Thread by @tscquizzato

4 RCTs published in the last few hours you can’t miss if you work with critically ill patients:

#1 Fluids in septic shock
#2 Mobilisation and long-term cognitive impairment
#3 NIV for extubation of obese patients
#4 Nutrition before extubation

A thread 🧵👇

#FOAMcc #SCCM2023

#1

#CLOVERStrial compared a restrictive fluid strategy (with early vasopressors) to a liberal one in septic shock patients.

➡️ Restrictive fluid strategy (with early vasopressors) did not result in significantly lower (or higher) mortality

🔗 nej.md/3CWSXBA

#FOAMcc

#2

What’s the effect of early mobilisation on long-term cognitive impairment in ICU survivors after mechanical ventilation?

➡️ Early mobilisation improved long-term cognitive impairment at 1 y (24% vs 43%) but increased adverse events (6%)

🔗 bit.ly/3CYIZQ7

#FOAMcc

#3

Does NIV (alternated with HFNO or standard O2) reduce treatment-failure in obese ICU pts undergoing extubation compared to HFNO or standard O2 alone?

➡️ NIV reduced treatment failure (e.g., reintubation) within 3 days after extubation

🔗 bit.ly/3QQg8mM

#FOAMcc

#4

Does continued enteral nutrition vs fasting (max gastric vacuity) before extubation reduce extubation failure (reintubation or death) within 7d in ICU pts?

➡️ Continued enteral nutrition until extubation was non-inferior to a 6 h fasting

🔗 bit.ly/3kqTup5

#FOAMcc

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