JAMA Clinical Reviews JAMA Research at Critical Care Reviews 2024 (CCR Down Under)
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Dec 11, 2024 Derek Angus, Chair of Critical Care Medicine at UPMC, joins the discussion alongside JAMA Editor in Chief Kirsten Bibbins-Domingo. They delve into four pivotal critical care trials recently presented in Melbourne. Topics include the effectiveness of sepsis alert systems that significantly lower hospital mortality, evolving oxygen strategies, and the comparison of high-flow nasal oxygen against non-invasive ventilation. They also explore the impact of biomarker-guided protocols in reducing unnecessary antibiotic use among sepsis patients, emphasizing personalized patient care.
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Sepsis Alerts Reduce Mortality
- The SCREEN trial, a randomized trial, shows sepsis alerts can lower in-hospital mortality.
- This is the first large-scale randomized trial on sepsis alerts, showing positive results despite prior observational studies.
Oxygen Strategies in Trauma Patients
- The Traumox-2 trial found no difference in mortality between restrictive and liberal oxygen strategies for trauma patients.
- This suggests a one-size-fits-all oxygen strategy may not be the best approach.
High-Flow Nasal Oxygen vs. Non-Invasive Ventilation
- High-flow nasal oxygen is a simpler alternative to non-invasive ventilation for acute respiratory failure.
- The RENOVATE trial, the largest in this area, found high-flow oxygen to be largely non-inferior to non-invasive ventilation.