Critical Care Reviews Podcast

You're listening to the audio version of the TEAM trial presentation from the Critical Care Reviews Meeting 2023. The TEAM trial investigated early active mobilisation in critically ill mechanically ventilated patients. The trial is presented by Carol Hodgson from Melbourne. Darren Taichman from Philadelphia, delivers the editorial. The session is chaired by Paul Mouncey (Pittsburgh).

Matthew Semler (Nashville, USA) presents the PILOT trial at the Critical care Reviews Meeting 2023, in Titanic Belfast. The PILOT trial compared low, intermediate and high oxygenation targets in critically ill mechanically ventilated patients.  Kath Maitland from Kigali, Kenya, delivers an independent editorial. The session is chaired by Chris Seymour from  Pittsburgh, USA. PILOT was published in the New England Journal of Medicine on November 10th, 2022.

Dr Francois Lamontagne joins Rob Mac Sweeney to discuss the harmonised REMAP-CAP / LOVIT-COVID vitamin C trial. The trial was presented at the European Society of Intensive Care Medicine annual congress and simultaneously published in the New England Journal of Medicine.

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.

Scott Berry and Danny McAuley discuss the results of the statin domain of the REMAP-CAP trial, investigating the effectiveness of simvastatin in treating severe COVID-19. They explore the rationale behind using statins as an intervention, the trial's design and eligibility criteria, and the decision to stop the trial early. The primary outcome and results are presented, highlighting the potential benefits for clinicians. They also discuss response adaptive randomization, the inflammatory phenotype of patients, and the challenges of conducting mechanistic work alongside clinical trials during a pandemic.

Jan Jansen and Marion Campbell present the results of the UK-REBOA trial, investigating the use of REBOA in trauma patients. They discuss the enrollment process, data collection, and clinical trial results. The podcast also covers the importance of reducing time to hemostasis in hemorrhagic deaths and the challenges of managing blunt trauma injuries. Additionally, they explore the difficulties of intubation in children and evaluating efficacy.

Profs Nikki Curry and Karim Brohi present the results of the CRYOSTAT-2 trial, evaluating early and empiric high-dose cryoprecipitate in patients with major traumatic hemorrhage. The panel discusses the importance of fibrinogen in hemostasis, the feasibility and findings of the Cryostat treatment trial, comparing treatment against placebo in trauma trials, military trauma care, delays in analysis and caution with small sample sizes, and the discussion on formula composition and trial framework.

Prof Ivor Douglas (Denver, USA) presents the CLOVERS trial, comparing an early restrictive fluid strategy with an early liberal fluid strategy in adult patients with sepsis-induced hypotension. Prof Fernando Zampieri (Edmonton, Canada), delivers an editorial. The session is chaired by Dr Paul Mouncey (London, England). 

Russell Gruen, Brian Burns and Stephen Bernard present the results of the PATCH-Trauma trial, investigating tranexamic acid in severe trauma. An independent editorial is delivered by Karim Brohi (London). Caroline Leech (Coventry) chairs a panel discussion consisting of Susan Rowell (Chicago), Carol Hodgson (Melbourne), John Holcomb (Birmingham, USA) and John Norrie (Edinburgh).