Questions discussed in this category
Is there a threshold amount of oxygen above which you would avoid bronchoscopy?
Estimating blood loss from hemoptysis is not always reliable. The bleeding may be due to the PE itself. Is anticoagulation with any degree of hemoptys...
Is there a role for oral vancomycin in these patients, or is oral vancomycin redundant if other routes of administration are being used (i.e intracolo...
High-risk PEs are typically treated with loading doses of anticoagulants or bridging with LMWH. Do you omit the bridging/loading period and go straigh...
If they have been on IV heparin for 3 days, for example, would you subtract those days from the recommended loading dose time?
Data on the role of steroids in HIV negative patients with PJP has been conflicting.
Have recent trials (TRAIN trial and HEMOTION trial) influenced your approach?
For example, is captopril dialyzable?
Some data showed early enteral nutrition improves outcomes in DKA. Some thought that enteral nutrition could counteract the insulin gtt.
The new SCCM guidelines suggest an upper limit of 200 compared to the conventional 180.
Blood pressure targets for ischemic stroke and intracerebral hemorrhage are described in several guidelines. However, in patients with acute stroke wh...
Hendriks, et al., PMID 38576380
ACORN Randomized Clinical Trial
Assume thrombolytics are not indicated. Do you favor early DOAC transition after 24-48 hours of heparin gtt or do you favor LMWH for 10-14 days follow...
If yes, what is the rationale for doing that?
Do the findings of the NICO trial influence your stance?
Multiple recent trials have shown higher first pass success rate with VL over DL.
Do the findings of the PROPHY-VAP trial influence your approach?
Do the results of the recent study (Misset et al., PMID 37889107) showing reduction in 28-day mortality in patients with high neutralizing antibody ti...
Do you favor gradual reduction in oxygen and pressure support with intermittent medication as needed or immediate extubation with peri-extubation medi...
For example, in the setting of TBI, how do you guide the duration of the medical treatment?
In light of published data from the CAPE COD trial...
In the span between the HACA trial and the Targeted Temperature Management in Out-of-Hospital Cardiac Arrest study (Dankiewicz et al., PMID 34133859),...
What are the sources for this and are they reliable by today’s standards? Numerous case series report various abnormal movements but how reliabl...
Is it different than early mobility that we always encourage?
Though there is data to support using both hydrocortisone and fludrocortisone, it seems to be used rarely in clinical practice. A review publishe...
Patient became acutely flushed, developed severe and prolonged hypotension with brief loss of consciousness, dizziness, nausea, dry heaves and headach...
Do you favor awake intubation in these cases?
What factors do you consider while deciding between bronchoscopic vs surgical management?
What’s your threshold to get the three AFBs and place the patient in airborne isolation?
To help interpret clinical applications of the CAPE COD (2023) and DEXA ARDS (2020) trials.
Are there any quantitative indices (eg. volume, pleural fluid hematocrit) that would impact your decision to stop subsequent TPA/dornase treatments?
Do you do start therapy at a certain vasopressor requirement?
How do you decide between starting infliximab, MMF, or IVIG? If a patient presents in respiratory failure (nearing or requiring intubation), woul...
Is there any role of tube thoracostomy as opposed to only antibiotics?
Do your respiratory therapists independently adjust ventilator settings without direct physician involvement?
How do you approach which risk to accept given that steroids have evidence for use in COVID-19 while is suggestion for harm in using steroids in influ...
For instance, if the patient doesn’t tolerate apnea testing, is too unstable to go for ancillary testing outside the ICU, and TCDs/EEG are unava...
Do you use hydrocortisone 200 mg/day as studied in ADRENAL/APROCCHSS or dexamethasone 20 mg/day as studied in DEXA-ARDS?
Given the substantial risks associated with transporting an intubated and ventilated patient to Radiation Oncology, is there any evidence to support t...
Would you discontinue Methotrexate and TNF inhibitors even if previously no side effects from these medications, and would you consider Cyclophosphami...
Would you consider treating the full mediastinum or any mildly enlarged nodes, even contralateral? Do you have a strategy that transitions from a pall...
Would you treat if there is active infection? How much improvement would you expect?
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JAMA, 2005-10-05
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