Here is edition 8 of the hottest critical care trials and papers generating buzz across Critical Care Reviews, EMCrit/PulmCrit, REBEL EM, LITFL, The Bottom Line, and many others. A huge thank you as always to all the incredible curators in the FOAMed community — you know who you are!
Focused on the latest July drops across ventilation mechanics, sepsis phenotypes, AKI prevention, neuroprognostication, and infection control.
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Click the buttons, then the pics for the trial / paper / guideline to read more!
1. VICTORY: High-Dose Vitamin C in Severe Burns
Multicentre RCT: High-dose IV vitamin C in severe burn patients — impact on fluid resuscitation requirements and organ dysfunction.
2. LOGICAL: Liberal vs Conservative Oxygenation Post-Cardiac Arrest
RCT: Oxygenation targets in patients with suspected hypoxic-ischaemic encephalopathy after cardiac arrest.
3. SNAP-Cephazolin: Continuous vs Intermittent Vancomycin in Critically Ill Children
Paediatric RCT: Infusion strategies for gram-positive infections in PICU.
4. Diaphragm Neurostimulation in Difficult Weaning
RCT: Mitigating adverse cardiopulmonary effects of positive pressure ventilation via neurostimulation.
5. Demystifying Volume Status: Ultrasound-Guided Framework
Review with new validation data: Physiologic approach to volume assessment using point-of-care ultrasound.
6. Shared Decision-Making in Critically Ill Patients: Systematic Review & Meta-Analysis
Meta-analysis: Impact on mortality, length of stay, and family satisfaction.
7. BigpAK-2: Preventive Care Strategy to Reduce AKI After Major Surgery
Multinational RCT: Bundle to prevent moderate/severe AKI in high-risk surgical patients.
8. SODa-BIC: Sodium Bicarbonate in Critically Ill Adults with Metabolic Acidosis and Shock
Multicentre RCT: Bicarbonate therapy in septic shock with acidosis.
9. ARISE FLUIDS: Vasopressors or Fluids in Early Septic Shock
RCT: Restricted fluids + early vasopressors vs standard fluid resuscitation.
10. HI-PEITHO: Low-Dose Alteplase in Intermediate-High Risk PE
RCT: Fibrinolytic strategy in submassive pulmonary embolism.
11. Immunomodulation with Anakinra in Severe Community-Acquired Pneumonia
Phase IIa RCT: Anakinra reduced progression to organ dysfunction in CAP — promising signal for targeted immunomodulation.
12. Neuromuscular Blockade Monitoring in ARDS: New Consensus Recommendations
International Consensus: Updated guidance on monitoring and titration of neuromuscular blocking agents in ARDS patients.
13. Plasma Haemoadsorption in Endotoxic Septic Shock (TIGRIS Update)
Follow-up analysis: Longer-term outcomes from the Bayesian phase 3 trial.
14. PRONTO: Procalcitonin + NEWS2 in ED Sepsis
Phase 3 RCT: Guided antibiotic initiation vs usual care.
15. Bronchoalveolar Lavage in Prone ARDS Patients
Study: Safety, diagnostic yield, and procedural considerations.
16. Inhaled Nitric Oxide in Moderate-to-Severe ARDS: Multicentre RCT
RCT: Inhaled nitric oxide vs placebo in moderate-to-severe ARDS — effects on oxygenation and clinical outcomes.
17. Evaluating the Association Between Patient Priorities and ICU Care Delivery in Adults Receiving Mechanical Ventilation
Global perspectives: The patient first discussion, what do patients want?! More to the point….priorities change over time and may be poorly captured in medical records!
18. The role of thoracic ultrasound in fluid management in critical care: a narrative review
Review: Does it have a role? We are all POCUS mad…..
19. Comparison of Esmolol Versus Landiolol on Mortality in Adult Patients With Sepsis: A Systematic Review and Network Meta-Analysis
Study: Loads of hype about Landiolol in sepsis…but IS it really worth it on your formulary?!
20. Impact of Time to Antibiotics on In-hospital Mortality in Neutropenic Sepsis: A Prospective Multicenter Cohort Study
Study: What’s the relationship between TTA and in-hospital mortality for patients with neutropenic sepsis and to identify specific phenotypes most vulnerable to TTA delays
Quick Hits from the Trenches
- HISTAP, BigpAK-2, and ARISE FLUIDS shaping perioperative and early septic shock fluid/BP strategies.
- VICTORY and SODa-BIC adding to adjunctive therapies in burns and acidosis.
- Growing focus on time-limited trials and shared decision-making amid resource pressures.
- Practical procedural insights (BAL in prone, diaphragm stimulation) gaining #FOAMcc traction.
