CCR-Newsletter-BannerESICM Congress 2017 / September 27th

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Welcome to a supplemental Critical Care Reviews Newsletter, bringing you the 5 major research studies presented and published at the 2017 ESICM Hot Topics Session in Vienna this afternoon. There have been multiple studies presented over the past few days, but not all have been published. Many were pre-published by Intensive Care Medicine and included in last week's newsletter. Unfortunately, the videos of the talks from the start of the week appear to be paywalled on the ESICM website, while the recordings of today's talks aren't up yet.

Of note, three of the trials presenting during these sessions will be discussed at the Critical Care Reviews Meeting next January. Prof Alistair Nichol will explain the findings of the TRANSFUSE trial, comparing transfusion of the freshest available blood with standard issue (oldest) red cells. Once again, fresh blood appears to offer little benefit, and may be harmful. Prof Alexandre Biasi Cavalcanti is travelling from São Paulo to talk about the ART Trial, investigating alveolar recruitment in ARDS. Interestingly, stepwise recruitment, as performed in this trial, resulted in increased mortality. The third trial presented was BREATHE, evaluating the role of extubation to non-invasive ventilation in patients failing spontaneous breathing trials. This reported multiple benefits amongst the secondary endpoints, but doesn't seem to have been published today. Two other studies were published today - ICE-CUB 2, evaluating routine admission of elderly sick patients to ICU, and a trial from Zambia, adding yet more weight to the argument against early goal-directed sepsis resuscitation. There were three other studies presented today: the preliminary results of the SUPERNOVA trial, suggesting ECCO2R is safe to use; the REDUCE trial, which reported no benefit from low dose haloperidol for the prevention of delirium in patients at high risk of this condition, and INPRESS, evaluating blood pressure targets in major surgery (whch I missed the presentation of).

If you like this newsletter containing the latest research in critical care, then you'll love the next Critical Care Reviews Meeting 2018, where you'll have a chance to discuss some of these trials with their chief investigators, as well as deliberating over the other most interesting critical care studies of the year. You'll also get a copy of the Critical Care Reviews Book 2018, summarising, critiquing and putting in context the best critical care trials of 2017.

In January, we will also have four other major RCTs to discuss. From Nantes, France, Dr Jean-Baptiste Lascarrou will consider the findings of the MACMAN trial, evaluating video laryngoscopy in the ICU. Dr Ashish Khanna, from the Cleveland Clinic, USA, will reflect on ATHOS-3 the first large clinical trial examining angiotensin II in septic shock. Prof John Simpson, from Newcastle, England, will discuss the VAP-RAPID trial, evaluating the use of a biomarker-guided approach to exclude ventilator-associated pneumonia. Lastly, From Brisbane, Australia, Prof Bala Ventakesh will explore the currently unpublished ADRENAL trial, examining hydrocortisone in septic shock in the biggest sepsis trial ever undertaken.

If that's not enough, we also have Prof Andrew Rhodes, from London, exploring the latest iteration of the Surviving Sepsis Campaign, published earlier this year and Dr Sophie Wallace (Perth, Australia), who will deliver the honorary John Hinds Trauma Lecture, entitled "Disaster on Everest - Trauma at the Top of the World". As ever, we finish with the "Informal Chat", where speakers and delegates get a drink, sit around and a huge meandering discussion about all things critical care takes place. If you want to review the best critical care research of this year, #CCR18 is the meeting for you.







Early Goal Directed Therapy in Septic Shock in Zambia

Until the weekend



Supported by the Health Research Board

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