Interesting literature September 2008

September 21, 2008 by  
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Hearts and Minds
Some interesting stuff in the literature in the last few months, from high quality RCTs that may change your practice to review articles that can bring you up to date on the latest management of common emergencies:

HEARTS
Are you happy with the diagnostic criteria for MI? What about relative benefits of thrombolysis vs PCI? Have you heard of the newer alternatives to heparin: the DTIs and Factor Xa inhibitors? Check out the Lancet review of Myocardial Infarction
http://www.ncbi.nlm.nih.gov/pubmed/18707987

Extracorporeal Life Support (ECLS) vs convential CPR? Wouldn’t that be nice!
http://www.ncbi.nlm.nih.gov/pubmed/18603291

Hard to imagine how this evidence could be applied locally, but for interest here’s an article on the pre-hospital administration of GP 2b-3a antagonists for STEMI:
http://www.ncbi.nlm.nih.gov/pubmed/18707985?ordinalpos=1&itool=Entrez…

This has to be the best paper of the season: the CAT study by Sydney’s own John Myburgh comparing noradrenaline vs adrenaline in 280 critically ill patients requiring vasopressors. What do you think the difference in outcome was?
http://www.ncbi.nlm.nih.gov/pubmed/18654759

MINDS
Review of therapeutic hypothermia for neuroprotection – what it works for, and the dos and don’ts. Recommended reading for FACEM and FJFICM candidates – this is a favourite topic for exams at moment
http://www.ncbi.nlm.nih.gov/pubmed/18539227

Thrombolysis for stroke – up to 4.5 hours now, although that’s not an excuse to dawdle (if you’re a believer).
http://content.nejm.org/cgi/content/short/359/13/1317

Want to waste money and time? Then give rFVIIa for intracerebral haemorrhage! Hemostatic therapy with rFVIIa reduced growth of the hematoma but did not improve survival or functional outcome after intracerebral hemorrhage.
http://content.nejm.org/cgi/content/short/358/20/2127

More soon!