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CCR-Newsletter-BannerNewsletter 198  |  September 27th 2015


Welcome to the 198th Critical Care Reviews Newsletter, bringing you the best critical care research published in the past week, plus a wide range of free full text review articles, guidelines, commentaries, editorials, study critiques, correspondence and case reports from hundreds of clinical and scientific journals.

The highlights of this week's newsletter are randomized controlled trials investigating the site of central venous catheterization and methylprednisolone for cardiopulmonary bypass, observational studies examining ICU admission for older patients with pneumonia and the alignment of do-not-resuscitate orders with the liklihood of favourable neurological survival after in-hospital cardiac arrest, plus review articles on cardiac arrest, surgery and haemostasis and a series on thoracic anaesthesia. If you only have time for one paper this week, try this one on non-invasive monitoring of oxygen delivery in acutely ill patients.

In the run up to the presentation and publication of the SPLIT, HEAT and VANISH trials at ESICM the week after next, each study will be the focus of the Topic of the Week over the next few weeks. All three studies are being discussed by their chief investigators at the Critical Care Reviews Meeting 2016, so it's a perfect time to look at these issues in greater detail. We start with the age old question of balanced versus unbalanced solutions in the ICU, ahead of Paul Young's SPLIT trial results, with this being the Topic of the Week, starting with one half of a pro/con debate on the use of 0.9% saline in tomorrow's Paper of the Day.



Review Articles










The University of Cambridge are offering a Masters in Clinical Medicine (Intensive Care Medicine), aimed at peri/post CCT trainees from the UK and overseas who aspire to tertiary centre consultant positions. This two year course incorporates concepts within FOAMed and the wider distributed education networks, requiring students to interact with SoMe and FOAM as part of their assessments. The two year programme comprises:

  • A one year part time PGCert, consisting of modules in clinical research, clinical leadership, and clinical education.
  • A two year part time MSt, which typically runs concurrently with the PGCert and consists of a broad range of modules in sub-speciality intensive care medicine and a research dissertation.

Oli Flower, Matt McPartlin and co at Intensive Care Network recently highlighted this fantastic initiative. Further details and registration are available at www.ice.cam.ac.uk/ClinMed


Due to hugely successful previous events, the meeting has moved to a brand new venue, the stunning, multi-million pound Titanic Centre, birthplace of RMS Titanic,  From Wellington, New Zealand, Dr Paul Young will talk on his studies SPLIT (saline versus plasmalyte) and HEAT (paracetamol for pyrexia control). Dr John Holcomb (Houston, USA) will review his mega trial PROPPR, evaluating blood product transfusion ratios in traumatic haemorrhage. Prof Tim Walsh (Edinburgh, Scotland) will review the ABLE study, evaluating age of transfused red cells, as well as RECOVER, a post-ICU rehab study. A late edition to the programme, Dr Anthony Gordon (London, England), will review his VANISH study, a multi-centre randomized controlled trial comparing vasopressin with noradrenaline, with or without hydrocortisone, for first-line vasopressor support in septic shock. In addition, two of the most eminent intensivists in global critical care, Prof Jean-Louis Vincent (Brussels, Belgium) and Prof Luciano Gattinoni (Milan, Italy) will be on hand to discuss the significance of these findings. It won't be all study discussion, with other elements to the meeting, including the spectacularly popular "Informal Chat", taking place that evening.

If you haven't yet attended this modern, niche meeting, then put the date Friday January 29th in your diary. Both delegate and speaker feedback from previous meetings has been incredibly positive, allowing the event to grow and attract some of the biggest names in critical care. The Titanic Centre is just minutes from Belfast City Airport, with a hotel within 3 minutes walking distance, and is a 20 minute walk from the city centre, including the Cathedral Quarter, Belfast's cultural centre full of great restaurants and pubs. Further details regarding delegate rate accommodation should be available in the next week or two. Talks are given in the setting of the rebuilt famous staircase from the great ship, while both the "Informal Chat" session and dinner overlook the floodlit slipways where Titanic and Olympic were launched. With some exciting new innovations planned, this new meeting promises to delivery on its burgeoning reputation. The programme is all but finalised, so don't wait too long before registering, as numbers are capped to keep this an intimate event. It is as strong a one day programme as you could possibly find. If you think your colleagues would find this event interesting, please circulate this information - this is a not-for-profit event, run in association with the Northern Ireland Intensive Care Society. The accommodation for the meeting is now available on the meeting webpage, consisting of discounted rooms at 3*, 4* and 5* hotels in city centre Belfast.

The 4th SMACC Conference comes to Dublin next June. It's on in the spectatcular Dublin Convention Centre, on June 13th to 16th. Registration hasn't opened yet, but I'll keep you informed when it's due to open. Early registration is advised, as the event could book out within 24 hours.

Under the inspired guidance of meeting organiser Ganesh Suntharalingam, this year's State-of-the-Art Meeting promises an exciting programme in a new dynamic format.  It aims to be the first major national society to fully embrace social media and free open access medical education, with an opening plenary session and a workshop, as well full integration of Twitter questions into sessions, live blogging, and open-access AV materials. 

State-of-the-Art is the biggest critical care meeting in the UK, and it's on the move: by combining the resources and influence of the ICS, with a radical redesign and the input of a whole new committee, including several from the FOAMed world, such as Steve Mathieu (The Bottom Line), Jonathan Downham (Critical Care Practitioner), and me. The result should be something unique. It's also the only meeting of this size where the delegates get to steer how the meeting evolves, so have your say.

Take a look at the website or the flyer. The meeting is at London ExCeL, 20 minutes from the West End.

CCH Journal

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