The Latest in Critical Care, 10/9/23 (Issue #16)
Intensive blood glucose control in the ICU is not helpful (TGC-FAST trial)
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Hyperglycemia is associated with worse outcomes in the ICU (and in medical patients generally), so correcting it must improve outcomes … right? After two studies published in NEJM 2001 and 2006 showed intensive glucose control (to 80-110 g/dL) improved outcomes in adult medical and surgical patients, and then
Extracorporeal membrane oxygenation (ECMO) for cardiogenic shock after MI (ECLS-SHOCK trial)
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When patients with massive myocardial infarctions develop cardiogenic shock, it’s a terrible sign. Even if they undergo rapid revascularization of the culprit lesion(s) with percutaneous coronary intervention (PCI) with stent placement, as many as half die within a month. Many of the rest are left with significant disability.
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