04:12 PM Dec 23rd
JAMA: RCT of calcium chloride (IO or IV) delivered during OHCA was not superior to N.S in terms of sustained return of spontaneous circulation, or longer term outcomes. Although not reaching statistical significance, and the caution required when interpreting results of a trial stopped early, calcium was associated with worse outcomes
02:12 PM Dec 23rd
JAMA BOUGIE Trial bougie as ETT introducer not superior to stylet for first pass intubation success in critically ill adults in a cohort of predominantly ER physician operators with median experience of 60 intubations. Surprisingly, and difficult to plausibly attribute causation, trend with bougie to improved short-term cardiovascular outcomes, decreased ICU LOS and increased ventilator free days.
01:12 PM Dec 23rd
JAMA COVID: Open label RCT comparing HFNC to conventional oxygen in adult patients with severe COVID reported HFNC associated with significant improvement in terms of the need for intubation, 28-day clinical recovery, and 28-day VFDs
01:12 PM Dec 22nd
JAMA COVID ECMO: Overall this thoughtful and expert viewpoint offers a response to the data reporting increasing duration and mortality of ECMO observed during COVID, in the absence of comparator and baseline data to allow us to elucidate reasons. 1. Regular review candidacy criteria and outcomes 2. Optimise regional capability 3. Robust trials. Understanding the best place for ECMO in the COVID algorithm is yet to be determined
05:11 PM Nov 23rd
JAMA Viewpoint - “How will we know if we succeed?”. How can we progress the efficacy of physician wellbeing, if we only measure major outcomes - patient mortality and physician burnout. We need to add and validate intermediate outcome measures, and this viewpoint makes the case beautifully.