🔍 Searchable Index

NUTRIREA-1: no GRV monitoring non-inferior for VAP; ESICM AGI grading I-IV; cirrhosis-specific prokinetic survival benefit

PRESENCE trial: offering choice reduced PTSD; Cochrane review found insufficient evidence - genuine strong-trial-vs-cautious-meta-analysis tension

FEAST trial: fluid boluses increased mortality in African children, overturning global assumption

TADA avoids the word 'futility' deliberately; real data shows only 27 actual withdrawals from 974 consultations

Telestroke transforms rural hospital capability; reimbursement flows to remote specialist not local hospital - real sustainability barrier

Earplugs/eye masks improve sleep quality but not proven to reduce delirium; multicomponent bundles clearly superior

Life-threatening injury takes precedence over decontamination; 36-48h surgical window before cytopenia worsens

Counterintuitive chest compression finding; REBOA vs thoracotomy comparable outcomes; 77% distal thrombus rate

NPWT+dynamic fascial traction: 80-90% closure rates, lower mortality vs alternatives

Association vs causation gap; RADAR-2 subgroup harm signal in ventilated septic patients with early de-resuscitation

Mechanism-dependent agent selection; MBL producers remain the persistent gap; colistin's genuine demotion (RESTORE-IMI 1)

2024 ATS guideline against routine empiric antifungals; Candida score trigger; rezafungin once-weekly dosing

Strong process-outcome evidence, honestly mixed hard-outcome data (HAP/VAP meta-analysis found no mortality benefit)

Unresolved debate: is NCSE independently harmful or just a severity marker; ictal-interictal continuum

2023 unified guideline: single exam sufficient; strict determination/donation conflict-of-interest separation

Never abruptly stop home PDE5i or iNO - rebound RV failure/pulmonary hypertension; PDE5i+nitrate contraindication

RV systolic+diastolic coronary perfusion; norepinephrine's mixed human RV effect; caution with inodilators in RV MI

DanGer Shock: first MCS mortality benefit ever shown (45.8% vs 58.5%); VA-ECMO downgraded to Class 3

Nearly half die within 1 year; half of survivors ADL-dependent at 2 years; genuine prognostic uncertainty at trach decision point

REST trial found harm signal for routine use; targeted selective use per 2022 consensus may differ

SUPPORT trial harm signal; conflicting modern meta-analyses; confounding by indication

NPWT works for treatment (reduces mortality/reinfection) but prophylactic use showed MORE infections in one study

Remote-HIT heparin re-exposure strategy; bivalirudin CHOOSE-ON trial; diagnostic confounding in post-CPB thrombocytopenia

VHA-guided transfusion genuine evidence; three protamine reaction types; NPH insulin risk factor

Flutter/VT/AV block management; low threshold for permanent pacing given late AV block risk

Type 5 MI threshold officially 'arbitrary'; normal-troponin CABG patients hit 270x URL with no infarction

STS Expert Consensus: 3-shock rule, 5-min resternotomy target, deliberate departure from ACLS

PCCS-specific outcomes worse than general CS (34% vs 20-65%); combo IABP+ECMO improves weaning

Methylene blue vs hydroxocobalamin mixed evidence; serotonin syndrome risk with methylene blue

10-45% complex separation rate; difficulty independently predicts survival; TEE-guided approach

Complement/coagulation activation data; multi-hit hypothesis; honest skepticism on anti-inflammatory interventions

Jamieson classification; PA catheter balloon must NEVER be wedged post-PEA; massive hemoptysis emergency

ISHLT PGD 0-3 grading rule; Grade 3 linked to long-term CLAD risk

PGD drops 1-year survival 95%->75%; dd-cfDNA/GEP modern surveillance vs biopsy-only

Conflicting DAPT trials (CASCADE/DACAB/TOP-CABG); tamponade case with wrong vasopressor choice

DHCA vs ACP unresolved after a decade; devastating missed-malperfusion case study

RE-ALIGN DOAC contraindication; Merie registry challenges bioprosthetic low-risk guidance; dramatic case study

Three-tier CSC framework; Truog critique of ventilator allocation protocol workability

Up to 80% physician burnout; direct link to medical errors; systems approach vs individual resilience framing

