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The Bottom Line https://staging-thebottomlineh.kinsta.cloud A compendium of critical appraisals in Intensive Care Medicine research and related specialties Tue, 04 Jan 2022 14:10:36 +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 The Bottom Line https://staging-thebottomlineh.kinsta.cloud 32 32 Critical Care Evidence Updates – December 2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-december-2021/?utm_source=rss&utm_medium=rss&utm_campaign=critical-care-evidence-updates-december-2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-december-2021/#respond Tue, 04 Jan 2022 14:10:36 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10239 What’s new in the Critical Care literature – monthly updates]]> https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-december-2021/feed/ 0 PALACS https://staging-thebottomlineh.kinsta.cloud/summaries/icm/palacs/?utm_source=rss&utm_medium=rss&utm_campaign=palacs https://staging-thebottomlineh.kinsta.cloud/summaries/icm/palacs/#respond Fri, 31 Dec 2021 01:04:56 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10192   Posterior left pericardiotomy for the prevention of atrial fibrillation after cardiac surgery Mario Gaudino, The Lancet Dec 4 2021; 398: 2075–83 https://doi.org/10.1016/S0140-6736(21)02490-9 Clinical Question In selected patients undergoing cardiac surgery, does posterior left pericardiotomy compared with usual care, reduce the incidence of postoperative atrial fibrillation? Background Atrial fibrillation is common following cardiac surgery with approximately one-third of patients developing […]]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/palacs/feed/ 0 CONTROLING 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 Critical Care Evidence Updates – November 2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-november-2021/?utm_source=rss&utm_medium=rss&utm_campaign=critical-care-evidence-updates-november-2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-november-2021/#respond Thu, 16 Dec 2021 10:54:55 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10215 What’s new in the Critical Care literature – monthly updates]]> https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-november-2021/feed/ 0 COMBAT-COVID https://staging-thebottomlineh.kinsta.cloud/summaries/combat-covid/?utm_source=rss&utm_medium=rss&utm_campaign=combat-covid https://staging-thebottomlineh.kinsta.cloud/summaries/combat-covid/#respond Fri, 10 Dec 2021 10:36:49 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10166 In mechanically ventilated patients with COVID-19 and severe endotheliopathy, does prostacylin compared with placebo, improve days alive without ventilation by day 28?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/combat-covid/feed/ 0 COCA https://staging-thebottomlineh.kinsta.cloud/summaries/coca/?utm_source=rss&utm_medium=rss&utm_campaign=coca https://staging-thebottomlineh.kinsta.cloud/summaries/coca/#respond Fri, 03 Dec 2021 16:20:28 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10160 In patients with out-of-hospital cardiac arrest, does calcium compared with placebo, improve sustained return of spontaneous circulation?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/coca/feed/ 0 Critical Care Evidence Updates – October 2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-october-2021/?utm_source=rss&utm_medium=rss&utm_campaign=critical-care-evidence-updates-october-2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-october-2021/#respond Thu, 18 Nov 2021 13:31:28 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10157 What’s new in the Critical Care literature – monthly updates ]]> https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-october-2021/feed/ 0 SILENCE https://staging-thebottomlineh.kinsta.cloud/summaries/silence/?utm_source=rss&utm_medium=rss&utm_campaign=silence https://staging-thebottomlineh.kinsta.cloud/summaries/silence/#respond Wed, 17 Nov 2021 10:45:28 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9874 In patients near end of life, does subcutaneous scopolamine butylbromide compared with placebo, reduce the incidence of death rattle?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/silence/feed/ 0 SNOCAT https://staging-thebottomlineh.kinsta.cloud/summaries/snocat/?utm_source=rss&utm_medium=rss&utm_campaign=snocat https://staging-thebottomlineh.kinsta.cloud/summaries/snocat/#respond Fri, 22 Oct 2021 13:31:38 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9594 Effect of Out-of-Hospital Sodium Nitrite on Survival to Hospital Admission After Cardiac Arrest: A Randomized Clinical Trial Kim @uwcardiology. JAMA. 2021 January 12;325(2):138-145. doi: 10.1001/jama.2020.24326. Clinical Question In patients with out-of-hospital cardiac arrest, does sodium nitrite, compared with placebo, improve survival to hospital admission? Background Out-of-hospital cardiac arrest continues to have a high risk of morbidity and mortality Nitrate therapy […]]]> https://staging-thebottomlineh.kinsta.cloud/summaries/snocat/feed/ 0 VAM-IHCA 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 COAST https://staging-thebottomlineh.kinsta.cloud/summaries/coast/?utm_source=rss&utm_medium=rss&utm_campaign=coast https://staging-thebottomlineh.kinsta.cloud/summaries/coast/#respond Fri, 08 Oct 2021 15:16:10 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9869 In hypoxic African children (oxygen saturations of between 80 and 91%) with pneumonia, does oxygen therapy reduce mortality when compared with a permissive hypoxia (no oxygen) strategy? In severely hypoxic children (oxygen saturations less than 80%), does high-flow nasal therapy reduce mortality when compared with low-flow oxygen therapy?