The Resus Room

January 2019; papers of the month

01.01.2019 - By Simon Laing, Rob Fenwick & James YatesPlay

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Happy New Year!! Hopefully you got a bit of downtime over the festive period and are feeling suitably refreshed and ready to attack 2019! We've got 3 great papers to kick off the year. First up we look at the recent PReVENT trial which looks at ventilator strategies in patients without ARDS with respect to tidal volumes. This paper continues the work from the much cited ARDSNet paper from 2000, and we'd highly recommend you go and have a look at that paper first. Next we look at another paper from JAMA which compares Thrombolysis to Aspirin in minor non-disabling strokes. We say enough about this one in the podcast, but for a bit of background to our thoughts and the evidence surrounding stroke, check out our previous Stroke Thrombolysis podcast. Lastly we have a look at a paper investigating their systems use of push-dose-pressors, which whilst not the most methodologically sound piece of research, certainly brings out some interesting thoughts and points. As always make sure you take a look at the papers yourselves and we'd love to hear and comments or feedback you've got. Enjoy! Simon & Rob References & Further Reading Effectof a LowvsIntermediateTidalVolumeStrategyon Ventilator-FreeDaysin IntensiveCareUnitPatientsWithout ARDS: A Randomized Clinical Trial. JAMA.2018 Writing Group for the PReVENT Investigators Ventilationwith lowertidal volumesas comparedwith traditionaltidal volumesfor acute lung injury and the acute respiratory distress syndrome. Acute Respiratory Distress SyndromeNetwork. N Engl J Med.2000 PReVENT; The Bottom Line EMCrit; Vent and Prevent, an update Effectof AlteplasevsAspirinon FunctionalOutcomefor PatientsWith AcuteIschemicStrokeand MinorNondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial. Khatri P. JAMA.2018 TheResusRoom; Stroke Thrombolysis podcast Push dose pressors: Experience in critically ill patients outside of the operating room. Rotando A. Am J Emerg Med.2018

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