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The Last Drop

The REMAP CAP Ivermectin for COVID-19 Trial

Our latest blog is out

Some treatments save lives. Others teach medicine how to stop.

For centuries, bloodletting was medicine’s answer to illness: plausible, authoritative, visible, and wrong. It survived because it made sense — until clinicians began to count.

The Last Drop follows that old lesson into the COVID-19 pandemic, where ivermectin travelled from in-vitro signal to public certainty, influencer promotion, widespread use, and clinical demand before robust evidence caught up.

REMAP-CAP’s ivermectin trial did not produce a miracle. It produced something more uncomfortable, and perhaps just as important: evidence of non-benefit.

This is a story about bloodletting, ivermectin, REMAP-CAP, and why de-implementing a non-beneficial treatment can be as important as discovering a beneficial one.

added May 13th

CCR26

The Best Critical Care Trials in the World

June 10th - 12th, 2026

Titanic Belfast, Belfast, Northern Ireland

Register

Join us for the SODa BIC trial results on Friday, June 12th. What is the role of sodium bicarbonate in the management of severe metabolic acidosis?.

ABC post ICU Trial Session Flyer
GASTRIC-PICU Trial Session Flyer
SODa BIC Trial Session Flyer
FISSH Trial Results Session Flyer
BIHCA Trial Result Session
ARISE-FLUIDS Results Session
Tele-Rehab Trial Results Session Flyer
MARCH trial session
LOGICAL Trial Session

CCR Meeting Talks

After 14 meetings, we have a huge collection of superb presentations. We'll showcase them here, one at a time.

CCR22  |  FIRST-ABC Trial

Drs Padmanabhan Ramnarayan and Paul Mouncey (both London) present the results of the FIRST-ABC trial, comparing high-flow nasal cannulae therapy with CPAP in acute ill children with respiratory failure, at the Critical Care Reviews Meeting 2022. Dr Srinivas Murthy (Vancouver) delivers an editorial, which is followed by a panel discussion including Profs Kathryn Maitland (Kalifi), John Marshall (Toronto) and Marion Campbell (Aberdeen). The session is chaired by Prof Howard Bauchner.

added April 20th

FIRST-ABC (Step Down) Trial Presentation

Dr Padmanabhan Ramnarayan (London) and Mr Alvin Richards-Belle (London) present the results of the FIRST-ABC (Step Down) trial, comparing high flow nasal oxygen with continuous positive airway pressure in recently extubated children. This was presented during a Critical Care Reviews Livestream event.

Papers

FIRST-ABC (Step-Up)
FIRST-ABC (Step Down)

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Foundational Trials Collection

After many months of preparation, we're delighted to release our Foundational Trials Collection.

250 critical care contemporary trials are summarised and critiqued in depth.

If you are new to the field, are undertaking exams, or just want to refresh your knowledge, this is an excellent place to start.

added February 17th

COVID-ICU

Sample Summaries

CCR Content

CT showing a PE

Paper of the Day

McGuire. Management Strategies for Acute Pulmonary Embolism in the ICU. Chest 2024;166(6):1532-1545

added Thursday May 14th

CCR Newsletter icon

Latest Newsletter

Newsletter 752

(subscription required)

added May 11th

Ventilated patient in bed in the ICU

Highlighted Guideline

Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026. Crit Care Med 2026;epublished March 23rd

added March 24th