Hanne T. Olsen, Helene K. Nedergaard et el published a trial of no sedation versus light sedation in mechanically ventilated patients in NEJM. WHAT Multi center randomized controlled trial, in a 1 : 1 ratio, comparing be mechanically ventilated ICU patients to no sedation versus light sedation strategy( RASS Richmond agitation and sedation Scale score … Read more
Tomoko Fujii, Nora Luethi, Paul J. Young et al published the results of much awaited VITAMINS (The Vitamin C, Hydrocortisone and Thiamine in Patients With Septic Shock) trial. WHAT It was an investigator-initiated, multicenter, open-label, parallel-group randomized trial comparing vitamin-C, thiamine and hydrocortisone to hydrocortisone alone in patients with septic shock. WHERE 10 intensive … Read more
Joshua P. Metlay, Grant W. Waterer, Ann C. Long et el published the official IDSA /ATS guidelines for treatment of community-acquired pneumonia. BACKGROUND Last IDSA/ATS Guidelines for community-acquired pneumonia were updated in 2007 . In 2016, IDSA/ATS updated guidelines on ventilator-associated pneumonia as well as Hospital-acquired pneumonia which were discussed in comparison with European guidelines here. … Read more
Alpha A. Fowler , Jonathon D. Truwit , R. Duncan Hite et el published results of CITRIS-ALI trial in JAMA on Oct1, 2019. WHAT It was a randomized double blind placebo controlled multi Center trial conducted in 7 medical ICUs in the USA, comparing placebo to vitamin-C infusion( 50 milligram/kilogram, every 6 hours for 96 … Read more
Y. Shehabi, B.D. Howe, R. Bellomo et el recently published results of SPICE III trial (Sedation Practice in Intensive Care Evaluation), dexmedetomidine as the sole or primary sedative comparing to receive usual care (propofol, midazolam, or other sedatives). BACKGROUND Dexmedetomidine was initially approved by the United States Food and Drug Administration (FDA) in 1999 for the … Read more
The National Heart, Lung, and Blood Institute PETAL Clinical Trials Network published a large randomized controlled trial comparing NMBs(neuromuscular blocker) to placebo in patients with moderate to severe adult respiratory distress syndrome(PEEP of at least >8 with ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen of <150 mm Hg). … Read more
Skin and soft-tissue infections (SSTIs) or Acute bacterial skin and skin-structure infections (ABSSSIs) encompass a variety of pathological conditions that involve the skin and underlying subcutaneous tissue, fascia, or muscle, ranging from simple superficial infections to severe necrotizing infections. Two terms are used interchangeably in literature but according to FDA, ABSSSIs include cellulitis/erysipelas, wound infection, … Read more
Community-acquired pneumonia (CAP) is the leading cause of death worldwide, with a significant impact on morbidity rates. Increasing antibiotic resistance amongst the common bacterial pathogens associated with CAP, especially staphylococci and Streptococcus pneumoniae, has made the empiric treatment of this infection increasingly problematic. Approximately 6% of CAP are caused by antibiotic-resistant pathogens. During recent decades, … Read more
Levy B, Clere-Jehl R, Legras A et el published results of prospective double-blind multicenter randomized control trial comparing Epinephrine and norepinephrine in patients with cardiogenic shock secondary to percutaneous coronary intervention treated acute myocardial infarction. BACKGROUND Use of vasopressor agents during severe cardiogenic shock is to maintain the adequacy of and organ blood flow, which … Read more
Fang Fang, Yu Zhang, Jingjing Tang et el published a meta-analysis of use of corticosteroids in septic shock in Dec, 2018 in JAMA internal medicine. This ignites the age old debate of use of steroids in septic shock. You may recall that B. Venkatesh, S. Finfer, J. Cohen, D. Rajbhandari et el published adrenal trial which showed that … Read more
T.D. Girard, M.C. Exline, S.S. Carson, C.L. Hough, P. Rock, M.N. Gong et el published the results of MIND-USA(Modifying the Impact of ICU-Induced Neurological Dysfunction-USA) trial in New England Journal of Medicine October 22, 2018 Issue. STUDY It was a randomized, double-blind, placebo-controlled trial comparing patients with acute respiratory failure or shock and hypoactive or hyperactive delirium to … Read more
Kristine A. Sobolewski , Alison Brophy , Yekaterina Opsha et el published a retrospective cohort study comparing abrupt withdrawal versus taper of hydrocortisone in resolving septic shock patients. BACKGROUND Severe sepsis and septic shock remains one of the most common diagnosis as well as cause of death in intensive care units around the world. Hydrocortisone has been shown to quicker … Read more