Welcome to the 498th Critical Care Reviews Newsletter, bringing you the best critical care research and open access articles from across the medical literature over the past seven days.
The highlights of this week's edition are 4 randomised controlled trials on COVID-19, two each from the REMAP-CAP and RECOVERY trial teams, all published in preprint form; a systematic review and meta analysis on the association of frailty with post-cardiac arrest outcomes; and observational studies on biological subphenotypes of the acute respiratory distress syndrome & new physical, mental, and cognitive problems 1 year after ICU admission.
There are also guidelines on the management of Clostridioides difficile infection & nursing practice in the care of ECMO–supported patients; narrative reviews on the basics of coagulopathy & the assessment and management of cardiovascular disease in the intensive care unit; editorials on SARS-CoV-2 variants of concern & non invasive respiratory support therapies in COVID-19 related acute respiratory failure; and commentaries on rapid response teams as a patient safety practice for failure to rescue & the evolution of clinical medicine: from expert opinion to artificial intelligence.
If you only have time to read one review article this week, try this one on sedation in the intensive care unit.
Recently, the global SYNAPSE-ICU observational study was published in Lancet Neurology. This work investigated the role intracranial pressure monitoring currently plays in the management of patients with acute brain injury. I spoke with the chief investigator, Prof Giuseppe Citerio from Milan.
POINT: Is It Ethically Permissible to Unilaterally Withdraw Life-Sustaining Treatments During Crisis Standards of Care? CHEST 2021;159(6):2165–2170