04:07 PM Jul 31st
JAMA OPTIMAL Trial - High vs low dose infusion TXA for adults undergoing cardiac surgery with bypass associated modest, significant decrease red cell transfusion proportion, and non-inferiority for composite 30-day mortality, seizure, renal dysfunction and thrombotic events. Proportion post-operative seizures in secondary and post-hoc analysis requires further consideration.
12:06 PM Jun 28th
JAMA NITRIC Trial: Among 1371 infants undergoing congenital heart surgery requiring CPB, delivery of nitric oxide into the CPB did not increase ventilator-free survival censored at 28 days. No benefit in secondary outcomes or subgroups was observed, including subgroup of children less than 6-weeks.
10:06 AM Jun 28th
JAMA Viewpoint: Surrogate decision-making is difficult. Respecting the authenticity and sovereignty of advance care directives,. Juggling these with the emotional burden of conflicting family morals during substituted judgement. Wendler expertly provides us the hierarchy of values for autonomy in treatment decision-making - non-intrusion, sovereignty, authenticity, best interest, moral standing - and urges us to consider them in our care.
02:06 PM Jun 23rd
NEJM LOVIT IV vitamin C in critically ill patients with sepsis requiring vasopressors associated increased risk of death or organ dysfunction at D28 vs placebo. Secondary outcomes including biomarkers identify no mechanism. Only RCT reporting benefit is CITRIS-ALI (lung injury), with no benefit septic shock (LOVIT, VITAMINS, ACTS, VICTAS). Ongoing COVID-19 and ARDS trials may further elucidate.
01:06 PM Jun 23rd
NEJM CLASSIC Trial: No difference 90-day mortality or serious adverse events among patients who received restricted fluid therapy vs standard therapy. The two groups had similar survival durations without life support and after hospital discharge at 90 days