Critical Care Reviews Newsletter

Welcome to the 514th 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 randomised controlled trials on oxygenation strategies in acute cardiogenic pulmonary oedema & opioids for sedoanalgesia in the ICU; systematic reviews and meta analyses on prophylactic anticoagulation dosing regimens in critically and non-critically ill patients with COVID-19 & barotrauma in Coronavirus disease 2019 patients undergoing invasive mechanical ventilation; and observational studies on subphenotypes in patients with COVID-19-related acute respiratory distress syndrome & bacterial superinfection pneumonia in patients mechanically ventilated for COVID-19 pneumonia.

There are also guidelines on precision medicine in sepsis and ARDS & basic and advanced cardiac life support in adults, children, and neonates with suspected or confirmed COVID-19; narrative reviews on pulmonary thrombosis and thromboembolism in COVID-19 & timing of antibiotic therapy in the ICU; editorials on the impact of COVID-19 care on the health of the population & do interleukin receptor antagonists provide additional benefit in COVID‑19; and commentaries on circulation of influenza, RSV, and SARS-CoV-2 & the future of antimicrobial dosing in the ICU; as well as correspondence on securing the airway in critical care scenarios & critical influenza and prophylactic antifungal therapy for aspergillosis. 

If you only have time to read one review article this week, try either this one on reflections on critical care’s past, present, and future or clinical research: from case reports to international multicenter clinical trials.

COVID STEROID 2 Trial Result Livestream

The RECOVERY trial demonstrated improved survival with 6mg dexamethasone in hypoxic patients with COVID-19. Since then, tocilizumab and other monoclonal antibodies have also demonstrated benefit in dampening the immune response. But what if a higher dose of dexamethasone was used? The preprint of the main paper was published on March 12th in MedRxiv. The group receiving 12mg dexamethasone had a 5% lower mortality rate than those receiving 6mg, but this large effect size failed to reach statistical significant. How do we interpret this?

With a panel containing expert clinicians, methodologists and trialists, and a statistician and trialist of international renown delivering the editorial, the big question of how to interpret this trial result will be front and centre of our discussions. Don't miss it!