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/coast/feed/ 0 Critical Care Evidence Updates – September 2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-september-2021/?utm_source=rss&utm_medium=rss&utm_campaign=critical-care-evidence-updates-september-2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-september-2021/#respond Wed, 06 Oct 2021 08:51:12 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=10080 What’s new in the Critical Care literature – monthly updates]]> https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-september-2021/feed/ 0 COVERT MI https://staging-thebottomlineh.kinsta.cloud/summaries/covert-mi/?utm_source=rss&utm_medium=rss&utm_campaign=covert-mi https://staging-thebottomlineh.kinsta.cloud/summaries/covert-mi/#respond Mon, 04 Oct 2021 19:56:41 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9944 In patients who present with an acute STEMI  and are referred for percutaneous coronary intervention (PCI), does colchicine in comparsion with placebo reduce myocardial injury?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/covert-mi/feed/ 0 RECOVERY REGEN-COV https://staging-thebottomlineh.kinsta.cloud/summaries/recovery-regen-cov/?utm_source=rss&utm_medium=rss&utm_campaign=recovery-regen-cov https://staging-thebottomlineh.kinsta.cloud/summaries/recovery-regen-cov/#respond Thu, 30 Sep 2021 21:29:01 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9857 Casirivimab and imdevimab in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial @PeterHorby. medRxiv pre-print 2021 doi: https://doi.org/10.1101/2021.06.15.21258542 Clinical Question In hospitalised patients with COVID-19, does the addition of monoclonal antibodies REGEN-COV (carsirivimab & imdevimab) to standard care, compared with standard care alone, improve 28 day mortality? Background Monoclonal antibodies have been shown to be […]]]> https://staging-thebottomlineh.kinsta.cloud/summaries/recovery-regen-cov/feed/ 0 The REST Trial https://staging-thebottomlineh.kinsta.cloud/summaries/icm/the-rest-trial/?utm_source=rss&utm_medium=rss&utm_campaign=the-rest-trial https://staging-thebottomlineh.kinsta.cloud/summaries/icm/the-rest-trial/#comments Mon, 13 Sep 2021 07:08:00 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9920 In mechanically ventilated patients with acute hypoxaemic respiratory failure, does lowering tidal volume using extracorporeal carbon dioxide removal, compared with conventional low tidal volume ventilation, improve day 90 all-cause mortality?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/the-rest-trial/feed/ 1 COVID STEROID 2 https://staging-thebottomlineh.kinsta.cloud/summaries/covid-steroid-2/?utm_source=rss&utm_medium=rss&utm_campaign=covid-steroid-2 https://staging-thebottomlineh.kinsta.cloud/summaries/covid-steroid-2/#respond Thu, 09 Sep 2021 09:38:49 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9836 In patients with severe COVID, does 12mg dexamethasone vs 6mg dexamethasone increase the number of days alive without life support at 28 days?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/covid-steroid-2/feed/ 0 COV-BARRIER https://staging-thebottomlineh.kinsta.cloud/summaries/icm/cov-barrier/?utm_source=rss&utm_medium=rss&utm_campaign=cov-barrier https://staging-thebottomlineh.kinsta.cloud/summaries/icm/cov-barrier/#respond Thu, 09 Sep 2021 09:31:21 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9932 In hospitalised adult patient with COVID-19, does baricitinib compared with placebo decrease a composite outcome of progression of illness and mortality?]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/cov-barrier/feed/ 0 TOMAHAWK 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 Critical Care Evidence Updates – August 2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-august-2021/?utm_source=rss&utm_medium=rss&utm_campaign=critical-care-evidence-updates-august-2021 https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-august-2021/#respond Sat, 04 Sep 2021 16:29:00 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9923 What's new in the Critical Care literature - monthly updates ]]> https://staging-thebottomlineh.kinsta.cloud/blog/critical-care-evidence-updates-august-2021/feed/ 0 DOREMI https://staging-thebottomlineh.kinsta.cloud/summaries/icm/doremi/?utm_source=rss&utm_medium=rss&utm_campaign=doremi https://staging-thebottomlineh.kinsta.cloud/summaries/icm/doremi/#respond Thu, 02 Sep 2021 08:36:25 +0000 https://staging-thebottomlineh.kinsta.cloud/?p=9806 Milrinone as compared with Dobutamine in the Treatment of Cardiogenic Shock  Matthew. N Engl J Med 2021; 385:516-525, doi: 10.1056/NEJMoa2026845 Clinical Question In patients with cardiogenic shock, does milrinone as compared with dobutamine improve the composite outcome of in-hospital death, resuscitated cardiac arrest, receipt of cardiac transplant or mechanical circulatory support, non-fatal myocardial infarction, cerebrovascular event or renal replacement therapy? […]]]> https://staging-thebottomlineh.kinsta.cloud/summaries/icm/doremi/feed/ 0