2023 Critical Care Year in Review (Part 2)
Research in mechanical ventilation, intubation, trauma and hemorrhage, neurology, nutrition, intensive insulin therapy, post-ICU outcomes
Intubation and mechanical ventilation
Video laryngoscopy was superior to direct laryngoscopy in first-pass success among ED residents and CCM fellows intubating critically ill patients (DEVICE trial). Besides confirming video laryngoscopy’s shorter learning curve, this result may also in part represent the decay in direct laryngoscopy skills in the post-video era.
Intubated trauma patients receiving a larger extra breath (sigh) every six minutes had markedly lower mortality in a randomized trial. If replicated, the finding would be remarkable and practice-changing. (SiVent)
Intoxicated patients (mostly by alcohol) with GCS of 8 or less did better if intubation was delayed. (NICO trial)
Does oxygen target matter? In a large, complicated pragmatic cluster-crossover study at a single academic center, there was no difference in any meaningful outcome (death, ventilator-free days, or severe complications) between patients randomized to an oxygen saturation target of 90%, 94%, or 98%. (PILOT t…
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