Critical Connections Blog

Concise Critical Appraisal: Impact of Mentoring in Academic Medicine
Efstathiou et al (PLoS One. 2018;13:e0207634) developed a standardized mentorship program and a series of surveys to evaluate the program’s impact, specifically measuring faculty satisfaction and productivity.
Posted: 5/9/2019 | 1 comments

Concise Critical Appraisal: Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status Versus Serum Lactate
Hernández et al (JAMA. 2019;321:654-664) set out to address that question with a multicenter randomized trial in which they compared two resuscitative targets: the normalization of blood lactate and the normalization of peripheral perfusion as quantified by capillary refill time.
Posted: 4/11/2019 | 0 comments

Concise Critical Appraisal: Epinephrine Versus Norepinephrine for Cardiogenic Shock
Levy et al (J Am Coll Cardiol. 2018;72:173-182) conducted a prospective, double-blind, multicenter RCT comparing epinephrine to norepinephrine in the setting of CS in patients who underwent AMI treated with percutaneous coronary intervention.
Posted: 3/12/2019 | 0 comments

Concise Critical Appraisal: Effect of Low Versus Intermediate Tidal Volume Strategy
Simonis et al (JAMA. 2018;320;1872-1880) set out to evaluate the effect of an LTVV strategy versus an intermediate tidal volume ventilation strategy in intensive care unit patients without ARDS.
Posted: 2/12/2019 | 0 comments

Concise Critical Appraisal: Antipsychotic Medications for Delirium in the ICU
Girard et al (N Engl J Med. 2018;379:2506-2516) and Page et al (Lancet Respir Med. 2013;1:515-523) evaluated the treatment of acute delirium with antipsychotics.
Posted: 1/8/2019 | 1 comments

Concise Critical Appraisal: Use of Telemedicine During Interhospital Transport of Children
Jackson et al (Ped Crit Care Med. 2018;19:1033-1038) set out to analyze the impact telemedicine had on time to surgery in children with intracranial hemorrhage (ICH).
Posted: 12/10/2018 | 0 comments

Concise Critical Appraisal: Epinephrine in Out-of-Hospital Cardiac Arrest
Perkins et al (N Engl J Med. 2018;379:711-721) set out to examine the effects of epinephrine during OHCA.
Posted: 11/8/2018 | 0 comments

Concise Critical Appraisal: Ultra-Low Tidal Volume Ventilation During CPR
Ruemmler et al (Resuscitation. 2018;132:56-62) set out to compare intermittent positive pressure ventilation to passive oxygenation (continuous positive airway pressure) and a novel ultra-low tidal volume ventilation (ULTVV) regimen.
Posted: 10/9/2018 | 0 comments

Concise Critical Appraisal: Effect of Sodium Bicarbonate Infusion on Patient Outcomes
Jaber et al (Lancet. 2018;392:31-40) set out to evaluate the effect of sodium bicarbonate infusion on critically ill patient outcomes.
Posted: 9/13/2018 | 0 comments

Concise Critical Appraisal: The Effect of Ramelteon Administration on the Duration of ICU Stay
Nishikimi et al (Crit Care Med. 2018;46:1099-1105) set out to identify the effects of ramelteon, a melatonin agonist, on ICU length of stay for critically ill patients.
Posted: 8/9/2018 | 0 comments

Concise Critical Appraisal: Fluid Administration and Diabetic Ketoacidosis
Kuppermann et al (N Engl J Med. 2018;378:2275-2287) sought to prospectively determine the role that fluid makeup and rate have on the development of neurologic injury in children with DKA.
Posted: 7/12/2018 | 0 comments

Concise Critical Appraisal: The Efficacy of ECMO for Severe ARDS
Combes et al (N Engl J Med. 2018;378:1965-1975) set out to determine whether the use of ECMO reduced mortality in patients with ARDS when defined by one of three criteria: P/F ratio < 50 mm Hg for > 3 hours, P/F ratio < 80 mm Hg for > 6 hours, or pH < 7.25 coupled with Paco2 ≥ 60 mm Hg for > 6 hours (with respiratory rate < 35 beats/min and plateau pressure ≤ 32 cm H2O). 
Posted: 6/21/2018 | 0 comments

Concise Critical Appraisal: Cerebral Oxygen Metabolism and RBC Transfusion in Infants
Neunhoeffer et al (Pediatr Crit Care Med. 2018;19:318-327) sought to use noninvasive means to determine the changes in cerebral oxygen metabolism in infants younger than 6 months who have undergone major surgery.  
Posted: 6/15/2018 | 0 comments