This randomized trial investigated two different thresholds for triggering transfusion in patients with septic shock: 9 g/dL or 7 g/dL. The lower threshold group received a median of 1 unit of blood compared to 4 in the higher threshold group. 90 day mortality rates and other morbidity were similar between the groups.
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Critical Care
October 8, 2014
The Comprehensive Complication Index (CCI) was compared to more standard methods of categorizing complications for their utility in assessing outcomes after randomized surgical trials. The CCI outperformed standard methods in 2 of 3 published randomized trials (pancreatic and esophageal surgery), demonstrating significant differences in outcomes whe
September 29, 2014
This randomized double-blind multicenter study involving 667 pts evaluated the utility of IV fenoldopam in reducing the rate of renal replacement therapy for patients undergoing cardiac surgery who exhibit postoperative acute kidney injury. Fenoldopam did not importantly reduce the need for renal replacement therapy or 30 day mortality. Its use was
August 25, 2014
This interesting overview points out the negative effects of adrenaline on outcomes in a number of observational and randomized studies of patients experiencing cardiac arrest. The author recommends using Vasopressin after the first dose of adrenaline during resuscitation from cardiac arrest.
August 11, 2014
In an effort to identify clinical findings associated with deterioration and mortality after PE, the authors prospectively monitored 298 pts admitted through the ED with documented PE. 34% of pts experienced clinical deterioration, which was associated with hypotension, hypoxia, residual DVT, CAD, and right heart strain on echocardiogram. In contra
August 6, 2014
This prospective trial from 14 ICUs in northern Europe evaluated the potential benefit of adding immune-modulating nutrients (IMHP) to standard enteral nutrition in reducing infectious complications in ventilated patients. The addition of IMHP did not alter the incidence of infectious complications, but was associated with much worse 6 month surviva
August 2, 2014
2014 consensus guidelines on the perioperative evaluation and management of patients undergoing NONCARDIAC surgery.
June 26, 2014
The cause of ischemic stroke remains elusive in up to 20-40% of cases. In patients with cryptogenic stroke, 8.9% of patients with long term monitoring using an insertable cardiac monitor were found to an episode of atrial fibrillation, which may have implications in therapy.
June 16, 2014
Using data from the Australian Cardiac Surgical Database, the authors provide further information regarding acute kidney damage after cardiac surgery. This study has added to the evidence that preoperative impairment, IABP use, red cell transfusion and infective endocarditis are predictive factors.
June 16, 2014
The rate of cerebral embolism in patients with acute infective endocarditis (AIE) was about one quarter on CT scanning, with about one third having silent emboli. This had an adverse impact on survival. Haemorrhagic transformation was low. The authors indicate CT scanning should be routine for all patients with AIE.