SCCM Resource Library-March Journal Club Webcast: Spotlight on Pharmacy (2022)

Video Transcription

Video Summary

This Journal Club Spotlight on Pharmacy webcast discussed the use of a balanced multi-electrolyte solution versus saline in critically ill adult patients. The presenters reviewed several randomized controlled trials that compared the two fluids and found no significant difference in mortality rates. They also discussed the potential mechanisms of injury associated with the use of normal saline, such as metabolic acidosis and impaired organ function. The presenters concluded that for volumes of 3.5 to 4 liters, both balanced solutions and normal saline are likely appropriate for fluid resuscitation in most patients. However, they noted that specific patient populations, such as those with traumatic brain injury or diabetic ketoacidosis, may benefit from a specific fluid. The second presenter discussed the use of 5% human albumin versus normal saline for fluid resuscitation in sepsis-induced hypotension among patients with cirrhosis. The presenter highlighted a study that found a positive response rate to albumin and identified lower baseline P-to-F ratio and non-COVID-19 ARDS as variables associated with a positive response. The third presenter discussed the use of inhaled epiprostanol in the treatment of acute respiratory distress syndrome, including patients with SARS-CoV-2 infections. The presenter reviewed several studies that found a positive response rate to inhaled epiprostanol in both COVID-19 ARDS and non-COVID-19 ARDS patients, particularly in those with lower baseline P-to-F ratio. The presenter concluded that while the use of inhaled epiprostanol may have some benefits in improving oxygenation, more research is needed to assess its clinical benefits, such as days on the ventilator and mortality rates. Overall, the webcast provided an overview of the current evidence regarding the use of these fluids and inhaled epiprostanol in critically ill patients and highlighted the need for further research in these areas.

Asset Subtitle

Pharmacology, Pulmonary, Sepsis, 2022

Asset Caption

"The Journal Club: Spotlight on Pharmacy webcast series focuses on pharmacy topics. This event is held on the third Friday of each month and features lively discussion and in-depth presentations on the latest research.

Anna White, PharmD, MBA
Finfer S, Micallef S, Hammond N, et al. Balanced multielectrolyte solution versus saline in critically ill adults. N Engl J Med. 2022 Mar 3;386(9):825-826. doi: 10.1056/NEJMoa2114464

Cathy To, PharmD
Philips CA, Maiwall R, Sharma MK, et al. Comparison of 5% human albumin and normal saline for fluid resuscitation in sepsis induced hypotension among patients with cirrhosis (FRISC study): a randomized controlled trial. Hepatol Int. 2021 Aug; 15(4): 983-994.

Matthew Bjornstad, PharmD
Niss HL, Mohamed A, Berry TP, Saettele TM, Haines MM, Thomas EL. Evaluation of continuous inhaled epoprostenol in the treatment of acute respiratory distress syndrome, including patients with SARS-CoV-2 infection. Ann Pharmacother. 2022 Jan 13;10600280211069182. doi: 10.1177/10600280211069182

Follow the conversation at #SCCMCPPJC."

Meta Tag

Content Type Webcast

Knowledge Area Pharmacology

Knowledge Area Pulmonary

Knowledge Area Sepsis

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Tag Fluids Resuscitation Management

Tag Acute Respiratory Distress Syndrome ARDS

Tag Sepsis

Year 2022

Keywords

balanced multi-electrolyte solution

saline

critically ill patients

fluid resuscitation

traumatic brain injury

diabetic ketoacidosis

5% human albumin

sepsis-induced hypotension

inhaled epiprostanol

acute respiratory distress syndrome

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