RCTs are Killing Critical Care | Vincent: Damn Right! | Gattinoni: You're Having a Laugh?
Welcome to the 260th Critical Care Reviews Newsletter, which marks 5 years of consecutive weekly newsletters. The highlights of this week's newsletter are two RCTs on inhaled amikacin fosfomycin for gram negative VAP and clarithromycin-naproxen-oseltamivir for influenza A (H3N2), as well as reviews on Plasma-Lyte 148 and the inflammatory response to ECMO.
The Intensive Care Society's State-of-the-Art Meeting is on this week, including round two of the Great Debate from #CCR16 earlier this year. This time Jean-Louis Vincent takes on ANZICS' Steve Webb, again disputing the role of randomised controlled trials in critical care. Have a look at the fascinating discussion between Jean-Louis Vincent and Luciano Gattinoni in Belfast last January and make your own mind up. If you'd like to come to next month's Critical Care Reviews Meeting, John Myburgh will continue the theme in a talk called "The Path to Truth". Can't wait for this one! And speaking of talks from recent conferences, the plenary discussion on the future of publishing and knowledge dissemination from SMACC DUB has just been released. The next ticket allocation for dasSMACC in Berlin in June go on sale on Tuesday night, depending on where in the world you are.
If you'd like to work in the field of critical care social media, there is an opportunity to undertake a fellowship with me in Belfast, where you will learn a wide range of contemporary skills. This post is offered by the Belfast Health and Social Care Trust. Further details can be found here or contact me via email. There are also three other critical care fellowship available, in
The Regional Intensive Care Unit is a world class research hub and the home unit for the REST Trial, investigating extracorporeal CO2 removal in respiratory failure. All fellowships are available for a six month to one year duration, although it may be possible to facilitate longer periods.
See you in London. Please say hi if you're around.
- Abstract: Kollef. A randomized trial of the amikacin fosfomycin inhalation system for the adjunctive therapy of Gram-negative ventilator-associated pneumonia: IASIS Trial. Chest 2016;epublished November 24th
- Abstract: Hung. Efficacy of clarithromycin-naproxen-oseltamivir combination in the treatment of patients hospitalized for influenza A(H3N2) infection: an open-label, randomized controlled, phase 2b/3 trial. Chest 2016;epublished November 21st
- Abstract: Corley. High-flow oxygen via tracheostomy improves oxygenation in patients weaning from mechanical ventilation: a randomised crossover study. Intensive Care Med 2016;epublished November 30th
- Abstract: Giglio. Perioperative hemodynamic goal-directed therapy and mortality: a systematic review and meta-analysis with meta-regression. Minerva Anestesiologica 2016;82(11):1199-213
- Abstract: Desborough. Desmopressin for treatment of platelet dysfunction and reversal of antiplatelet agents: a systematic review and meta-analysis of randomised controlled trials. J Thromb Haemost 2016;epublished November 28th
- Full Text: Yang. Association between time of discharge from ICU and hospital mortality: a systematic review and meta-analysis. Critical Care 2016;20:390
- Abstract: Lonneke. Comparative Analysis of the Host Response to Community-acquired and Hospital-acquired Pneumonia in Critically Ill Patients. Am J Respir Crit Care Med 2016;194(11):1366-1374
- Full Text: Guérin. Effect of driving pressure on mortality in ARDS patients during lung protective mechanical ventilation in two randomized controlled trials. Critical Care 2016;20:384
- Full Text: Ho. The involvement of regulatory non-coding RNAs in sepsis: a systematic review. Critical Care 2016;20:383
- Full Text: Glover. Intravascular versus surface cooling for targeted temperature management after out-of-hospital cardiac arrest – an analysis of the TTM trial data. Critical Care 2016;20:381
- Full Text: Klingele. Prognostic value of procalcitonin in patients after elective cardiac surgery: a prospective cohort study. Annals of Intensive Care 2016;6:116
- Abstract: Flevari. Diaphragmatic ultrasonography as an adjunct predictor tool of weaning success in patients with difficult and prolonged weaning. Minerva Anestesiologica 2016;(11):1149-57
- Abstract: Oeyen. Critically ill octogenarians and nonagenarians: evaluation of long-term outcomes, post-hospital trajectories and quality of life one year and seven years after ICU discharge. Minerva Anestesiologica 2016;epublished November 30th
- Full Text: Dechartres. Reporting of statistically significant results at ClinicalTrials.gov for completed superiority randomized controlled trials. BMC Medicine 2016;14:192
