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I am pleased & proud to see the #PLUStrial published in @NEJM today. It is my 10th @NEJM paper! Here’s my list of @NEJM papers and what I think they mean for clinical practice
#1: The #HEATtrial (Dec 2015) showed that using paracetamol to treat fever in ICU patients with suspected infections did not affect the number of ICU-free days. Mortality rates were similar in paracetamol & placebo-treated patients:
nejm.org/doi/full/10.10…
nejm.org/doi/full/10.10…
These data provide reassurance that if paracetamol is administered to treat fever in the setting of an infection or given for another reason to a patient who happens to have fever & infection, such as for analgesia, harm is unlikely to result.
The @hrcNewZealand and @nhmrc funded #PLUStrial is the latest in a series of RCTs that have compared balanced crystalloids with saline in patients who are critically ill. It was published today in the @nejm nejm.org/doi/full/10.10…
Millions of litres of intravenous fluids are administered around the world every day. For patients who are acutely ill, small differences in mortality attributable to fluid choice would have profound global public health importance
We included 5037 patients from 53 ICUs in Australia & New Zealand. The primary end point was 90 day mortality. Day 90 mortality was 21.8% and 22% for balanced crystalloid and saline respectively (P=0.90).
