pediatric Septic Shock. Ann Emerg Med. 2022 May 28;S0196-0644(22)00245-1. doi: 10.1016/j.annemergmed.2022.04.008. Online ahead of print. -
Jul 11 2022
CLASSIC RCT – Does Fluid Restriction Lower ICU Mortality?
It's IV Fluid Week on JournalFeed. Embrace Your Inner Nerd!
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In large a multicenter RCT of patients admitted to the ICU with septic shock, there was no difference in 90-day all-cause mortality when following a restrictive IV fluid protocol vs. standard protocol.Source
Restriction of Intravenous Fluid in ICU Patients with Septic Shock. N Engl J Med. 2022 Jun 17. doi: 10.1056/NEJMoa2202707. Online ahead of print. -
Jul 08 2022
Can We Use Droperidol for Pediatric Agitation?
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This systematic review suggests that droperidol is both safe and effective for treating agitation in the pediatric population.Source
A Systematic Review of the Effectiveness and Safety of Droperidol for Pediatric Agitation in Acute Care Settings. Acad Emerg Med. 2022 May 1. doi: 10.1111/acem.14515. Online ahead of print. -
Jul 07 2022
Mental Gymnastics – Does Yoga Help Migraines?
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This meta-analysis supports the recommendation of yoga as a treatment for migraine. How this generalizes to the emergency department is unknown.Source
Effectiveness of yoga therapy for migraine treatment: A meta-analysis of randomized controlled studies. Am J Emerg Med. 2022 May 2;58:95-99. doi: 10.1016/j.ajem.2022.04.050. Epub ahead of print. -
Jul 06 2022
Do Hypothermic Infants Need a Sepsis Workup?
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Given the prevalence of serious infection, this review suggests hypothermic infants (<36.5oC, 97.7oF) ages 60 days or younger need a sepsis workup. -
Jul 05 2022
CRITICAL – Indications for ECPR
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Registry study data finds the criteria to start extracorporeal cardiopulmonary resuscitation (ECPR) of age <75, time from emergency call to hospital arrival within 45 minutes and initial shockable rhythm to be predictive of good neurological outcomes and survival at one month.Source
Clinical outcomes among out-of-hospital cardiac arrest patients treated by extracorporeal cardiopulmonary resuscitation: The CRITICAL study in Osaka. Resuscitation. 2022 Jun 14:S0300-9572(22)00568-8. doi: 10.1016/j.resuscitation.2022.06.007. Epub ahead of print. -
Jul 04 2022
A Real-Life Analysis of Paxlovid – Does It Work?
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In the omicron era, nirmatrelvir/ritonavir (Paxlovid) is highly effective in reducing the risk of severe COVID-19 and mortality.Source
Effectiveness of Paxlovid in Reducing Severe COVID-19 and Mortality in High Risk Patients. Clin Infect Dis. 2022 Jun 2;ciac443. doi: 10.1093/cid/ciac443. Online ahead of print.