Round 2 : ICU Jeopardy - Copy

Trials by Fire

100

Published in NEJM in 2010

In patients with severe ARDS, early administration of a neuromuscular blocking agent (Cisatracurium) improved the adjusted 90-day survival and increased the time off the ventilator without increasing muscle weakness.

ACURACYS TRIAL

200

Published in NEJM 2023, 31 French ICUs

Research Question : In patients with severe CAP does the use of hydrocortisone compared to a placebo reduce 28-day mortality?

I : 200mg Inj Hydrocort as a infusion in severe CAP

Outcomes:

Death by day 28: Hydrocortisone 6.2% vs Placebo 11.9% 

CAPE COD trial

300

• Published in NEJM 2018
• In non-critically ill adult patients admitted from the Emergency Department (ED), does the administration of a balanced salt solution compared with normal saline, reduce hospital free days to day 28?
• There was no difference in the number of hospital-free days between patients in the balanced crystalloids and saline groups
• Patients in the balanced-crystalloids group had a significantly lower incidence of Major Adverse Kidney Events within 30 days (MAKE 30) 
• NNT 111

SALT-ED TRIAL

400

Published in JAMA 2021

In mechanically ventilated patients with acute hypoxaemic respiratory failure, does lowering tidal volume using ECCOR, compared with conventional low tidal volume ventilation, improve day 90 all-cause mortality?

Outcome : No difference in primary outcome of day 90 all cause mortality 

REST Trial

500

This 2022 phase 3 RCT published in NEJM, investigated whether high-dose intravenous vitamin C could improve outcomes in ICU patients with sepsis on vasopressors—but instead found higher rates of death or persistent organ dysfunction in the treatment group.

LOVIT 

(Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit)

'Figure' me out

100

Cocaine toxicity

200

Specific treatment of the condition given below

Hypertriglyceridemic pancreatitis

Plasma exchange

Insulin + Dextrose infusion

300

What is being depicted here?

Ethylene Glycol Poisoning

400

Identify the possible diagnosis/causative organism

Meliodosis/ Burkholderia pseudomallei

500

What is being measured in this figure?

Indirect calorimetry 

(resting energy expenditure)

'Candid'ly yours

100

Most common Non Albicans Candida sps isolated in India

Candida tropicalis

200

This MDR Candida sps was first identified in 2009 in Japan, specifically from the ear canal of a patient

Candida auris

300

Amongst the current azoles we use in our ICU, this agent has the broadest spectrum of activity

Posaconazole

400

This Candida species is intrinsically resistant to amphotericin B. 

Candida haemulonii

Candida lusitaniae

500

This class of antifungal drugs are fungicidal against Candida sps but fungistatic against Aspergillus

Echinocandins

HOCUS POCUS

100

Portal Vein

200

Identify the "??"

Pleural effusion

300

What is being measured here?

Mitral Annular Plane Systolic Excursion (MAPSE)

400

Aortic dissection

500

30 male admitted with  3 day  H/0 headache , vomiting , altered consciousness. Pt intubated and put on sedation infusion and TCD done. Interpret

Features suggestive of cerebral vasospasm

Take my 'breath' away

100

"Otis Equation" is used in this ventilatory mode

Adaptive support ventilation (Hamilton)

200

Drinker Collins respirator is another name for this ventilator. (Clue "Polio Epidemic")

Iron lung

300

A patient is being ventilated in volume control mode with the following settings:

Tidal Volume (VT): 400 mL

I:E ratio: 1:2

Respiratory Rate (RR): 20 breaths/min

FiO₂: 40%

PEEP: 10 cmH₂O

Peak Inspiratory Pressure (PIP): 37 cmH₂O

Plateau Pressure (Pplat): 25 cmH₂O

Calculate the airway resistance (Raw) in cmH₂O/L/s.

Raw = (PIP - Pplat) / Flow

PIP – Pplat = 40 – 25 = 15 cmH₂O

Inspiratory time = Total cycle time / (I + E ratio)

→ 60 / 20 = 3 seconds/cycle → Inspiratory time = 3 s × 1 / (1+2) = 1 s

Flow = VT / Ti = 0.4 L / 1 s = 0.4 L/s

Raw = 12 / 0.4 = 30 cmH₂O/L/s

400

Which technique is considered the gold standard for measuring static lung compliance in anesthetized or paralyzed patients?

Super syringe method

500

Identify the equipment/machine and 2 trials why it fell out of favour?

HFOV

OSCAR and OSCILLATE