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CCR Blog

The Etomidate Conundrum

Induction for rapid sequence intubation (RSI) in the critically ill often feels like the swing of a pendulum. Toward etomidate—hemodynamic poise, clean hypnosis, and familiar dosing. Back toward ketamine—sympathomimetic support, bronchodilation, and neuro-myths in slow retreat. The science, at times, looks just as mercurial. This review examines the terrain with a steady eye: what goes wrong when we intubate the critically ill; why physiology, not just anatomy, governs risk; what etomidate and ketamine truly offer; what the best comparative trials show; and a look forward to the upcoming results of the RSI trial at CCR Down Under 2025.

Added September 4th

ENCOMPASS Trial Results Presentation

Stephanie Parks Taylor (Michigan) presents the results of the ENCOMPASS trial at CCR25. Jo McPeake (Cambridge) gives an independent editorial. Fernando Zampieri (Edmonton), Monica Taljaard (Toronto) and Lee-anne Chapple (Adelaide) join chair Bronwen Connolly (Belfast) in a panel discussion. The ENCOMPASS trial evaluated a multicomponent, navigator-led sepsis transition and recovery program.

JAMA Internal Medicine Paper

Parks Taylor. Proactive Telehealth-Based Sepsis Transition and Recovery Support, Hospital Readmission, and MortalityA Randomized Clinical Trial. JAMA Intern Med 2025;epublished August 11th

Interview with the Trialists

Journal Watch Latest

AABB Red Cell Transfusion Guideline in Acute Myocardial Infarction

Recommendations

  • For hospitalized patients with AMI, the panel suggests a liberal red cell transfusion strategy when the hemoglobin concentration is less than 10 g/dL (conditional recommendation, low-certainty evidence).
  • A restrictive strategy of 7 to 8 g/dL may result in increased mortality in patients with AMI.
  • The direction of the recommendation for the liberal strategy was based on the great importance of mortality for patients.
  • The conditional recommendation was based on the low certainty of evidence and the competing consideration of blood supply conservation.

added August 19th

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Narrative Reviews

Frat. Noninvasive respiratory supports in ICU. Intensive Care Med 2025;51:1476–1489

added August 21st

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Transcranial doppler ultrasound

Narrative Review

Cashmore. Transcranial ultrasound in the critically ill patient: a narrative review. ICMx 2025;13:86 

added August 19th

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Narrative Review

Yamamoto. Mechanism of sepsis. J Mol Pathol 2025;6:18

added August 14th

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Randomised Controlled Trial

TIGRIS Trial Result Press Release - Polymyxin B Hemoadsorption Therapy for Endotoxic Septic Shock

  • Results exceed prespecified primary endpoint of 95% posterior probability of benefit for PMX on 28-day mortality

added August 13th

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CCR Meeting Talks

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

CCR19

APROCCHSS Trial Review

Prof Djillali Annane (Paris) discusses the APROCCHSS trial, investigating fludrocortisone and hydrocortisone in septic shock.

added August 17th

CCR Content

Liver transplant operation

Paper of the Day

Friday, September 5th

Téblick. Critical Illness–induced Corticosteroid Insufficiency: What It Is Not and What It Could Be, J Clin Endocrinol Metab 2022;107(7):2057–2064

Join us to read one paper per day and cover the spectrum of critical care across 2025. Previous papers of the day are available here.

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Newsletter 715

Critical Care Reviews Newsletter 715, bringing you the best critical care research and open access articles for the week August 18th to 24th.

Subscriptions are available to individuals and departments.

added August 24th

CRRT machine

Highlighted Narrative Reviews

With thousands of open access narrative reviews listed across the website, CCR provides a comprehensive educational resource. We'll highlight one topic here every few days. Today, we look at Acute Kidney Injury

added August 20th

Hydroxyethyl starch fluid hanging from a drip stand

Foundational Trials

Myburgh JA, Finfer S, Bellomo R, Billot L, Cass A, Gattas D, et al; CHEST Investigators; the Australian and New Zealand Intensive Care Society Clinical Trials Group. Hydroxyethyl Starch or Saline for Fluid Resuscitation in Intensive Care. N Engl J Med. 2012;367(20):1901–1911

It's the latest in our Foundational Trials collection, looking at the trials which underpin contemporary critical care practice

added August 19th

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Highlighted Guidelines

Need a guideline, or just want to refresh your knowledge on the evidence-based management of a particular condition? We provide more up-to-date guidelines than any other critical care resource. Have a look at our ARDS Guideline section

added August 12th

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CCR Down Under 2025

Registration has opened for CCR Down Under in Melbourne, on December 9th and 10th, again at the Edge in Federation Square.

We aim to bring another set of fantastic international critical care trials to Australia. If you are interested in the science underlying clinical practice, this is the meeting for you.

We're delighted to be partnering once again with the Alfred Intensive Care Academic Centre, and this year, with Monash University.

If you missed the presentations last December, the presentations of the so far published trials are available here.

Register