General Critical Care

Atrial fibrillation (AF) is observed to be 15 times more common in patients with cirrhosis compared to the general population. Despite this high incidence, individuals with cirrhosis have been systematically excluded from randomized clinical trials evaluating anticoagulants in AF patients. To address this gap, researchers utilized two extensive U.S. insurance databases comprising nearly 25,000 patients with cirrhosis and new-onset nonvalvular AF. They conducted a propensity score–matched comparison between patients who began treatment with apixaban and those who initiated either rivaroxaban or warfarin.

The findings revealed that patients treated with apixaban had a significantly lower risk of major bleeding compared to those treated with rivaroxaban (5.1% vs. 8.7% annually) or warfarin (5.1% vs. 7.9% annually). There were no observed differences in the rates of ischemic embolic events (such as stroke) or all-cause mortality among the different oral anticoagulant groups.

This retrospective study, which emulates a randomized study design through the use…

Inorganic nitrate benefits contrast-induced nephropathy after coronary angiography for acute coronary syndromes: the NITRATE-CIN trial | European Heart Journal | Oxford Academic (oup.com)

Videolaryngoscope versus conventional technique for insertion of a transesophageal echocardiography probe in intubated ICU patients (VIDLARECO trial): A randomized control trial

In a clinical trial with 100 intubated critically ill patients, using a videolaryngoscope for transesophageal echocardiogram probe insertion resulted in a higher first-attempt success rate (90% vs. 58%) and overall success rate (100% vs. 72%) compared to conventional techniques. It also reduced pharyngeal complications (14% vs. 52%).

https://www.sciencedirect.com/science/article/abs/pii/S2352556824000043