Slides from a presentation at Critical Care Symposium 2017 Steve Mathieu & Rob MacSweeney

1. Critical Care Game
changers
@CritCareReviews
@WICSBottomLine
@stevemathieu75

2. LeoPARDS
Levosimendan for the Prevention of
Acute oRgan Dysfunction in Sepsis

3. Gordon. NEJM 2017; Oct 5
Mean daily SOFA score in the ICU up to day
28
Death at 28 days, at ICU discharge and at
hospital discharge
No difference between groups

5. Kudenchuk NEJM 2016;374(18):1711-22

6. RESCUE-ICPTrial of Decompressive Craniectomy for Trau
Intracranial Hypertension

7. GOS-E at 6 months in craniectomy vs medical
group
Death: 26.9% vs. 48.9%
Vegetative state (VS): 8.5% vs. 2.1%
Lower severe disability (LSD): 21.9% vs. 14.4%
Upper severe disability (USD): 15.4% vs. 8%
Lower moderate disability: 10% vs. 10.1%
Upper moderate disability: 13.4% vs. 9.6%
Lower or upper good recovery: 2.5% vs. 3.2%
Upper good recovery: 1.5% vs. 3.7%

9. VANISHEffect of early vasopressin
vs NADR on kidney failure in
patients with septic shock

11. REACT 2
Immediate total-body CT scanning Vs
conventional imaging & selective CT
scanning in patients with severe
trauma

14. ELAIN - Early RRT
Improved 90 day mortality:
55% vs 39% P=0.03; FI = 3
Shorter duration of RRT:
9 vs 24 days
Greater recovery of renal function:
54% vs 39%
Zarbock JAMA 2016;315(20):2190-2199

16. AKIKI
60 day mortality: No difference
Early 48.5% vs Late 49.7% P=0.79
Gaudry NEJM 2016;375:122-133

17. OXYGEN-ICUEffects of conservative vs conventional O2 therapy on
mortality among patients in an ICU

18. ICU mortality
Conservative group (94-98%) = 11.6%
Intervention group (97-100%) = 20.2%
Significantly lower in the conservative oxygen
group
Giardis. JAMA 2016;316(15):1583-1589

19. MACMAN
VL vs DL on successful first
pass orotracheal intubation
among
ICU patients

20. Successful first pass intubation (capnography
> 4 breaths)
VL 67.7% vs. DL 70.3% P=0.6
Lascarrou. JAMA 2017; 317(5):483-493

21. Effect of Postextubation HFNO vs
conventional oxygen therapy on
Reintubation in Low-Risk Patients

22. Reintubation within 72 hours
Significantly reduced in the HFNO group
13 patients (4.9%) vs 32 patients (12.2%)
P=0.004; NNT 14; FI 5
Hernandez JAMA 2016;315(13):1354-1361

23. Effect of Postextubation HFNO vs NIV on
Reintubation and post-extubation
Respiratory Failure in High-Risk Patients

24. Reintubation within 72 hours
HFNV non-inferior to NIV
HFNO: 66 patients (22.8%)
NIV: 60 patients (19.1%)
Hernandez JAMA 2016;316(15):1565-1574

26. Critical Care Game
changers
@CritCareReview
s
@WICSBottomLin
e
@stevemathieu75