Papers of January 2019

Happy New Year!! Hopefully you got a bit of downtime over the festive period and are feeling suitably refreshed and ready to attack 2019!

We’ve got 3 great papers to kick off the year. First up we look at the recent PReVENT trial which looks at ventilator strategies in patients without ARDS with respect to tidal volumes. This paper continues the work from the much cited ARDSNet paper from 2000, and we’d highly recommend you go and have a look at that paper first.

Next we look at another paper from JAMA which compares Thrombolysis to Aspirin in minor non-disabling strokes. We say enough about this one in the podcast, but for a bit of background to our thoughts and the evidence surrounding stroke, check out our previous Stroke Thrombolysis podcast.

Lastly we have a look at a paper investigating their systems use of push-dose-pressors, which whilst not the most methodologically sound piece of research, certainly brings out some interesting thoughts and points.

As always make sure you take a look at the papers yourselves and we’d love to hear and comments or feedback you’ve got.

Enjoy!

Simon & Rob

References & Further Reading

Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in Intensive Care Unit Patients Without ARDS: A Randomized Clinical Trial. JAMA. 2018 Writing Group for the PReVENT Investigators

Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. Acute Respiratory Distress Syndrome Network. N Engl J Med. 2000

PReVENT; The Bottom Line

EMCrit; Vent and Prevent, an update

Effect of Alteplase vs Aspirin on Functional Outcome for PatientsWith Acute Ischemic Stroke and Minor Nondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial. Khatri P. JAMA. 2018

TheResusRoom; Stroke Thrombolysis podcast

Push dose pressors: Experience in critically ill patients outside of the operating room. Rotando A. Am J Emerg Med. 2018