- Parker. A trial to determine whether septic shock-reversal is quicker in pediatric patients randomized to an early goal-directed fluid-sparing strategy versus usual care (SQUEEZE): study protocol for a pilot randomized controlled trial. Trials 2016;17:556
- Kim. The effects of water lubrication of tracheal tubes on post-intubation airway complications: study protocol for a randomized controlled trial. Trials 2016;17:562
- MIllar. The inflammatory response to extracorporeal membrane oxygenation (ECMO): a review of the pathophysiology. Critical Care 2016;20:387
- Weinberg. Plasma-Lyte 148: A clinical review. World J Crit Care Med 2016;5(4):235–250
- Li. Protective approaches against myocardial ischemia reperfusion injury. Experimental and Therapeutic Medicine 2016;12(6):3823-3829
- Della Rocca. What is the Goal of Fluid Management “Optimization”? Turk J Anaesthesiol Reanim 2016;44:224-6
- Licker. Fluid Therapy in Thoracic Surgery: A Zero-Balance Target is Always Best! urk J Anaesthesiol Reanim 2016; 44: 227-9
- Licker. Less Fluids and a More Physiological Approach. Turk J Anaesthesiol Reanim 2016;44: 230-2
- Della Rocca. Fluid Therapy Today: Where are We? Turk J Anaesthesiol Reanim 2016; 44: 233-5
- Ataya. Do patients with submassive pulmonary embolism benefit from thrombolytic therapy? CCJM 2016;83(12):923-932
- Tsai. Recent advances in the management of pulmonary arterial hypertension. F1000Research 2016;5(F1000 Faculty Rev):2755
- Ryu. Current concepts and dilemmas in idiopathic interstitial pneumonias. F1000Research 2016, 5(F1000 Faculty Rev):2661
- Ramdeen. What stool testing is appropriate when diarrhea develops in a hospitalized patient? CCJM 2016;83(12):882-884
- Krajicek. Small Intestinal Bacterial Overgrowth. CCJM 2016;91(12):1828–1833
- Bharadwaj. Malnutrition: laboratory markers vs nutritional assessment. Gastroenterol Rep 2016;4(4):272-280
- Gupte. Liver Transplantation – What the Physician Should Know? JAPI 2016;4:64-69
- Umbro. Acute kidney injury and post-reperfusion syndrome in liver transplantation. World J Gastroenterol 2016;22(42):9314–9323
- Annamalai. Management of refractory ascites in cirrhosis: Are we out of date? World J Hepatol 2016;8(28):1182-1193
- Patel. Utility of blood culture in sepsis diagnostics. J Acad Clin Microbiol 2016;18:74-9
- Nair. Ceftaroline Fosamil: An update. J Acad Clin Microbiol 2016;18:72-3
- Murphy. Update in Pediatric Neurotrauma. Curr Trauma Rep 2016;2(4):222-231
- Thaete. Minimally Invasive Techniques in Orthopedic Trauma. Curr Trauma Rep 2016;2(4):232-237
- Ozkan. Laparoscopy in Abdominal Trauma. Curr Trauma Rep 2016;2(4):238-246
- Morimoto. Awareness during anesthesia: Current status in Japan. World J Anesthesiol 2016;5(3):62-66
- Gunaydin. Anesthetic considerations for liver diseases unique to pregnancy. World J Anesthesiol 2016;5(3):54-61
- Desousa. Pain on propofol injection: Causes and remedies. Indian J Pharmacol 2016;48:617-23
American Journal of Respiratory & Critical Care Medicine
- Goligher. Physiologic Responsiveness Should Guide Entry into Randomized Controlled Trials. Am J Respir Crit Care Med 2015;192(11):141-1419
- Klompas. Potential Strategies to Prevent Ventilator-associated Events. Am J Respir Crit Care Med 2015;192(11):1420-1430
- Palevsky. High-Volume Hemofiltration in Post–Cardiac Surgery Shock. A Heroic Therapy? Am J Respir Crit Care Med 2015;192(10):1143-1144
- Hebert. Does Age of Blood Matter? It Depends. Am J Respir Crit Care Med 2015;192(10):1150-1151
- Chastre. Continuous β-Lactam Infusion to Optimize Antibiotic Use for Severe Sepsis. A Knife Cutting Water? Am J Respir Crit Care Med 2015;192(11):1266-1268
- Ataya. Cardiac Dextroversion after Right Lower Lobe Lobectomy. Am J Respir Crit Care Med 2015;192(10):e55-56
- Lee. Foreign Body Aspiration of a Press-Through Package That Lodged between the Vocal Cords. Am J Respir Crit Care Med 2015;192(11):1517
- Palkar. Pulmonary Venous Varix. Am J Respir Crit Care Med 2015;192(11):e59
Anesthesia & Analgesia
- Dexter. Associated Roles of Perioperative Medical Directors and Anesthesia: Hospital Agreements for Operating Room Management. Anesthesia & Analgesia. Anesth Analg 2015;121(6):1469-1478
- Mason. Caring for the Jehovah’s Witness Parturient. Anesth Analg 2015;121(6):1564–1569
- Weidman. The Cognitive Science of Learning: Concepts and Strategies for the Educator and Learner. Anesth Analg 2015;121(6):1586-1599
- Levin. Data, Big Data, and Metadata in Anesthesiology. Anesth Analg 2015;121(6):1661-1667
- McCunn. Trauma, Critical Care, and Emergency Care Anesthesiology: A New Paradigm for the “Acute Care” Anesthesiologist? Anesth Analg 2015;121(6):1668-1673
