Critical Care Alert – February 1, 2024

Using Targeted Trials to Investigate Early vs. Late Intubation Strategies

Authors used a machine learning framework to show that delaying intubation in critically ill patients when compared to early intubation does not result in a greater 30-day mortality.

Buprenorphine May Be an Effective Alternative to Full Opioids for Pain in the ICU

In a small, single-center, retrospective, propensity-matched cohort study examining enteral oxycodone vs. sublingual buprenorphine in a critically ill population, pain control was equivalent, indicating that sublingual buprenorphine may be an effective and appropriate alternative.

Small-Volume Blood Collection May Reduce Transfusion Needs in the ICU

The STRATUS randomized clinical trial was a stepped-wedge cluster randomized trial in 25 adult medical-surgical intensive care units (ICUs) in Canada that studied standard-volume to small-volume vacuum tubes for blood collection in the ICU. In the primary analysis, there was no significant difference in red blood cell transfusion between groups. However, in a pre-specified secondary analysis, red blood cell transfusion decreased after the transition from standard-volume tubes to small-volume tubes.

Percutaneous Coronary Intervention vs. Placebo for Stable Angina Patients

In this randomized trial of patients with stable angina and objective evidence of ischemia, percutaneous coronary intervention resulted in a significant reduction in angina compared to a placebo procedure.