Experts from diverse backgrounds discuss causality at the Critical Care Reviews Meeting 2023. They explore challenges in establishing causality through trials and the importance of maintaining integrity in research practices. The panel delves into the complexities of determining causality in clinical trials, emphasizing personalized treatment approaches and the future of critical care research.

Mark Peters and Doug Gould present the OXY-PICU trial results comparing conservative with liberal oxygenation targets in critically ill children. Luregn Schlapbach delivers an independent editorial. Topics discussed include findings of a study on conservative oxygenation, trial design and methodology, organ support analysis, statistical methods, deciding on initial analysis, role of journal editors in implementing study results, and importance of including nurses in ICU discussions.

Theresa Olasveengen, Victoria Cornelius, and Christopher Seymour join trialists Mikael Fink Vallentin and Lars Andersen, as well as editorialist Gavin Perkins, to discuss the COCA trial. They explore the stone heart phenomenon, the use of dual analytic approaches in trials, and reflections on trial design and execution.