Kirkpatrick levels 1-2 vs 3-4 gap; CVC mastery learning cut CLABSI 74% - the genuine exception

BIV vs LCV values framework; PARTNER trial mixed result; Schneiderman ethics consultation trial

28% autopsy misdiagnosis rate; bias training doesn't reliably fix real-time reasoning

Closed vs open ICU mortality data; tele-ICU outcome trial; nurse ratio evidence

Epic Sepsis Model deployment failure (AUC 0.63) vs TREWS/Sepsis Watch validated success

15 Gaba/Rall principles; closed-loop communication; strong sim evidence, thinner real-outcome data

SPIKES framework; ICUconnect trial found unequal benefit across racial groups

PALACS: pericardiotomy nearly halves POAF but no 30-day outcome benefit yet shown

CONSCIOUS trials: angiographic vasospasm reduced, functional outcome not improved

EPaNIC, PermiT, EFFORT Protein/PRECISe/TARGET Protein

NOTE: overlaps with 9. Refeeding Syndrome (Endocrine) - manual review needed. Doig RCT evidence review

SMART vs BaSICS/PLUS; pre-enrollment fluid exposure

Contrast with Goals of Care's cautionary findings

eCASH; SPICE III/MENDS2 vs PADIS guideline tension

23%/30% error reduction vs weaker replication at higher study rigor

Prevention-during-ICU vs disappointing post-discharge evidence

TEAM trial's prediction-accuracy lesson

Carson et al. and condolence-letter harm signals

SAFE's rare decisive result; persistent shock-specific signal

CIWA-Ar's non-verbal-patient limitation; phenobarbital evidence

Delphi consensus; nighttime discharge mortality signal

PREVENT trial; LMWH vs UFH

PENT screening tool for non-cooperative patients

VIP1/VIP2/COVIP; frailty over chronological age

NOTE: possible duplicate with another 2. Ruptured AAA page - worth a manual check

2025 exploratory analysis narrows window to ~90 min

NNT 274; WOMAN-2 negative prevention result

Full revision incorporating recent landmark trials

ANNEXA-I: surrogate efficacy met, clinical outcome not improved

HEMOTION/TRAIN exception for acute brain injury

2022 SHEA/IDSA updates; SDD flagged as unresolved

SIRS/MEWS over qSOFA; source control timing; active de-resuscitation

Pooled-vs-individual-trial tension

BALANCE trial; source-control-dependent duration table

Contrasts with TTM's fever-avoidance recommendation

Augmented renal clearance; BLING III Bayesian reframing

Single-center enthusiasm to LOVIT harm signal

Full revision incorporating March 2026 SSC guideline

ADRENAL vs APROCCHSS discordance; fludrocortisone practice gap

Shrinking effect size as fixed-duration stewardship matures

Leuven-to-NICE-SUGAR arc; 140-180 mg/dL standard

NOTE: overlapping deep-dive exists in Miscellaneous Topics - see index note

Propensity-matched/counterfactual evidence vs traditional teaching

STARRT-AKI; watchful-waiting with defined boundary

Practice-resolving REVISE trial

ABCDEF bundle; MIND-USA, AID-ICU, melatonin controversy

Phenotype-driven agent selection; SSC ladder

TTM2; fever prevention vs hypothermia; HYPERION exception

EF-mortality dissociation; RV dysfunction as better marker

ARREST vs INCEPTION; systems-dependency of outcomes

Catheter-directed thrombolysis intermediate-high-risk PE

Morelli's dramatic result vs STRESS-L's harm signal

Dynamic vs static measures; CLASSIC/CLOVERS equipoise

Frequentist negative vs 96% Bayesian posterior probability

Clinical-prediction-failure lesson

Dose-response explanation for largest single-trial effect

Risk-stratified extubation planning; NIV/HFNC timing

UK-ROX 2025; population-specific signals

MACOCHA, DAS 2025, SOCCA Delphi, INTUBE

Primary-vs-secondary-outcome caution; HIGH trial discordance

Comparator drift, not the drug, explains the discordance

Ehrmann meta-trial; dose-response duration finding

Subira's mortality finding and co-intervention confound

Agent-specific divergence under shared negative headline