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Critical Care Journal Club Blog

The goal of this blog is to inform and briefly discuss new papers in Adult and Pediatric Critical Care and Hospital Medicine.
  • Two papers regarding definition of ARDS- JAMA (criteria) + AJRCCM (autopsy findings to validate these criteria). It would be nice to do both papers together. I like the autopsy paper - quite impressive to see that a lot of patients that were thought to have ARDS simply had bad pneumonia or pulmonary edema + allows us to discuss sensitivity and specificity of a test. http://jama.jamanetwork.com/article.aspx?articleid=1160659 http://www.atsjournals.org/doi/abs/10.1164/rccm.201211-1981O

  • http://www.nejm.org/doi/full/10.1056/NEJMoa1302854 There have 2 nice papers - this RCT and a previous observational study led by David Wallace and Jeremy looking at this issue. Maybe worth discussing together.

  • http://www.nejm.org/doi/full/10.1056/NEJMoa1214609 Wondered about how fast and aggressively to control BP in ICH. Would have important implications for NICU population.

  • http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60592-9/fulltext?elsca1=ETOC-LANCET&elsca2=email&elsca3=E24A35F Interesting synopsis of the literature looking at risk of DVT with PICC lines .... seems like the risk is quite high compared to central lines in critically ill patients

  • Interesting study for discussion. There has been some debate as to whether proning really impacts patient outcomes or is just a temporizing measure. A few years ago, Taccone et al published an RCT suggesting a trend towards reduced mortality specially in the sickest (i.e. more severe ARDS) patients, and a meta-analysis found benefit. The PROSEVA study brings new information to the table which may impact our daily practice. http://www.nejm.org/doi/full/10.1056/NEJMoa1214103?query=OF

  • Interesting study and good commentary.....case for 'personalized hemodynamic targets'? 1. Increasing mean arterial blood pressure in sepsis: effects on fluid balance, vasopressor load and renal function. Corrêa TD, Vuda M, Takala J, Djafarzadeh S, Silva E, Jakob SM. Crit Care. 2013 Jan 30;17(1):R21 2. Target blood pressure in sepsis: between a rock and a hard place. Beloncle F, Lerolle N, Radermacher P, Asfar P. Crit Care. 2013 Mar 26;17(2):126

  • One of the only RCTs on this topic. Paper reveals no difference in IL-6 levels, no difference in mortality, no difference in length of stay. Interestingly, mortality benefit in those already on statins who were randomized to continued statin therapy vs. receiving placebo. http://www.atsjournals.org/doi/abs/10.1164/rccm.201209-1718OC

  • Another negative nutrition trial and possible harm with glutamine. A Randomized Trial of Glutamine and Antioxidants in Critically Ill Patients. http://www.nejm.org/doi/full/10.1056/NEJMoa1212722 We discussed some nutrition papers previously, including the EDEN trial. http://www.nejm.org/doi/full/10.1056/NEJMoa1102662

  • Hi folks, Welcome to the Journal Club Blog for our department. The goal of this blog is to briefly discuss important papers and serve as a resource for fellows to choose papers for journal club. Ground rules: Keep discussion brief (500 words) and courteous. Provide links to articles for others to retrieve and avoid posting sensitive info (site isn't password protected). Happy blogging!! Let Christy and me know about any problems/suggestions. Sachin