- Mascha. Alpha, Beta, Meta: Guidelines for Assessing Power and Type I Error in Meta-Analyses. Anesth Analg 2015;121(6):1430–1433
- Parry-Jones. Haematological malignancy and critical care - new bedfellows?. Anaesthesia 2015;70:1341–1344
- Busani. Intravenous immunoglobulin in septic shock: review of the mechanisms of action and meta-analysis of the clinical effectiveness. Minerva Anestesiologica 2016 May;82(5):559-72
- Le Guen. Closed-loop anesthesia. Minerva Anestesiologica 2016 May;82(5):573-81
- Cabrini. Critical care in the near future: patient-centered, beyond space and time boundaries. Minerva Anestesiologica 2016;82(5):599-604
- Anonymous. Updates on blood transfusion guidelines. Lancet Haematology 2016;3(12):e547
- Beam. Translating Artificial Intelligence Into Clinical Care. JAMA 2016;epublished November 29th
- Guertin. New avenues for reducing intensive care needs in patients with chronic spinal cord injury. World J Crit Care Med 2016;5(4):201-203
- Arabi. Intensive Care Medicine in 2050: global perspectives. Intensive Care Med 2016;epublished November 29th
- Kim. Can a high-flow nasal cannula substitute for noninvasive positive pressure ventilation in post-extubation respiratory failure? Korean J Intern Med 2016;31(1):36-39
Once again the Critical Care Reviews Meeting will be discussing the biggest studies of the previous year with their chief investigators, asking the question "should we implement the results of this trial into our dialy practice?". We also have the John Hinds Trauma Lecture, delivered this year by Prof Donat Spahn (Zurich), lead for the new European Trauma Guideline, published a few months ago. Paul Marik thinks he has discovered "The Cure for Sepsis", while John Myburgh will explain the ins and outs of research methodology in the "Path to Truth". In addition, there is the very popular "How I Manage....." series of short talks from our speakers on conditions they are experts in, the "Year in Review" and the now famous "Informal Chat" in the bar after the main event.
Don't forget to register for dinner also, where the menu is based on an original menu from the only sailing the Titanic made. Registration for both the meeting and meal is available on the meeting webpage. The Critical Care Reviews Meeting is a not-for-profit event.
Following last year's massively successful event, the UK Intensive Care Society's State-of-the-Art Meeting is starting its build-up to 2016. The ICS completely changed its game in 2015, and relaunched SOA as a new beacon for forward-looking clinical content, open-access education, and medical social media. In keeping with the times, the podcasts and other materials from last year's meeting have been made open access.
This year the programme is looking even better, with topics ranging from the futuristic (space medicine, Formula 1 applied technology, Google Deepmind, and AI) through to the human, practical, and controversial (look out for the clinical scenarios, controversies, and the "From Ivory Tower to Desert Island" session). Speakers include Peter Brindley, Kevin Fong, Jack Iwashyna, Kath Maitland, Louise Rose, Mervyn Singer, and Jean-Louis Vincent among many others. It runs from Mon 5th - Wed 7th Dec, and I hope I'll see you there. Keep an eye on http://soa.ics.ac.uk for programme and registration, and meanwhile enjoy the comprehensive FOAM from last year.
The first release of tickets for Das SMACC sold out in just 2.5 hours this week. The next opportunity will be on Wednesday December 7th (depending on where you are in the world). If you haven't yet checked out the programme and workshops, then have a look on the SMACC website. The Hardcore Intensive Care workshop being organised by Steve Mathieu and Sarah Yong will cover all your critical care questions.
(Image from Chensiyuan via Wikipedia)
Critical Care Horizons is a fresh new voice in the critical care literature, offering thought-provoking, cutting-edge commentary and opinion papers, plus state-of-the-art review articles. The journal is free to publish with and free to read, opening authorship opportunity to all. The energetic editorial board consists of a deliberate mix of clinicians active in social media and world renowned academics, all driven by a desire to improve the care we offer our patients, and operate without financial gain or incentive. If you have an idea for a paper, and can say it in an engaging manner, please get in touch. We also need peer reviewers.
COI - I am the editor-in-chief of this new journal, but work in a voluntary capacity, as do all the editors.
I hope you find these links useful.
Until next week