Another really busy week with various meetings going on around the world. This is a selection offering you an insight into what has been going on out there recently, and do remember that many of the Twitter shots contain clickable links! Lots of POCUS, as well as lots of new papers and reviews from Critical... Continue Reading →
There has been a lot of action on the POCUS front, as well as some of the usual fabulous and bountiful FOAM Tweets this week and last. We have had a lot of activity over the last couple of months and a massive thanks to you all for supporting us. We are up to around... Continue Reading →
A bad week on ICU! Pericardial tamponades, many of the sickest patients I have seen for quite some time, tight aortic valves and a lot of POCUS!!! So..a lot going on this week, but I have been trawling and hope this gives you an idea of what's been going on? Make sure the kids are... Continue Reading →
Loads to get through here...so if you're looking at this in theatre (ensuring your patient is safe as No. 1 priority, obviously), you are probably doing it during a long case. To the rest of you, grab a large coffee and relax as you read. Lots of the screenshots may also have links, so do... Continue Reading →
More top picks for you all....more coming next week! Enjoy. JW Big papers 5 days...is that too long?? URANGA - Take a look at this as ever fabulous bit of work from the crew at TBL. Looking at duration of Abx therapy in pneumonia. See here. FICE & Echo RAP measurement made easy! Here is... Continue Reading →
There is a lot to look at here, but these are the main points to take home and to follow. A fair amount of expert work went into these recommendations from some of the biggest names in the field.The original document can be found below. 2017-surviving-sepsis-recommendations A. INITIAL RESUSCITATION 1. Sepsis and septic shock are... Continue Reading →
We are going to try to produce regular sections on the best of FOAMed. Here's the first! Sit down with a coffee and enjoy....more to come! Great Papers Fits or frozen?! The Bottom Line Crew (Adrian Wong), debate the HYBERNATUS Study looking at whether we should cool status patients to improve outcome. Thanks again team see... Continue Reading →
Take a look at our Top Papers section to see some of the best evidence out there, as adjudged by us and also from deep perusal of Critical Care Reviews site. Thanks to them!! We will try to keep this as up to date as possible...missing papers you think should be included...let us know?!
Glycaemic control in Critical Care In the ICU world we obsess and quite rightly, on physiology and correcting what is deranged. There is a vast abundance and ever accumulating bank of research out there focussing on the gold standard...morbidity and mortality and how we can reduce it. As a result we have looked at, to... Continue Reading →
Thanks to the guys at the Bottom Line again for their analysis of this interesting trial. Please see here for what they say and see here for the IRONMAN trial. Thoughts from us on this.... There will certainly be less Guinness coloured stools amongst your ITU patients now!! It is rather a shame this made... Continue Reading →
There's a lot here, so bare with us. Each is colour coded for ease of sifting and we offer our take on each abstract too. A lot of hard work was presented within many different fields. Thanks to Critical Care for this! Colour key: Green = Observational logistics studies Red = Genetic studies Purple =... Continue Reading →
via The BHAT: Propranolol after acute myocardial infarction [Classics Series] | 2 Minute Medicine Just thought I'd start to pick out some of these. If you haven't checked out 2 minute medicine's stuff, you should. This has to be a dead cert to double check on in any of your patients who have suffered a... Continue Reading →
WHATS IT ABOUT? The maintenance of optimal blood volume without the development of a positive fluid balance is something we are all striving to achieve for our critically ill patients. Sick patients become 'leaky' and we continue to fill them with fluids, chasing a worsening situation as they seem hypovolaemic. They get: Large... Continue Reading →
via Communicating with conscious and mechanically ventilated critically ill patients: a systematic review | Critical Care | Full Text Topical and in my eyes, an area massively neglected at times. Patients lie in front of us, 'wired for sound' as we massage the monitors and attempt to normalise their physiological parameters. Speaking from my point of... Continue Reading →
A study carried out in an academic county hospital in the US examined the associations between volume overload on ICU discharge, mobility limitation and discharge to a healthcare facility amongst survivors of septic shock. Septic shock is commonplace in critical care and indeed, its incidence is on the increase. With this however, we are seeing... Continue Reading →
This trial is worth a read. Courtesy of critical care (Click Icon) Basically They wanted to see whether sepsis-associated ARDS patients had better outcomes when given Hydrocortisone therapy. Methods They randomised patients to receive either hydrocortisone 50 mg every 6 h or placebo. What they demonstrated The patients who got hydrocortisone had significant improvement P:F ratios and... Continue Reading →
So we all hang on this as a prognosticator, as well as a gauge of the state of our patients both on the unit and prior to coming up to us. But should we be focussing on Lactate as much as we think we should? Is it the 'magic bullet' to adequate resuscitation? A bit... Continue Reading →
Intro... There has been a lot of discussion regarding the LEOPARDS trial on FOAMed recently. Particularly after the ESICM meeting in Milan. The drug Levosimendan was thought to be of some hope in the treatment of sepsis...to better current Vaso/Inotherapy we currently use (starving coronary blood flow, pushing the heart too hard and causing horrendous... Continue Reading →
Intro I am always asked by vigilant ITU trainees of all grades, 'should we give some albumin here; what do you think?'. In answer, my response is normally...no, it has no mortality benefit at all. But am I being harsh? Physiology for dummies! So albumin: Maintains the oncotic pressure (+ plasma volume) in blood vessels... Continue Reading →
A recent editorial discusses the thorny issue of fluid resuscitation. Notably, there is still no consensus about the major aspects of fluid resuscitation. It's the usual rigmarole we face....no clarity about when to start and stop fluids, how to guide them or even how much to give. The bulk of the research has been focused on comparing... Continue Reading →
