The WELPICUS study group have used an interesting approach (using the Likert scale to assess a number of statements) to try to gain international consensus (from more than 30 countries) on what matters in end of life care in the ICU. Autonomy and decision making There was considerable support for respecting advanced directives (AD), …
PROCESS has been backed up by ARISE in goal-directed therapy for sepsis. PROMISE is awaited (finished recruiting in July). A large (1600), international, randomised, un-blinded, intention-to-treat trial with sensible exclusion criteria, conducted 2008-2014 of excellent quality. ARISE showed no benefit in using a protocolised 6 hour package for septic shock which involved continuous ScvO2 and CVP …
Raghunathan has used some interesting statistics to try and extract the effects of using Saline or Ringer’s lactate in resuscitating sepsis. Elixhauser comborbidities, 5:1 greedy matching, Generalized Estimating Equation models, and “missing-ness” are just a few of the terms I didn’t understand. Nevertheless this appears to be a retrospective study that suggests there’s measurable mortality benefit in using balanced …
LITFL Wessex ICS BottomLine Emcrit