A pneumothorax (collapsed lung) occurs when air enters the pleural space, disrupting normal lung expansion. Early recognition and appropriate management are critical to prevent progression to tension pneumothorax, a life-threatening emergency. This post breaks down the systematic approach to pneumothorax … Read More
Critical Care
Approach to Acid-Base Disorders — A Stepwise Guide for Clinicians
Maintaining acid-base balance is vital for cellular function. Our bodies tightly regulate blood pH around 7.4, since even slight deviations can alter enzyme activity and protein structure. Let’s break down how clinicians approach acid-base disorders in a systematic way. Source … Read More
ARREST Trial: Transfer to Cardiac Arrest Center after Out-of-Hospital CA
The ARREST Trial (2023) was a multicenter, open-label, randomized controlled study that assessed whether expedited transfer of resuscitated out-of-hospital cardiac arrest (OHCA) patients without ST-elevation to a cardiac arrest center (CAC) improved outcomes compared with transfer to the nearest emergency … Read More
FERRRARI Trial: Diuretics or Volume Expansion in PE
The FERRARI trial (2022) compared early intravenous diuretic therapy using 40 mg IV furosemide versus volume expansion in adults with acute intermediate high-risk pulmonary embolism (PE) and right-ventricular (RV) dysfunction. Sixty patients with CT-confirmed PE, RV dilatation, dysfunction, and elevated … Read More
ADAPT-Sepsis Trial: PCT vs. CRP-Guided Antibiotic Duration
Understanding the ADAPT-Sepsis Trial: PCT vs. CRP-Guided Antibiotic Duration Sepsis remains a critical challenge in intensive care units (ICUs), often requiring prolonged antibiotic use. The ADAPT-Sepsis trial, published in JAMA (2024), aimed to determine whether procalcitonin (PCT)-guided or C-reactive protein … Read More
DanGer Shock Trial: Impella in Cardiogenic Shock
“DanGer Shock” study, which is an international, open-label, randomized trial examining the impact of a Microaxial Flow Pump (Impella CP) plus standard care versus standard care alone in infarct-related cardiogenic shock. Objective: To compare the safety and efficacy of Impella … Read More
TGC-Fast Trial: Tight Glucose Control in ICU
The TGC-Fast Trial, featured in the New England Journal of Medicine in 2023, was a multicenter, randomized, controlled trial that aimed to assess the benefits of tight glucose control without early parenteral nutrition in the intensive care unit (ICU). The … Read More
ECLS-SHOCK Trial: Extracorporeal Life Support in Cardiogenic Shock
The ECLS-SHOCK trial, as reported in the New England Journal of Medicine in 2023, was a multicenter, parallel, randomized controlled trial designed to evaluate the efficacy of extracorporeal life support (ECLS) in patients with acute myocardial infarction (MI) complicated by … Read More
AMIKINHAL Trial: Inhaled Amikacin in Preventing VAP
The medical world is continually seeking innovative methods to combat and prevent life-threatening conditions. One such condition is ventilator-associated pneumonia, a severe complication that affects patients undergoing mechanical ventilation. The recent AMIKINHAL trial, a multicenter, double-blind, randomized, controlled, superiority study, … Read More
VIOLET Trial: High-Dose Vitamin D3 for Critically Ill
VIOLET Trial Summary The VIOLET trial was a phase 3, randomized, double-blind, placebo-controlled study designed to evaluate the effects of early vitamin D3 supplementation in critically ill patients with vitamin D deficiency who were at high risk for death. Vitamin … Read More