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Journal Club

See you most Wednesdays at 0830 on Zoom by clicking here (password 624445). Also have a look at the ICU Trials App on iOS or Android.

SAFE study (click to download)

  • 1832 -> Having inserted a tube into the basilic vein, cautiously, anxiously, I watched the effect; ounce after ounce was injected, but no visible change was produced. Still persevering, I thought she began to breath less laboriously; soon the sharpened features and sunken eye and fallen jaw, pale and cold, bearing the manifest impress of death’s signet, began to glow with returning animation; the pulse which had long ceased, returned to the wrist, at first small and quick, by degrees it became more and more distinct, fuller, slower and firmer, and in a short space of half an hour, when six pints had been injected, she expressed in a firm voice that she was free from all uneasiness, actually became jocular, and fancied all she needed was a little sleep; her extremities were warm, and every feature bore the aspect of comfort and health.
  • Rise of ANZICS
  • Subgroups (sepsis/TBI)

Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin — Final Report (click to download)

  • Mechanical Butane Ignition Vaporizer, Joseph Robinson
  • Public health examples
  • Death off case reports

Acute mesenteric ischemia: guidelines of the World Society of Emergency Surgery (click to download)

  • Hammers and nails.
  • Anticoagulation.
  • Chicken or egg.

Electrolyte disorders during the initiation of nutrition therapy in the ICU (click to download)

  • DB and NEJM?
  • Early feeding?
  • PO4

Outcomes and Resource Utilization Among Patients Admitted to the Intensive Care Unit Following Acute Exacerbation of Chronic Obstructive Pulmonary Disease (click to download)

  • Coding humans
  • Decisions to die
  • End of life and resources

A Prospective Randomized Controlled Trial on the Efficacy of Noninvasive Ventilation in Severe Acute Asthma (click to download)

  • Retrospective
  • Propensity
  • Codes
  • % go on to ventilation or die same

Blood Culture Results Before and After Antimicrobial Administration in Patients With Severe Manifestations of Sepsis (click to download)

  • Cultures only?
  • Who are you treating?
  • Time to first dose?

Early versus Late Parenteral Nutrition in Critically Ill Adults (click to download).

  • Primary outcome (patient entered?)
  • Short LOS
  • Insulin?
  • How to work with commercial companies?

Prednisolone or Pentoxifylline for Alcoholic Hepatitis (click for download)

Relevance of Lung Ultrasound in the Diagnosis of Acute Respiratory Failure (click for download)

  • Why is 28 days important?
  • Placebo?
  • Read about Julius Fieser
  • Single diagnosis?
  • Experiences?
  • Validation?
  • Now watch this video.

Effect of Intravenous Acetaminophen on Postoperative Hypoxemia After Abdominal Surgery
The FACTOR Randomized Clinical Trial (click for download)

  • Secondary more important that primary
  • Sats and oxygen
  • ASA 1/2 and abdominal surgery

Hydrocortisone and Treatment of Multiple Trauma (click to download)

  • How to define a definition?
  • Patient centred outcomes?
  • What is VAP?

British aneurysm nimodipine trial: Nimodipine in subarachnoid hemorrhage (click for download)

  • Diagnosis?
  • Grade?
  • Vasospasm?
  • Now read this

REDCAP (click for download)

  • Blind leading the blind?
  • Words are not always free.
  • Cap or no cap?

SUP-ICU (click for download)

  • Drink vommit?
  • NNT 60 to prevent treatment with PPI?
  • High / low risk

Remdesivir for the Treatment of Covid-19 — Final Report (click for download)

  • 10 days but not 10 days
  • The Tamiflu of COVID?
  • Primary changes

PR decision-making conversations in the UK: an integrative review (click here for document)

  • UK English (1.5/7.5 billion)
  • McMillian?
  • ECMO
  • Nurses before and after

Standard versus Accelerated Initiation of Renal Replacement Therapy (click here to download)

Think about:

  • Who are the three sisters?
  • Why economics matters.
  • Are these like our patients?

Conservative Oxygen Therapy during Mechanical Ventilation in the ICU (click to download)

Thank about:

  • Low vs low?
  • MEGAROX trial
  • Future trial direction?

DAILY INTERRUPTION OF SEDATIVE INFUSIONS IN CRITICALLY ILL PATIENTS UNDERGOING MECHANICAL VENTILATION (click to read original paper)

Think about:

  • Two countries divided by a common language
  • Protocol violations
  • Blinding

PROSEVA (click to read original paper)

  • High volume = high benefit?
  • Too good to be true?
  • Self-selected groups?

Now have a read of the excellent Bottom Line review on the trial.

CITRIS-AL (click to read original paper)

  • Vic C and the start of evidence
  • Primary end points are political
  • Syndrome + syndrome

FRAIL-FIT (click to read original paper)

  • Invisible women?
  • Cause vs effect
  • Binary cut off using a hover.

SMART (click to read the original paper)

  • Why is everything sometimes less?
  • The blind following the blind?
  • Why are subgroups sub-optimal?

Now read https://emcrit.org/pulmcrit/smart/ and https://www.thebottomline.org.uk/summaries/icm/smart/.


RESCUE-ICP (click to read the original paper)

  • Why is timing is everything (this vs DECRA)?
  • What is the good life?
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