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Metronidazole Resistance - worth worrying about?

4/12/2016

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​The addition of Metronidazole to an antibiotic regimen is something generally done without much concern.  We ‘trust’ Metronidazole to not cause resistance, and to do the job we ask of it.  Why is that? I honestly can’t remember ever looking after a patient with an anaerobic infection resistant to Metronidazole.

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Sepsis Associated Atrial Fibrillation and Stroke Prevention

31/8/2016

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When a doctor diagnoses atrial fibrillation, 'the guideline' says that a CHA2DS2VASc and HAS-BLED score should be calculated, and depending on the outcome an anticoagulant given.  We see a lot of AF in the critical care (not as much as in CICU but that’s a different game), but we don’t follow the guidance.  Or at least I don’t, but why? 

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Is 0.9% NaCl all that bad? (by Dr Emma Watson)

4/1/2016

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​During my training I think I’ve been steered to think of 0.9% saline as akin to the devil, causing hyperchloraemic acidosis in all it touches – is that true?

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Routine Stress Ulcer Prophylaxis - Why??

12/7/2015

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Whether all critically ill patients need the routine administration of stress ulcer prophylaxis (SUP) has been controversial for over 20 years.  Much of the evidence both for and against is of poor quality, and is pretty old. 

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When a trial is not worth continuing...

1/8/2014

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statins_ards.pdf
File Size: 652 kb
File Type: pdf
Download File

The SAILS (Statins in Acutely Injured Lungs in Sepsis) trial is the latest output (and probably the last) from the ARDS clinical trials network.

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B Blockers in Sepsis

12/10/2013

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Do beta blockers help the body survive the stress response? 
It's fairly well accepted that chronic beta blockade should not be withheld at times of stress.  The POISE trial considered whether starting beta blockers before major non cardiac surgery improved outcome (it didn't - the results showed less MI but more CVAs and increased mortality).  This paper goes towards considering the same for sepsis. 

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    About

    This is a collection of blog posts written about new research or topics of interest.

    ​The posts are ordered as written, so it might make more sense to search by category below.  Failing that, to browse just click 'previous' ayty the bottom of the page and keep going.

    The opinions expressed here are those of the author (Dr P Hersey unless stated otherwise).  You may well disagree, and I certainly don't claim to be an expert or always correct in what I write.

    Conducting research is a nightmare, and any 'criticism' is made on the background of enormous respect for those who can get something from idea to publication.

    If interested, there are some articles about critical appraisal in the 'further reading' section of this website. 

    ​Finally, feel free to leave comments; they add a great deal to the posts.

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This site is written for healthcare professionals.  Nothing on it constitutes medical advice, and opinions expressed are those of the authors.

​Dr Peter Hersey & Dr Laura O'Connor
​​