Author: RS

Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest

Bruno François, Alain Cariou, Raphaël Clere-Jehl et el published a trial of  intravenous amoxicillin-clavulanate versus placebo  in patients undergoing  targeted temperature management and mechanical ventilation for out of hospital cardiac arrest  with shockable rhythm. BACKGROUND  Targeted temperature management remains  cornerstone of therapy for  out of hospital cardiac arrest.  however targeted temperature management is associated with …

Read More Prevention of Early Ventilator-Associated Pneumonia after Cardiac Arrest

IDSA/ATS guidelines for community acquired pneumonia

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 IDSA/ATS guidelines for community acquired pneumonia

Targeted Temperature Management in Cardiac Arrest with Nonshockable Rhythm

J.B. Lascarrou, H. Merdji, A. Le Gouge et el published the results of HYPERION (Hypothermia after Cardiac Arrest in Nonshockable Rhythm) trial in NEJM. WHAT Open-label, randomized, controlled trial comparing moderate therapeutic hypothermia (33°C during the first 24 hours) with targeted normothermia (37°C) in adult patients with coma(GCS <8) after resuscitation from cardiac arrest with …

Read More Targeted Temperature Management in Cardiac Arrest with Nonshockable Rhythm

Critical care trials which showed reduced mortality

Carlos A. Santacruz, Adriano J. Pereira et el published a systematic review in Critical Care Medicine about trials which showed reduced mortality. All trials published since inception to April, 2019 were searched in MEDLINE and pubmed (Adult, multicenter randomized controlled). A total of 212 trials were included. 27 trials reported reduction in mortality. 16 trials …

Read More Critical care trials which showed reduced mortality

Inferior Vena Caval filters in Severely injured patients

Kwok M. Ho, Sudhakar Rao, Stephen Honeybul Whereet el published results of a multicenter randomized trial of early prophylactic IVC filters in severely injured patients with contraindication to anticoagulation  in NEJM. BACKGROUND Venous thromboembolism is very common after major trauma and leads to major morbidity and mortality. In the prospective study of trauma patients who …

Read More Inferior Vena Caval filters in Severely injured patients

Dexmedetomidine in Critically Ill patients

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 Dexmedetomidine in Critically Ill patients

Paralytics in ARDS

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 Paralytics in ARDS

Newer Antibiotics for Acute Skin Infections

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 Newer Antibiotics for Acute Skin Infections

Newer Antibiotics for Community Acquired Pneumonia

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 Newer Antibiotics for Community Acquired Pneumonia