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https://staging-thebottomlineh.kinsta.cloud A compendium of critical appraisals in Intensive Care Medicine research and related specialties Fri, 17 Dec 2021 11:54:47 +0000 en-GB hourly 1 https://wordpress.org/?v=5.8.14 https://staging-thebottomlineh.kinsta.cloud/wp-content/uploads/2016/05/cropped-tbl-favicon-2-32x32.png https://staging-thebottomlineh.kinsta.cloud 32 32 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/controling/?utm_source=rss&utm_medium=rss&utm_campaign=controling https://staging-thebottomlineh.kinsta.cloud/summaries/icm/controling/#respond Fri, 17 Dec 2021 11:54:47 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10194 Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study—a randomized clinical trial Bohé. Intensive Care Medicine 2021. https://doi.org/10.1007/s00134-021-06526-8 Clinical Question In critically unwell adults does targeting individualised glycaemic control compared to glycaemia < 180 mg/dL improve 90 day mortality? Background Hyperglycaemia has been shown to result in worse outcomes in the critically ill, especially in non-diabetic patients In […]]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/controling/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/vam-ihca/?utm_source=rss&utm_medium=rss&utm_campaign=vam-ihca https://staging-thebottomlineh.kinsta.cloud/summaries/icm/vam-ihca/#comments Fri, 15 Oct 2021 18:19:29 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10090 Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial Anderson et al. JAMA 2021. doi:10.1001/jama.2021.16628 Clinical Question In adult patients suffering an in-hospital cardiac arrest (IHCA) does the use of vasopressin and methylprednisolone compared to a placebo result in increased rates of return of spontaneous circulation (ROSC)? […]]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/vam-ihca/feed/ 1 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/tomahawk/?utm_source=rss&utm_medium=rss&utm_campaign=tomahawk https://staging-thebottomlineh.kinsta.cloud/summaries/icm/tomahawk/#respond Sun, 05 Sep 2021 06:31:48 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9882 Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation Desch S et al. NEJM 2021. DOI: 10.1056/NEJMoa2101909 Clinical Question In adults > 30 years old suffering out-of-hospital cardiac arrest (OOHCA) without ST elevation on their ECG does routine immediate coronary angiography compared to a delayed or selective approach to coronary angiography improve 30-day all-cause mortality? Background The DISCO pilot study showed […]]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/tomahawk/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/basics/?utm_source=rss&utm_medium=rss&utm_campaign=basics https://staging-thebottomlineh.kinsta.cloud/summaries/icm/basics/#respond Thu, 12 Aug 2021 07:24:50 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9753 In adult intensive care patients does the use of a balanced crystalloid compared to 0.9% saline reduce 90-day all-cause mortality? In adult intensive care patients needing administration of resuscitation fluids, does the slow infusion compared to a fast infusion of a fluid boluses reduce 90-day all-cause mortality?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/basics/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/pom/traap2/?utm_source=rss&utm_medium=rss&utm_campaign=traap2 https://staging-thebottomlineh.kinsta.cloud/summaries/pom/traap2/#respond Fri, 14 May 2021 22:55:04 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9568 In patients undergoing caesarean section (CS) does the administration of tranexamic acid (TXA) when compared to placebo result in a lower incidence of calculated estimated blood loss of red blood cell transfusion by day 2?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/pom/traap2/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/feisty/?utm_source=rss&utm_medium=rss&utm_campaign=feisty https://staging-thebottomlineh.kinsta.cloud/summaries/feisty/#respond Fri, 09 Apr 2021 13:40:09 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=9389 In adult trauma patients with major haemorrhage and hypofibrinogenaemia  does the use fibrinogen concentrate (FC) compared to cryoprecipitate (cryo) result in a shorter time to administration?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/feisty/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/arrest/?utm_source=rss&utm_medium=rss&utm_campaign=arrest https://staging-thebottomlineh.kinsta.cloud/summaries/icm/arrest/#comments Fri, 20 Nov 2020 10:20:11 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=9102 In adults suffering out of hospital cardiac arrest (OHCA) presenting with an initial rhythm of VF or pulseless VT, does the implementation of early ECMO facilitated resuscitation compared to standard ACLS resuscitation improve survival to hospital discharge?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/arrest/feed/ 2 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/itactic/?utm_source=rss&utm_medium=rss&utm_campaign=itactic https://staging-thebottomlineh.kinsta.cloud/summaries/icm/itactic/#respond Wed, 21 Oct 2020 09:26:22 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=9015 In adult trauma patients presenting with signs of haemorrhagic shock does the utilisation of a viscoelastic haemostatic assay (VHA) augmented transfusion strategy compared to a strategy augmented by conventional coagulation tests (CCT) result in an increased number of patients alive and free of massive transfusion at 24 hours?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/itactic/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/midas/?utm_source=rss&utm_medium=rss&utm_campaign=midas https://staging-thebottomlineh.kinsta.cloud/summaries/midas/#respond Fri, 18 Sep 2020 15:41:38 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=8875 In patients aged > 18 years who were unable to be liberated from vasopressors for 24 hours, did the addition of midodrine when compared to a placebo result in the earlier discontinuation of vasopressors?