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

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

Vit C fails to deliver- VITAMINS trial

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

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

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