High-Impact Studies Review — June 2025 (3/4)

In this clinical dive from PACUPod, we explore three timely studies changing how we approach critical care, sepsis, and cardiac arrest. First up, we examine a bold randomized trial testing whether ultra-high doses of esomeprazole can reduce inflammation in septic patients. Despite the pharmacologic promise, the results show no reduction in organ dysfunction or inflammatory markers—reminding us that more isn't always better. Next, we break down the hemodynamic physiology of out-of-hospital cardiac arrest from the AMCPR trial. This study reveals that diastolic blood pressure, more than ETCO₂, strongly predicts return of spontaneous circulation—spotlighting real-time metrics that may guide resuscitation strategies in the field. Finally, we look at whether adding lactate to the qSOFA score (LqSOFA) enhances risk stratification for septic patients in the ED. The answer? A solid yes, with better sensitivity for identifying patients who will need ICU care, vasopressors, or who are at risk of death—though specificity takes a small hit. These are insights you can use on your next shift—evidence-based, fast-paced, and practice-changing.