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/midas/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/blog/ebm/bayesian-statistics/?utm_source=rss&utm_medium=rss&utm_campaign=bayesian-statistics https://staging-thebottomlineh.kinsta.cloud/blog/ebm/bayesian-statistics/#respond Fri, 11 Sep 2020 15:10:18 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=8894 Bayesian Statistics “Under Bayes’ Theorem, no theory is perfect. Rather it is a work in progress, always subject to refinement and further testing” Nate Silver Introduction With the recent publication of the REMAP-CAP steroid arm and the Bayesian post-hoc re-analysis of the EOLIA trial, it appears Bayesian statistics are appearing more frequently in critical care trials. The purpose of this […]]]> https://staging-thebottomlineh.kinsta.cloud/blog/ebm/bayesian-statistics/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/remap-cap/?utm_source=rss&utm_medium=rss&utm_campaign=remap-cap https://staging-thebottomlineh.kinsta.cloud/summaries/remap-cap/#respond Fri, 11 Sep 2020 15:08:39 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=8909 In patients with severe COVID-19, does intravenous hydrocortisone (either as a fixed dose or restricted to when shock is clinically evident) compared with standard care, improve 21-day organ support free days?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/remap-cap/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/em/timing-of-endoscopy-for-acute-upper-gastrointestinal-bleeding/?utm_source=rss&utm_medium=rss&utm_campaign=timing-of-endoscopy-for-acute-upper-gastrointestinal-bleeding https://staging-thebottomlineh.kinsta.cloud/summaries/em/timing-of-endoscopy-for-acute-upper-gastrointestinal-bleeding/#respond Thu, 20 Aug 2020 12:28:24 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=8732 In patients with acute upper GI (UGI) bleeding and a Glasgow-Blatchford score ≥ 12, does endoscopy performed within 6 hours of gastroenterological consultation, compared with endoscopy performed within 6 - 24 hours have a lower 30 day mortality?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/em/timing-of-endoscopy-for-acute-upper-gastrointestinal-bleeding/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/halt-it/?utm_source=rss&utm_medium=rss&utm_campaign=halt-it https://staging-thebottomlineh.kinsta.cloud/summaries/halt-it/#comments Fri, 26 Jun 2020 19:38:32 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=8609 In patients with gastrointestinal (GI) bleeding does high dose tranexamic acid (TXA) when compared to a placebo reduce mortality from GI bleeding?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/halt-it/feed/ 1 https://staging-thebottomlineh.kinsta.cloud/summaries/crash-3/?utm_source=rss&utm_medium=rss&utm_campaign=crash-3 https://staging-thebottomlineh.kinsta.cloud/summaries/crash-3/#comments Sat, 09 Nov 2019 08:10:49 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=7920 Effects of tranexamic acid on death, disability, vascular occlusive events and other morbidities in patients with acute traumatic brain injury (CRASH – 3): a randomised, placebo-controlled trial The CRASH-3 trial collaborators. The Lancet, 2019; doi.org/10.1016/S1040-6736(19)32233-0 Clinical Question In patients with traumatic brain injury (TBI), does the administration of tranexamic acid (TXA) under 3 hours from injury, compared with placebo, reduce […]]]> https://staging-thebottomlineh.kinsta.cloud/summaries/crash-3/feed/ 1 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/scarlet/?utm_source=rss&utm_medium=rss&utm_campaign=scarlet https://staging-thebottomlineh.kinsta.cloud/summaries/icm/scarlet/#respond Fri, 14 Jun 2019 22:23:46 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=7589 In adult patients with sepsis-associated coagulopathy does the administration of human recombinant thrombomodulin (rhsTM) compared to placebo reduce 28 day mortality?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/scarlet/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/tich-2/?utm_source=rss&utm_medium=rss&utm_campaign=tich-2 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/tich-2/#respond Fri, 08 Mar 2019 12:00:45 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=6583 In adults with acute, spontaneous intra-cerebral haemorrhage (ICH), does the administration of tranexamic acid (TXA) compared to a placebo improve functional status at 90 days?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/tich-2/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/paramedic2/?utm_source=rss&utm_medium=rss&utm_campaign=paramedic2 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/paramedic2/#comments Fri, 27 Jul 2018 12:00:56 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=6224 In adult patients with out-of-hospital cardiac arrest (OOHCA), does the administration of epinephrine compared to placebo improve survival?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/paramedic2/feed/ 2 https://staging-thebottomlineh.kinsta.cloud/summaries/icm/stockl/?utm_source=rss&utm_medium=rss&utm_campaign=stockl https://staging-thebottomlineh.kinsta.cloud/summaries/icm/stockl/#respond Fri, 04 May 2018 12:00:44 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=5689 In adult patients post out of hospital cardiac arrest does a continuous or on demand application of neuromuscular blockade (NMB) reduce the number of shivering episodes during targeted temperature management (TTM)?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/stockl/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/pom/atacas-txa/?utm_source=rss&utm_medium=rss&utm_campaign=atacas-txa https://staging-thebottomlineh.kinsta.cloud/summaries/pom/atacas-txa/#respond Fri, 29 Sep 2017 12:00:18 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=3745 In adult patients undergoing elective coronary-artery surgery does tranexamic acid (TXA) compared to a placebo increase the risk of death or thrombotic complications within the first 30 days after surgery?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/pom/atacas-txa/feed/ 0 https://staging-thebottomlineh.kinsta.cloud/summaries/pom/atacas-asp/?utm_source=rss&utm_medium=rss&utm_campaign=atacas-asp https://staging-thebottomlineh.kinsta.cloud/summaries/pom/atacas-asp/#respond Fri, 29 Sep 2017 12:00:00 +0000 http://staging-thebottomlineh.kinsta.cloud/?p=3389 In adults undergoing elective coronary artery graft surgery does the administration of aspirin prior to surgery compared to a placebo result in increased mortality or thrombotic complications?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/pom/atacas-asp/feed/ 0