When Care is Critical: Conservative vs Conventional Oxygen Treatment in the ICU and the Effect of Hydrocortisone on the Development of Septic Shock


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This week’s episode is jam-packed with critical care medicine. What is the effect of conservative versus conventional oxygen therapy on mortality in patients in the ICU? Hydrocortisone on development of septic shock? Kieran and Laura take listeners through two important studies examining these questions.

Prior research suggested excessive oxygenation in patients admitted to the ICU can lead to harm. A robust RCT was lacking to validate these results…until now! Tune in as Laura takes listeners through the next step forward in understanding oxygen targets in people admitted to the ICU.

Next, a NEW special segment! Sheliza Halani, University of Toronto medical student, brings listeners up to date with the latest research surrounding the Zika outbreak. Who knew that Zika caused ocular complications?

Kieran then takes listeners through the HYPRESS trial. The efficacy of hydrocortisone in preventing septic shock among patients with severe sepsis remains controversial. Does administration of early adjunctive glucocorticoids reduce this risk? Listen to find out!

Last, but definitely not least, the Good Stuff segment! Laura discusses steps to make health information on Wikipedia more trustworthy. Then, Kieran delves into the nuances of risk-stratified studies and how they may help physicians better identify patients more likely to respond to a given treatment.

Like what you hear? Rate us on iTunes! Follow us on Twitter @roundstable and tweet at this week’s hosts directly @kieranlquinn and @l_walk5.

The Papers

1. Oxygen ICU: http://jamanetwork.com/journals/jama/article-abstract/2565306

2. HYPRESS: http://jamanetwork.com/journals/jama/article-abstract/2565176

Zika

1. http://www.nejm.org/doi/full/10.1056/NEJMc1603618

2. http://archopht.jamanetwork.com/article.aspx?articleid=2491896

3. http://archopht.jamanetwork.com/article.aspx?articleid=2491895

4. http://femsle.oxfordjournals.org/content/363/18/fnw202.long

5. http://www.aao.org/clinical-statement/zika-virus-infection-potential-ophthalmic-manifest

6. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(16)00562-6/abstract

7. http://www.nejm.org/doi/full/10.1056/NEJMsr1604338#t=article

Good Stuff

1. Choosing Wisely: http://annals.org/aim/article/2580303/can-knowledge-about-heterogeneity-treatment-effects-help-us-choose-wisely

2. Wikipedia: http://www.npr.org/sections/health-shots/2016/11/08/501087493/should-i-trust-wikipedia-with-my-health?utm_medium=RSS&utm_campaign=health

Music Credits (Creative Commons)

In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart

Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music

Vintage Dream – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/vintage-dream-loungejazzy-background-music

All tracks have been modified for the purposes of this podcast.

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