Aggressive fluid therapy in Acute Pancreatitis is harmful

Enrique de-Madaria, M.D., Ph.D., James L. Buxbaum, M.D., Patrick Maisonneuve, Dipl.Eng., Ana García García de Paredes, M.D et el published study in NEJM comparing aggressive versus moderate fluid therapy in Acute pancreatitis.  BACKGROUND Early aggressive hydration is widely recommended for the management of acute pancreatitis.  This is based on animal model observation of regional hypoperfusion … Read more

Restrictive versus Liberal fluids in Septic shock

Tine S. Meyhoff, Peter B. Hjortrup et el(Classic Trial Group-Conservative versus Liberal Approach to Fluid Therapy of Septic Shock in Intensive Care) published study in NEJM comparing restrictive vs standard fluid therapy in septic shock. WHAT This was an international, stratified, parallel-group, open-label, randomized clinical trial in 31 ICUs in Denmark, Norway, Sweden, Switzerland, Italy, … Read more

Difficult airway algorithm

The American Society of Anesthesiologists (ASA) released their much anticipated difficult airway guidelines.  The new guidelines emphasize following-  Oxygenation prior to and throughout attempts at airway management. Use of end tidal CO2 after each attempt at airway management, regardless of the airway device or technique used. The role of clinical measures (eg, chest rise and fall, … Read more

Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest

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

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

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