SCCM Resource Library-August Journal Club: Spotlight on Pharmacy (2025))

Video Transcription

Video Summary

The Journal Club Spotlight on Pharmacy webcast featured three critical care pharmacy residents presenting recent studies relevant to ICU patient care. Nimita Patel discussed the AFT-IT trial investigating early Tirofiban administration after intravenous thrombolysis in acute ischemic stroke. This large Chinese multi-center randomized trial found Tirofiban improved excellent functional outcomes (modified Rankin score 0-1 at 90 days) compared to placebo but with a slight increase in symptomatic intracranial hemorrhage. The study excluded patients with cardioembolic stroke, atrial fibrillation, or high stroke severity, limiting generalizability. Patel suggested further investigation in diverse populations and more severe strokes. Layla Dugo presented a retrospective cohort study using MIMIC-4 data, comparing laxatives (Senna, Docusate sodium, PEG, Lactulose) in critically ill septic patients for 28-day mortality and ICU outcomes. Docusate sodium was associated with the highest survival probability, improved bowel sound recovery, and no increased risk of C. difficile infection, while lactulose showed worse outcomes and increased infection risk. Limitations included exclusion of combination laxative use and lack of control for confounders like opioid use. Dugo recommended continued docusate use but cautioned for further studies to define optimal bowel regimens. Petra Earhart reviewed the SAFE-ECMO pilot trial comparing low versus moderate-intensity anticoagulation in venovenous ECMO patients. Low intensity (prophylactic heparin/enoxaparin) showed fewer major bleeds with no significant rise in thromboembolic events versus moderate intensity (therapeutic heparin/bivalirudin). The small multi-center RCT suggests low intensity anticoagulation is feasible and may reduce bleeding risk, but larger trials are needed before practice changes. Overall, the webcast highlighted evolving evidence on stroke therapies, bowel management, and anticoagulation tailored to critically ill patients, emphasizing the need for further research to enhance safety and efficacy in ICU pharmacotherapy.

Asset Subtitle

Neuroscience, Sepsis, Cardiovascular, 2025

Meta Tag

Content Type Webcast

Knowledge Area Neuroscience

Knowledge Area Sepsis

Knowledge Area Cardiovascular

Membership Level Associate

Membership Level Professional

Membership Level Select

Tag Anticoagulation

Tag Extracorporeal Membrane Oxygenation ECMO

Year 2025

Keywords

Webcast

Neuroscience

Sepsis

Cardiovascular

Anticoagulation

Extracorporeal Membrane Oxygenation ECMO

2025

Associate

Professional

Select

AFT-IT trial

Tirofiban

acute ischemic stroke

laxatives in sepsis

Docusate sodium

SAFE-ECMO trial

low intensity anticoagulation

ICU pharmacotherapy

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