Evidence-based Decision Making in Critical Care http://www.EvidenceBased.net This feed will automatically provide you with notifications of new updates on the EvidenceBased.net site en-au http://www.evidencebased.net/img/cube3.gif EBDM Rubiks Cube http://www.evidencebased.net/ EvidenceBased.net Dr. Gordon S. Doig Gordon S. Doig Thu, 12 Jul 2007 04:23:51 GMT FeedEdit Effects of enteral feeding with eicosapentaenoic acid, gamma-linolenic acid, and antioxidants in mechanically ventilated patients with severe sepsis and septic http://icu-10.med.usyd.edu.au/ebdm/journal/therapy86.shtml A failure to report outcomes on 37% of enrolled and randomised patients is unacceptable. Elizabeth A Sweetman Fri, 27 Mar 2009 03:06:43 GMT Journal Club Benefit of an enteral diet enriched with eicosapentaenoic acid and gamma-linolenic acid in ventilated patients with acute lung injury. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy87.shtml Perhaps a reduction in 6 hours of ventilation... but what happens when you consider the outcomes of the patients who develop severe diarrhea??? EA Sweetman Fri, 27 Mar 2009 03:04:25 GMT Journal Club Early vs Late Enteral Feeding of mechanically ventilated pateints: Results of a clinical trial http://icu-10.med.usyd.edu.au/ebdm/journal/therapy83.shtml Not really a trial of Early vs Late EN... its actually Early vs Late full goals. Its also pseudo-randomised.... Elizabeth Sweetman Fri, 30 Jan 2009 01:28:22 GMT Journal Club Beta-hydroxy-beta-methylbutyrate supplementation in critically ill trauma patients http://icu-10.med.usyd.edu.au/ebdm/journal/therapy84.shtml 28% lost to follow-up, not reported by group. Why??? Elizabeth Sweetman Fri, 30 Jan 2009 01:26:53 GMT Journal Club Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients http://icu-10.med.usyd.edu.au/ebdm/journal/meta33.shtml A reveiw of the recommendation for early EN. Because its trendy ;) Pip Heighes Mon, 24 Nov 2008 02:27:28 GMT Journal Club Early enteral nutrition in acutely ill patients: A systematic review http://icu-10.med.usyd.edu.au/ebdm/journal/meta34.shtml Interesting. Is acute illness like critical illness??? Pip Heighes Mon, 24 Nov 2008 02:26:04 GMT Journal Club Early Enteral Nutrition Within 24h of Intestinal Surgery Versus Later Commencement of Feeding: A Systematic Review and Meta-Analysis http://icu-10.med.usyd.edu.au/ebdm/journal/meta32.shtml A reduction in mortality in a group of elective surgery patients at very low risk of mortality. Interesting... Pip Heighes Tue, 18 Nov 2008 03:31:47 GMT Journal Club Early versus delayed enteral nutrition support for burn injuries (review) http://icu-10.med.usyd.edu.au/ebdm/journal/meta31.shtml Inconclusive review of current trials. Pip Heighes Tue, 18 Nov 2008 03:30:28 GMT Journal Club VASST - Vasopressin versus Norepinephrine Infusion in patients with Septic shock http://icu-10.med.usyd.edu.au/ebdm/journal/therapy81.shtml Interesting results. Dose too low? Wrong patients? Just plain doesn't work? Unfortunately because this was a level II trial, the results won't change practice. Amit Kansal Tue, 18 Nov 2008 03:26:49 GMT Journal Club Lung open ventilation study group - Ventilation Strategy Using Low Tidal Volumes, Recruitment Maneuvers, and High Positive End-Expiratory Pressure for Acute Lung Injury and Acute Respiratory Distress Syndrome: A Randomized Controlled Trial http://icu-10.med.usyd.edu.au/ebdm/journal/therapy82.shtml Very well conducted trial... may help with difficult to vent ARDS patients. Amit Kansal Wed, 10 Sep 2008 22:24:14 GMT Journal Club Early goal-directed therapy in the treatment of severe sepsis and septic shock. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy46.shtml Our review has been updated as a result of controversy surrounding 25 missing patients who may have been randomised into the trial. If they were randomised into the trial, they should have contributed towards the ITT analysis. Gordon S Doig Fri, 05 Sep 2008 01:03:24 GMT Journal Club Are daily routine chest radiographs useful in critically ill, mechanically ventilated patients? A randomized study. