An article published in Crit_Care reviews the efficacy and safety of corticosteroids in patients following in-and out-of-hospital cardiac arrest.
Table 2 The GRADE approach was used to assess the certainty of evidenceComparing corticosteroids and placebo for the outcome of mortality closest to 28 days; results are shown by using the random-effects model with relative risk and 95% confidence intervals Comparing corticosteroids and placebo for the outcome of return of spontaneous circulation; results are shown by using the random-effects model with relative risk and 95% confidence intervals Comparing corticosteroids and placebo for the...
Previously published systematic reviews and meta-analyses assessing corticosteroids post-cardiac arrest have shown variable and inconclusive results [
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Early management of isolated severe traumatic brain injury patients in a hospital without neurosurgical capabilities: a consensus and clinical recommendations of the World Society of Emergency Surgery (WSES) - World Journal of Emergency SurgeryBackground Severe traumatic brain-injured (TBI) patients should be primarily admitted to a hub trauma center (hospital with neurosurgical capabilities) to allow immediate delivery of appropriate care in a specialized environment. Sometimes, severe TBI patients are admitted to a spoke hospital (hospital without neurosurgical capabilities), and scarce data are available regarding the optimal management of severe isolated TBI patients who do not have immediate access to neurosurgical care. Methods A multidisciplinary consensus panel composed of 41 physicians selected for their established clinical and scientific expertise in the acute management of TBI patients with different specializations (anesthesia/intensive care, neurocritical care, acute care surgery, neurosurgery and neuroradiology) was established. The consensus was endorsed by the World Society of Emergency Surgery, and a modified Delphi approach was adopted. Results A total of 28 statements were proposed and discussed. Consensus was reached on 22 strong recommendations and 3 weak recommendations. In three cases, where consensus was not reached, no recommendation was provided. Conclusions This consensus provides practical recommendations to support clinician’s decision making in the management of isolated severe TBI patients in centers without neurosurgical capabilities and during transfer to a hub center.
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Inside the Weghorst deal: Background checks, delays and Ten Hag talks◽️ Delays due to three-way deal ◽️ Erik ten Hag’s influence was crucial ◽️ Burnley's desire to 'fulfill a promise' lauriewhitwell, AndyMitten and others on how Wout Weghorst's move to Manchester United materialized.
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Person in critical condition as two others injured in serious M66 crash - liveRead everything we know so far on the two-car crash on the M66 tonight in the blog below. Three people sustained injuries, with one in a critical condition in hospital. The northbound carriageway is expected to be closed for 'several hours'.
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Cycling charity under 'critical threat' as it aims to raise £15kA cycling charity says it is under 'critical threat' as it aims to raise £15,000 to survive the winter.
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Comparative accuracy of biomarkers for the prediction of hospital-acquired acute kidney injury: a systematic review and meta-analysis - Critical CareBackground Several biomarkers have been proposed to predict the occurrence of acute kidney injury (AKI); however, their efficacy varies between different trials. The aim of this study was to compare the predictive performance of different candidate biomarkers for AKI. Methods In this systematic review, we searched PubMed, Medline, Embase, and the Cochrane Library for papers published up to August 15, 2022. We selected all studies of adults (| 18 years) that reported the predictive performance of damage biomarkers (neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), liver-type fatty acid-binding protein (L-FABP)), inflammatory biomarker (interleukin-18 (IL-18)), and stress biomarker (tissue inhibitor of metalloproteinases-2 × insulin-like growth factor-binding protein-7 (TIMP-2 × IGFBP-7)) for the occurrence of AKI. We performed pairwise meta-analyses to calculate odds ratios (ORs) and 95% confidence intervals (CIs) individually. Hierarchical summary receiver operating characteristic curves (HSROCs) were used to summarize the pooled test performance, and the Grading of Recommendations, Assessment, Development and Evaluations criteria were used to appraise the quality of evidence. Results We identified 242 published relevant studies from 1,803 screened abstracts, of which 110 studies with 38,725 patients were included in this meta-analysis. Urinary NGAL/creatinine (diagnostic odds ratio [DOR] 16.2, 95% CI 10.1–25.9), urinary NGAL (DOR 13.8, 95% CI 10.2–18.8), and serum NGAL (DOR 12.6, 95% CI 9.3–17.3) had the best diagnostic accuracy for the risk of AKI. In subgroup analyses, urinary NGAL, urinary NGAL/creatinine, and serum NGAL had better diagnostic accuracy for AKI than urinary IL-18 in non-critically ill patients. However, all of the biomarkers had similar diagnostic accuracy in critically ill patients. In the setting of medical and non-sepsis patients, urinary NGAL had better predictive performance than urinary IL-18, urinary L-FAB
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Aslan singer Christy Dignam receiving end-of-life careChristy Dignam, the lead singer of Irish rock band Aslan, is receiving palliative care at home, his family has confirmed.
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