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Multicenter, unblinded, randomized trial of patients with moderate to
severe ARDS
Their aim was to determine the efficacy and safety of early neuromuscular blockade (NMB) with heavy sedation c.f. use of lighter sedation targets without NMB
Read 24 tweets
This week's #Twitterjournalclub was prepared by @alexlin0528
It's the #HelpICUtrial (the hospital-based evaluation of laxative prophylaxis in ICU) which was published in the Journal of Critical Care 52 (2019) 86-91 doi.org/10.1016/j.jcrc…
570 adult mechanically ventilated and enterally fed patients were enrolled
Single ICU: cluster-crossover trial. Three pods in a single ICU each randomized to one of 3 regimens for 4 months with rolling crossover.
Participants were randomly allocated to:
A-One coloxyl with senna BD from day one, OR
B-Two coloxyl with senna + 20ml lactulose BD from day 3, OR
C-Two coloxyl with senna + 20ml lactulose BD from day 6
Read 9 tweets
Here is this week's @WellingtonICU #Twitterjournalclub prepared by Rosanna Rahman. We are so committed, we don't even stop for #SMACC
thelancet.com/journals/lanre…
Patients with acute hypoxemic respiratory failure (PaO2:FiO2 ratio ≤300mmHg) frequently require intubation in the intensive care unit.
Rapid sequence intubation (RSI) in the acute setting is associated with a high risk of life-threatening complications. Severe hypoxaemia (SpO2<80% for ≥5sec) occurs in 20-25% of patients and is associated with hypoxia-driven cardiac arrest.
Read 21 tweets
Bienvenidos al #twitterjournalclub de la #FFCHI. Esta semana vamos a discutir el #ANDROMEDA-SHOCK trial por Hernandez et al., publicado JAMA en febrero

jamanetwork.com/journals/jama/…

Autor: @jdianti
@jdianti El shock séptico es una entidad de elevada prevalencia y mortalidad y reanimación precoz y adecuada son factores claves para prevenir la progresión de la FMO y muerte en estos pacientes. 1/13
La #SSC sugiere utilizar el clearance de lactato como un objetivo de reanimación. Sin embargo, la su utilidad como guía en la reanimación está discutida

ncbi.nlm.nih.gov/pubmed/29754310
Read 14 tweets
Hypoxaemia is a potential contributing factor in peri-procedural cardiac arrest and death. RSIs involve delay of 45-90 secs between administration of drugs and laryngoscopy, during which time patient becomes apnoeic.
There are concerns that bag-mask ventilation between induction and laryngoscopy may increase aspiration risk. Previous studies to investigate this have been limited to healthy anaesthetised volunteers.
Read 23 tweets
#twitterjournalclub
The ANDROMEDA- SHOCK Randomised Clinical Trial
Thoughts by @z_cepillo
jamanetwork.com/journals/jama/…
Multicentre (28) open label RCT to determine if peripheral perfusion targeted resuscitation during early septic shock in adults is more effective than a lactate-targeted resuscitation for reducing mortality.
Inclusion criteria: adult patients with septic shock (infection, lactate >2, vasopressors to maintain MAP >65mmHg after IV fluid of 20ml/kg over 60 mins.
Read 26 tweets

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