RS Josef Dankiewicz, Tobias Cronberg, Gisela Lilja et el published a trial of normothermia vs hypothermia in out of hospital cardiac arrest in NEJM. BACKGROUND Targeted temperature management (TTM, therapeutic hypothermia) after cardiac arrest first came to use in clinical setting since the publication of two landmark articles in 2002(1,2). Earlier it was noted that persons … Read more
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Phillip W. Clapp, Emily E. Sickbert-Bennett et el published a study in JAMA regarding efficacy of various masks in COVID pandemic. INTRODUCTION Centers for Disease Control and Prevention (CDC) emphasizes the importance of wearing face masks that properly fit the face to slow the spread of SARS-CoV-2. Masks are a proven means to prevent … Read more
Yannopoulos D, Bartos J, Raveendran G, Walser E, et al published a trial in the Lancet about therapy in patients with out of hospital refractory ventricular fibrillation cardiac arrest. WHAT Phase 2, single-center, open-label, pragmatic, randomized clinical trial. WHERE University of Minnesota Medical Center (MN, USA) PATIENTS Adult patients (aged 18-75) with out of hospital … Read more
Since the beginning of the pandemic with covid-19, We have learned a lot regarding prevention and treatment. However, the knowledge Gap exists. Recent JAMA editorial summarized this for severe covid-19. PREVENTION Social distancing, frequent hand washing and mask wearing by the general public reduces the transmission of covid 19. Contact tracing and isolation are … Read more
Marcus J. Schultz, Anna Geke Algera, Luigi Pisani et el published a trial in JAMA comparing lower versus higher PEEP in Non ARDS patients who needed mechanical ventilation in intensive care unit. Background Higher PEEP has shown some beneficial effects in patients with ARDS. Effect of this observation has resulted in use of higher PEEP … Read more
Ashish Panchel, Jason Bartos, Jose Cabanas et el published uptdated guidelines for cardiac resuscitation in Circulation. Salient features are summarized in this picture. Now a days the guidelines are updated on a continuous basis but these are the salient changes summarized in a table form. Most updated treatment recommendations for cardiac arrest resuscitation FOR … Read more
Ian Roberts, Haleema Shakur-Still , Adefemi Afolabi, Christopher Hawkey et el (HALT-IT trial investigators) published a trial in Lancet comparing tranexamic acid to placebo in gastrointestinal hemorrhage. Background Tranexamic acid(TXA) is known to prevent the fibrinolysis. Early use of TXA reduces surgical bleeding and death related to bleeding from traumatic injury and has reduced the … Read more
Updated 7/22/2020 Since the discovery of Covid 19(Coronavirus SARS COV 2) in December 2019, flow of information and circumstances are changing everyday. It is hard to keep up with so much information and sort out real from myths. In general, following points are important to remember which are referenced from reputable sources Tolicizumab is the … Read more
Shilpa Sharma, Yvelynne P. Kelly et el published a study in Chest comparing intense vs usual renal replacement therapy in patients undergoing mechanical ventilation. It was a secondary analysis of already completed ATN study. BACKGROUND Randomized clinical trials have failed to show benefit from increasing intensity of renal replacement therapy (RRT). RRT is associated with an increase in … Read more
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