Anesthesia and ICU updates
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This is a scientific channel which aims to provide any important new evidence, original research, and practice guidelines in the fields of anesthesia, critical care, and emergency medicine
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This is an important article published in the NEJM this week about the use of hypertonic saline nebulizer and carbocisteine (mucosol) in patients with respiratory failure on MV.
The results of this large multicentre RCT was that none of the two drugs improved patient outcomes or shortened the duration of MV
https://www.nejm.org/doi/full/10.1056/NEJMoa2603406?query=WB
This is a recent article in BJA education which provides the full details and evidence about Erector Spinae plane block
New guidelines for prophylaxis against PONV are released this month in Anesthesia & Analgesia:
https://www.ovid.com/jnls/anesthesia-analgesia/fulltext/10.1213/ane.0000000000007816~fifth-consensus-guidelines-for-the-management-of?cid=eTOC%20Issues.2026-anesthesia-analgesia-00000539-202609000-00000&rid=V_0000000039150821&TargetID=&EjpToken=CUglw0wPn9MtyMuFQXfbPgtOwNzoc5vuW4rPZHEiJsxh3owtWQLjE8TEXez5s_48Q0M1DIyI7RrklxgOWwc&mkt_tok=NjgxLUZIRS00MjkAAAGjsFmhiM4Ieg9WlnkfVstElT0ExTI9X5iX7JGlf3ALTVBxPBusarg2nbH8H6rUCUVPVXV7ZXf77ShVsDLpgECKU6MTNkdqSNDENoNPzkJGgd55tatrVQ
This is the summary and the comparison between new guidelines with previous recommendations
The updated PROSPECT guidelines for oncological breast surgery
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/epdf/10.1111/anae.70313?campaign=wolearlyview
The PROSPECT guidelines for total hip arthroplasty
https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/full/10.1111/anae.70299?campaign=wolearlyview
This is an important updated review article about nutrition in critically ill adults. It was published last week in NEJM
Guidelines for the use of non invasive respiratory support in critically ill patients
https://academic.oup.com/ajrccm/advance-article/doi/10.1093/ajrccm/aamag302/8721554
https://www.nejm.org/doi/full/10.1056/NEJMoa2515820?query=TOC&logout=true
This is a very large RCT which was published in the NEJM about the value of routine use of tranexamic acid (Kapron) in patients undergoing non cardiac surgery. The routine use of the drug resulted in a lower incidence of red-cell transfusion and did not increase the risk of VTE. The study was conducted on about 8600 patients.
The results of this study support the routine use of 1 gm kapron in any major surgery before skin incision
https://link.springer.com/content/pdf/10.1007/s12028-026-02522-2
Guidelines for prophylaxis in patients undergoing supratentorial neurosurgery
A nee RCT was published today in NEJM about the use of sodium bicarbonate in critically ill patients with metabolic acidosis and shock
This poster summarizes a very common scenario in ICUs which is receiving a patient with respiratory failure due to fluid overload. Very common situation when you receive a patient who received several liters in the ward and a highly positive balance and the referring physician believes that the problem is pulmonary embolism
A concise review summarizing the uses of sodium bicarbonate in different clinical situations
First Aid in critical care medicine. A simplified summarized book is now available in the book stores
The latest guidelines for assessment of respiratory diseases in the ER