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy79.shtml Very interesting paper. Not quite so 'convincing' when I re-did the analysis under more conservative assumptions. Gordon S Doig Thu, 31 Jan 2008 22:01:28 GMT Journal Club Hydrocortisone Therapy for Patients with Septic Shock http://icu-10.med.usyd.edu.au/ebdm/journal/therapy75.shtml With 21 post-hoc subgroup analyses, you would expect we could identify a group were steroids work?? Greg Comadira Tue, 22 Jan 2008 22:04:11 GMT Journal Club Statin therapy is associated with fewer deaths in patients with bacteraemia. http://icu-10.med.usyd.edu.au/ebdm/journal/harm6.shtml Is there a major flaw in this paper? Gordon Doig Thu, 08 Nov 2007 00:45:28 GMT Journal Club Norepinephrine plus dobutamine versus epinephrine alone http://icu-10.med.usyd.edu.au/ebdm/journal/therapy72.shtml Although this trial was conducted at 95% power, we can only rule out a 20% difference in mortality between groups. A 5%, 10 or 15% difference may still be present. All would be clinically important!! John Field Thu, 08 Nov 2007 00:45:23 GMT Journal Club Activated protein C (Xigris) for the treatment of severe sepsis in adults. http://icu-10.med.usyd.edu.au/ebdm/journal/GradeA33.shtml Supports the use of aPC for the treatment of severe sepsis in adults who would have qualified for inclusion in PROWESS. Gordon S Doig Thu, 20 Sep 2007 00:23:39 GMT Evidence-based Recommendation Drotrecogin alfa (activated) for adults with severe sepsis and a low risk of death. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy73.shtml Review of the ADDRESS trial. Gordon S Doig Thu, 20 Sep 2007 00:22:35 GMT Journal Club Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy70.shtml Very intersting pooled analysis of three recent RCTs. Gordon Doig Thu, 12 Jul 2007 04:22:28 GMT Journal Club Oral decontamination for prevention of pneumonia in mechanically ventilated adults: systematic review and meta-analysis. http://icu-10.med.usyd.edu.au/ebdm/journal/meta28.shtml oral application of antiseptics significantly reduced the incidence of ventilator associated pneumonia Gordon S Doig Thu, 05 Jul 2007 02:58:39 GMT Journal Club 12-h pretreatment with methylprednisolone versus placebo for prevention of postextubation laryngeal oedema: a randomised double-blind trial. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy69.shtml ITT analysis conducted under conservative assumptions does NOT show reduction in reintubation rates. Gordon S Doig Wed, 06 Jun 2007 23:30:50 GMT Journal Club Continuous pralidoxime infusion versus repeated bolus http://icu-10.med.usyd.edu.au/ebdm/journal/therapy67.shtml Review of a landmark trial for the treatment of organophosphate poisoning. Very important in many countries. Stuart Green Wed, 23 May 2007 02:03:08 GMT Journal Club Levosimendan vs Dobutamine for Patients with acute decompensated heart failure http://icu-10.med.usyd.edu.au/ebdm/journal/therapy68.shtml Review of the latest levosimendan trial. Jon Field Wed, 23 May 2007 02:01:52 GMT Journal Club L-alanyl-L-glutamine dipeptide-supplemented total parenteral nutrition reduces infectious complications and glucose intolerance in critically ill patients: the French controlled, randomized, double-blind, multicenter study. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy66.shtml Review of the latest Glutamine RCT in critically ill patients. Ken Havill Tue, 22 May 2007 05:28:28 GMT Journal Club Evidence-based guideline for nutrition support in critical illness http://www.evidencebased.net/files 282 page book that provides in-depth critical appraisals of all ICU-based feeding trials and presents the results of a bi-national guideline development process. Gordon Doig and Fiona Simpson Wed, 31 Jan 2007 21:17:27 GMT E-B guidelines Selenium in Intensive Care (SIC): results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy63.shtml Review of the recent selenium in sepsis trial published in CCM Gordon S. Doig Thu, 01 Feb 2007 02:27:49 GMT Journal Club Erythromycin is more effective than metoclopramide in the treatment of feed intolerance in critical illness. http://icu-10.med.usyd.edu.au/ebdm/journal/therapy64.shtml Review of the recent Phase II (physiological surrogate outcome) trial published in CCM. Gordon S. Doig Thu, 01 Feb 2007 02:27:57 GMT Journal Club