eCritCare Podcast

In this episode, we discuss the recently published SWITCH trial which compared the efficacy of decompressive craniectomy with best medical treatment vs best medical treatment alone for deep intra-cerebral hemorrhage.

In this episode, we discuss the etiology of diaphragmatic dysfunction, its management and strategies for prevention. 

In this episode, we discuss the recently published RCT AMIKINHAL, which tested the efficacy of inhaled amikacin in preventing VAP in ICU patients who were ventilated for> 72 hours. Although, this trail demonstrated reduced incidence of VAP in intervention arm, it's premature to adopt these practices widely in intensive care.

In this episode, we discuss recently published RCT in JAMA "NICO trial", which evaluated the role of GCS based intubation vs non-invasive airway management. It is important to understand the nuances before generalising the conclusion of this trial.

In this episode, we discuss the recently published RCT in NEJM, which challenged the current dogma regarding the role of IV thyroxine in potential organ donor patient population. 

In this episode, we discuss the recently published RCT "ECLS-Shock" trial in NEJM. This trial tested the benefit of instituting early extra-corporeal support in cardiogenic shock and suggested more harm in intervention arm compared to control arm. 

In this episode, we discuss recently published landmark RCT which compared the timing for initiation of oral anticoagulation in patients who presented with ischaemic stroke with rapid AF. 

In this episode, we discuss the controversy surrounding the usage of steroids in Community-acquired pneumonia. This controversy arose after the CAPE-COD trial was published recently in NEJM. We discuss the pros and cons of administering steroids as a blanket treatment. We recommend caution and suggest considering the external validity of this trial before changing your practices.

In this episode, we discuss recently published RCT "MERCY Trial" which evaluated the efficacy of continuous infusion vs intermittent dosing strategy of Meropenem.

In this episode, we discuss the recently published RCT "PATCH Trial", which evaluated the efficacy of pre-hospital tranexamic acid in patients with severe trauma. This trial confirmed the results of CRASH-2 trial, which demonstrated 28-day mortality benefit with the use of tranexaic acid in trauma if administered in < 3 hours. However, it failed to demonstrate any significant benefit with favourable neurological output at 6 months. This highlights the importance of Post-ICU care which at this stage is not standardised and varies across the globe.

In this episode, we discuss recenetly published RCT, which compared the role of craniotomy vs decompressive craniectomy in managing acute SDH.

In this episode, we discuss the recently published non-inferiority RCT "PACER Trial", which evaluated the efficacy of prophylactic platelet transfusion in thrombocytopenic patients requiring CVC insertion.

In this episode, Prof Ian Seppelt, one of the lead investigators of SuDDICU, shares his insights and talks about the rationale for SDD in ICU. He also explains the reasons behind the failure to change practices despite the evidence of mortality benefit from the recent meta-analysis. He discusses the future of SDD and the strategy for its widespread adaptation.

In this episode, we dive deeper into the controversy surrounding using high-flow nasal cannula vs NIV in high-risk patients to prevent reintubation. The recently published trial raised some crucial questions and forced us to reconsider our overall approach to extubation in this subset of patients. 

In this episode, we discuss recently published RCT, which demonstrated the mortality benefit in Community-acquired pneumonia.

In this episode, we discuss the recently published RCT in NEJM, which evaluated the efficacy of ECMO CPR ( eCPR) in patients with OHCA secondary to a shockable rhythm. 

In this episode, we discuss the recently published CLOVERs trial, which compared fluid dominant vs vasopressor-dominant resuscitation strategies for patients in septic shock. 

In this podcast, we discuss another RCT which evaluated the efficacy of restrictive Vs liberal oxygenation targets in comatose OHCA survivors.  The trial showed no difference between the two groups w.r.t 90-day mortality or discharge from hospital 

In this episode, we discuss the recently published DOSE VF trial, which evaluated the efficacy of early double sequential defibrillation strategy over vector change and standard defibrillation strategies. This trial has demonstrated that this innovative strategy has the potential to improve mortality and is likely to change our practices.

In this episode, we discuss the recently published RCT "TEAM trial", which evaluated the role of early mobilisation in mechanically ventilated intensive care patients. 

In this episode, we discuss the SETPOINT 2 trial, which evaluated the controversy around the timing of tracheostomy. 

In this episode, we discuss a recently published randomised controlled trial evaluating the role of aggressive fluid resuscitation strategy in mild acute pancreatitis. 

Join us in this episode to discuss the evidence behind the use of tranexamic acid for various indications in intensive care. 

In our landmark 100th episode, we discuss the controversy around one of the most commonly used drugs in intensive care, i.e. Oxygen. In this episode, we dive deeper into the available evidence and recommend our approach for using oxygen in critically ill patients. 

