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Critical Care Reviews Meeting Day 3

The meeting begins at 39 minutes 15 seconds. This is an unedited version of today's talks.

Critical Care Reviews Meeting Day 2

The meeting starts at 40 minutes. This is an unedited version of the day's talks

Critical Care Reviews Meeting Day 1

The traditional 5 minute countdown video begins at 39 minutes 32 seconds. This is an unedited version of today's talks.


Critical Care Reviews Meeting 2021

HOT-ICU Trial Results

Lower or Higher Oxygenation Targets for Acute Hypoxemic Respiratory Failure

Presented at the Critical Care Reviews Meeting, January 20th, and simultaneously published in the New England Journal of Medicine.

January 20th, 2021

In a Danish led, international, multi-centre, randomised controlled trial trial in 2928 adults with acute hypoxaemic respiratory failure, targetting a PaO2 of 8 kPa, in comparison with 12 kPa, did not improve the primary outcome of 90-day mortality (42.9% vs 42.4%; adjusted risk ratio, 1.02; 95% CI, 0.94 to 1.11; P=0.64).

In comparison with the recent LOCO2 trial, there was no increased incidence in mesenteric ischaemia in the lower oxygenation target group.

Longer term outcomes are planned to be presented at CCR22 in Titanic Belfast, January 19th to 22nd.


The World has changed, so we have too

After investing over a decade of time, effort and money into the Critical Care Reviews website, I've decided it's time to refocus back to our main area - critical care trials. Over this period the website has expanded to almost 9000 webpage, consuming vast amounts of time to maintain.

It will take a few months to import the main sections of the old site, so please bear with me as this happens. The new site will be slicker and more streamlined, as well as more visually atractive. All the usual popular features will be maintained, such as journal watch, newsletters, podcasts, books and meeting materials.

The website is far from ideal for going live, but the eCCR21 section is complete, forcing an early move. Critical Care Reviews will continue to be the website to use to stay up-to-date with the latest literature. I hope you enjoy the new look and refocus. I'll have the site repopulated as quick as I can


Critical Care Reviews Meeting 2021

The Best Critical Care Trials in the World

It's less than a week to eCCR21, featuring 5 major trial results, 14 of the most important critical care trials reported in 2020 and 4 additional talks. The entire meeting is being live streamed for free across vimeo, twitter, LinkedIn and, of course, the Critical Care Reviews website.

Registration is open and required for claiming CPD / CME points. The meeting has been approved for 18 points by the Royal College of Anaesthetists. For those not wihing to claim CPD / CME, just watch the live stream on one of the many platforms on which it is available. If you are not free to watch it live, everything will be available afterwards for later viewing. Our talks are released in both video and audio formats.

Please feel free to tell your friends and colleagues.

Major Trial Results

Livestream url

Effect of tocilizumab on clinical outcomes at 15 days in patients with severe or critical coronavirus disease 2019: randomised controlled trial
COVID-19 Tocilizumab

In a Brazilian randomised controlled trial involving 9 hospitals, the use of tocilizumab as a single intravenous infusion of 8 mg/kg plus standard care (n=65) versus standard care alone (n=64), resulted in suimilar levels of mechanical ventilation at day 15 (28% vs. 20; (odds ratio 1.54, 95% CI0.66 to 3.66; P=0.32).), respectively, and increased mortality (17% vs. 3%; odds ratio 6.42, 95% CI,1.59 to 43.2).

BMJ 2021;372:n84, published January 20th


Neonatology

Higher or Lower Hemoglobin Transfusion Thresholds for Preterm Infants

In 1824 infants born prematurely between 22 and 26 weeks and weighing less than 1000 g, a higher hemoglobin threshold for red-cell transfusion did not improve survival without neurodevelopmental impairment at 22 to 26 months of age, corrected for prematurity

Kirpalani et al. N Engl J Med 2020; 383:2639-2651

M.Moira | Shutterstock

COVID-19

Tocilizumab & sarilumab reduce mortality in severe COVID-19

In a pre-print paper, the REMAP-CAP trial investigators have reported efficacy with interleukin 6 receptor anatgonists in critically ill patients with COVID-19. Hospital mortality was 28.0% (98/350) for tocilizumab, 22.2% (10/45) for sarilumab and 35.8% (142/397) for control.

RECOVERY Trial Halts Convalescent Plasma Arm

January 15th 21:00

In 10,406 randomised patients, with 1873 reported deaths, there was no significant difference in the primary endpoint of 28-day mortality -18% convalescent plasma vs. 18% usual care alone; risk ratio 1.04 [95% confidence interval 0.95-1.14]; p=0.34.

Prof Peter Horby, Tweet, Jan 15th

Therapeutic Anticoagualtion halted across 3 COVID-19 Trials

December 22nd

Three large randomised controlled trials, ATTACC, @ACTIV4a, and REMAP-CAP, have, for futility, halted recruitment to their therapeutic anticoagulation arms in critically ill patients with COVID-19.

Recent RCTS

Procalcitonin to Reduce Long-Term Infection-associated Adverse Events in Sepsis

In this trial PCT-guided antimicrobial treatment in sepsis was effective in reducing infection-associated adverse events like infections by multidrug-resistant organisms and Clostridioides difficile, as well as in-hospital and 28-day mortality.

Am J Respir Crit Care Med 2021;202(3):202–210

January 17th 2021

Infant Intubation

First-attempt success rate of video laryngoscopy in small infants

Lancet 2020;396(10266):1905-1913




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