Journal of critical care
-
Journal of critical care · Dec 2024
Randomized Controlled Trial Multicenter StudyAntisense therapy to block the Kallikrein-kinin pathway in COVID-19: The ASKCOV randomized controlled trial.
To assess the effect of antisense therapy to block kallikrein-kinin pathway in COVID-19 patients. ⋯ NCT04549922.
-
Journal of critical care · Dec 2024
Meta AnalysisDoes extracorporeal cardiopulmonary resuscitation improve survival with favorable neurological outcome in out-of-hospital cardiac arrest? A systematic review and meta-analysis.
Extracorporeal cardiopulmonary resuscitation (E-CPR) may improve survival with favorable neurological outcome in patients with refractory out-of-hospital cardiac arrest (OHCA). Unfortunately, recent results from randomized controlled trials were inconclusive. We performed a meta-analysis to investigate the impact of E-CPR on neurological outcome compared to conventional cardiopulmonary resuscitation (C-CPR). ⋯ In this meta-analysis, E-CPR had a positive effect on survival with favorable neurological outcome and, to a smaller extent, on overall mortality in patients with refractory OHCA.
-
Journal of critical care · Dec 2024
ReviewVenoarterial extracorporeal membrane oxygenation in high-risk pulmonary embolism: A narrative review.
Emergent reperfusion, most commonly with the administration of thrombolytic agents, is the recommended management approach for patients presenting with high-risk, or hemodynamically unstable pulmonary embolism. However, a subset of patients with a more catastrophic presentation, including refractory shock and impending or active cardiopulmonary arrest, may require immediate circulatory support. ⋯ Retrospective studies and registry data suggest favorable clinical outcomes with the use of VA-ECMO as an upfront stabilization strategy even among patients presenting with cardiopulmonary arrest. In this review, we discuss the physiologic rationale, evidence base, and an approach to ECMO deployment and subsequent management strategies among select patients with high-risk pulmonary embolism.