In this episode, we discuss the role of therapeutic hypothermia and targeted temperature management in severe TBI. We dive deeper into the available literature on this topic and share our recommendations on this controversy. 

In this episode, we discuss the controversies around the definitions, diagnostic criteria, investigations and management of ventilator-associated pneumonia.

In this episode, we discuss the recently published trial evaluating the efficacy of liberal vs restrictive fluid resuscitation strategy in patients with septic shock. 

In this episode, we discuss the recently published RCT evaluating the role of IV Vitamin C in patients with septic shock.  This trial has given us a clear answer on the future of vitamin C in these patients. We discuss the available evidence on this topic so far and suggest our approach to this toopic. 

In this episode, we discuss the evidence behind each target used in resuscitating a patient with septic shock. 

In this episode, we discuss the landmark trial published in JAMA, which evaluated the efficacy of eCPR over standard strategy. We believe although a well-conducted trial, it's still not enough evidence to decide one way or the other w.r.t performing eCPR in patients with out of hospital cardiac arrest. 

In this episode, we discuss the evidence behind the choice of adrenaline vs noradrenaline in patients who achieved ROSC (return of spontaneous circulation) after OHCA(out of hospital cardiac arrest). 

In this episode, we discuss the controversy surrounding the use of NIV in hypoxemic respiratory failure in severe COVID-19. The results of the RECOVERY-RS trial has provided us with significant evidence on this topic.

In this episode, we discuss the recently published trial on long term outcomes in COVID patients. 

In this episode, we discuss a recently published PLUS study comparing saline solution with Plasmalyte-148. This study demonstrated no significant mortality difference between the saline group and the plasmalyte-148 group.

In this episode, we discuss the recently published RCT evaluating the role of extended thromboprophylaxis in COVID-19.

In this episode, we discuss the challenges faced by healthcare systems and the patterns emerging from the current COVID-19 pandemic wave caused by the Omicron variant. 

In this episode, we discuss a recently published trial comparing conventional oxygen therapy and high flow nasal oxygen therapy. 

In this podcast, we discuss the controversy surrounding glycemic control in intensive care. We discuss the target range, the ideal amount of time spent in the target range and the utility of continuous glycemic monitoring in critically ill patients.

In this episode, we discuss the CONTROLLING study which compared the novel strategy of individualised glycemic control vs conventional glucose control. 

In this episode, we dive deeper into the controversy around the timing of initiation of RRT in Intensive Care. 

The controversy around the dose of steroid dose in COVID-19 still exists. In this podcast, we discuss the recently published RCT COVID Steroid 2 and dive deeper into this controversy. 

In this episode, we discuss some of the key recommendations and the rationale behind them from recently published SSCG 2021. 

Hyperventilation has been used to control raised ICP for decades. However, the evidence behind it is very weak. In this podcast, we discuss the recently published study by CENTRE-TBI to address this controversy. 

In this episode, we discuss the evidence behind the dogmatic practice of routinely using ICP monitoring in patients with traumatic brain injury admitted to ICU. 

The debate over low vs high oxygenation targets continue. In this podcast, we discuss the recently published trial in JAMA which evaluates the effect of high oxygenation on organ failure scores.

In this episode, we discuss the controversies around the long term sequelae of COVID-19. We dive deeper into the available evidence and suggest the next steps to address this very significant issue. 

In this podcast, we discuss another landmark study called BASIC, which evaluated the superiority of balanced salt solution over 0.9% saline in critically ill patients admitted to Brazilian intensive care units.

The evidence for the use of Remdesivir in COVID-19 is conflicting. Different guidelines have suggested contradictory recommendations on its use in COVID-19. Tocilizumab, although demonstrated mortality benefit in conjunction with steroids, we do not have data on its long term outcomes including quality of life. In this episode, we revisit the controversy surrounding the use of these agents in COVID-19. 

No standard protocol exists to decrease or eliminate preoperative fasting times for adult ICU patients with cuffed endotracheal tubes; however, multiple intensive care units across the globe have implemented their own protocols with adjusted times for the intubated patient. This has led to significant variability in practices along with potential harm to ICU patients. In this podcast, we challenge this another dogmatic practice in the Intensive care unit and dive deeper into available evidence.

In this episode, we talk about the novel concept called mechanical power in ventilating patients with ARDS. This concept has led to a new debate as to whether we should move away from the dogmatic approach of fixed tidal volume ventilation to an individualised ventilation strategy for patients with ARDS. 

In this episode, we discuss the recently published landmark RCT -TTM2. This trial has answered the important question and forced us to reconsider our management practices around post-out of hospital cardiac arrest management.