Welcome to the 491st Critical Care Reviews Newsletter, bringing you the best critical care research and open access articles from across the medical literature over the past seven days.
The highlights of this week's edition are the fascinating COAST randomised controlled trial, investigating oxygen therapy and high-flow nasal therapy in African children with pneumonia, and the REVERSE-AKI pilot trial, examining restrictive fluid management in acute kidney injury. There are also systematic reviews and meta analyses on prone positioning of nonintubated patients with COVID-19 & a comparison of culture-negative and culture-positive sepsis or septic shock; and observational studies on airway pressure release ventilation in mechanically ventilated patients with COVID-19 & adherence to lung-protective ventilation principles in pediatric ARDS.
The American College of Chest Physicians have issued guidance on the appropriate use of high-flow nasal oxygen in hospitalized patients for initial or postextubation management of acute respiratory failure & there is a suggested framework for the development and interpretation of sepsis subclasses. There are also narrative reviews on perioperative acute kidney injury & hemostatic challenges in neonates; editorials on microcirculation guided/targeted resuscitation & timing of intubation in immunocompromised patients with acute respiratory failure; and commentaries on precision medicine for COVID-19 & hyperventilation in severe traumatic brain injury.
If you only have time to read one article this week (after the COAST trial), try this superb overview of the pathophysiology and phenotypes of COVID-19.
The full set of edited videos from eCCR21 are now available on the eCCR21 webpage. This includes 4 major trial results, a first-in-field phase II trial result, 16 of the best critical care trials & studies from 2020, 3 discussions on trial design, methodology and publishing, as well as the annual John Hinds Lecture. As always, these are free to view.