ECMO in refractory out of hospital VFib cardiac arrest

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

Covid 19 : Current Knowledge and gaps

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

Update in cardiac resuscitation : New CPR Guidelines

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

Tranexamic Acid fails to work in Gastrointestinal hemorrhage

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

COVID 19 for critical care

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

Intense renal replacement therapy may lead to delayed extubation

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

IV Thiamine fails again in Septic Shock

Miyamoto, Yoshihisa, Aso, Shotaro et el published results of retrospective Cohort study in critical care medicine. With ongoing covid 19, all possible medications are being tried for which they were not originally intended. Similarly several medications have been tried in septic shock but failed. Recent trial was discussed here. Given there was a lot of … Read more

Thiamine supplementation in critically ill may reduce incidence of delirium. Read more
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