eCritCare Podcast

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The landscape of Intensive care is changing. In the era of evidence based medicine, we try to make best possible decision for our patients based on best available evidence. Every fortnight, Dr Swapnil Pawar & Dr Jose Chacko will bring you one hot topic in Critical care. If you want to stay up to date with recent evidence or learn how to critically evaluate the literature in critical care, this podcast is for you.

Swapnil Pawar


    • Jun 13, 2024 LATEST EPISODE
    • monthly NEW EPISODES
    • 27m AVG DURATION
    • 123 EPISODES


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    Latest episodes from eCritCare Podcast

    #Epi 123 - SWITCH Trial - Decompressive Craniectomy with Medical treatment Vs Best medical treatment for Deep intra-cerebral haemorrhage

    Play Episode Listen Later Jun 13, 2024 26:14


    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.

    #Epi 122 - Diaphragmatic Dysfunction in Critically Ill patients

    Play Episode Listen Later Mar 16, 2024 20:08


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

    # Epi 121 - AMIKINHAL Trial - Inhaled Amikacin to prevent Ventilator associated pneumonia

    Play Episode Listen Later Feb 27, 2024 27:10


    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.

    #Epi 120 - NICO Trial - Intubation in Acute Drug Overdose - Does GCS matter?

    Play Episode Listen Later Dec 23, 2023 22:13


    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.

    #Epi 119 - The role of IV Thyroxine in Brain Dead Organ Donor

    Play Episode Listen Later Dec 17, 2023 17:48


    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. 

    #Epi 118 - ECLS Shock Trial - Extra-corporeal support in Cardiogenic shock post-MI

    Play Episode Listen Later Oct 29, 2023 23:42


    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. 

    #Epi 117 - ELAN Trial - Early Vs Late Anticoagulation in Ischaemic stroke post -AF

    Play Episode Listen Later Oct 4, 2023 25:29


    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. 

    #Epi 116 - Steroids in Community Acquired Pneumonia

    Play Episode Listen Later Aug 21, 2023 26:33


    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.

    #Epi 115 - ICU Journal Club - MERCY Trial

    Play Episode Listen Later Aug 8, 2023 22:40


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

    #Episode 114- ICU Journal Club - PATCH Trial

    Play Episode Listen Later Jul 17, 2023 23:11


    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.

    #Episode 113- ICU Journal Club - RESCUE-ASDH Trial

    Play Episode Listen Later Jun 27, 2023 26:33


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

    #Episode 112- ICU Journal Club - PACER Trial

    Play Episode Listen Later Jun 6, 2023 24:27


    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.

    #Episode 111- Selective Digestive Decontamination - To be or Not to be

    Play Episode Listen Later May 24, 2023 34:35


    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.

    #Episode 110- High Flow Nasal Cannula Vs NIV in High risk patients

    Play Episode Listen Later May 6, 2023 23:57


    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. 

    #Episode 109- CAPE-COD Trial - Hydrocortisone in Community Acquired Pneumonia

    Play Episode Listen Later Apr 3, 2023 25:49


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

    #Episode 108- INCEPTION Trial - ECMO CPR in OHCA due to Shockable Rhythm

    Play Episode Listen Later Feb 16, 2023 26:32


    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. 

    #Episode 107- CLOVERS Trial - Restrictive fluid with early vasopressors vs liberal fluid in Septic shock

    Play Episode Listen Later Jan 29, 2023 25:09


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

    #Episode 106- BOX Trial - Oxygenation targets in OHCA Comatose Survivors

    Play Episode Listen Later Jan 12, 2023 22:48


    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 

    #Episode 105- DOSE VF Trial - Double Sequential Early Defibrillation in OHCA

    Play Episode Listen Later Jan 1, 2023 28:08


    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.

    #Episode 104- TEAM Trial - Early Mobilisation in Intensive care patietns

    Play Episode Listen Later Dec 16, 2022 26:38


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

    #Episode 103- SETPOINT 2 Trial - Early vs Late Tracheostomy in ICU patients with Stroke

    Play Episode Listen Later Nov 17, 2022 24:08


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

    #Episode 102- WATERFALL Trial - Fluid resuscitation in Acute Pancreatitis

    Play Episode Listen Later Nov 17, 2022 24:40


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

    Episode 101- Tranexamic Acid (TXA) in Intensive Care

    Play Episode Listen Later Sep 23, 2022 27:54


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

    Episode 100- Oxygen Therapy in Intensive Care

    Play Episode Listen Later Sep 4, 2022 23:12


    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. 

    Episode 99- Targeted Temperature Management in TBI

    Play Episode Listen Later Aug 27, 2022 19:17


    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. 

    Episode 98- Ventilator Associated Pneumonia

    Play Episode Listen Later Jul 28, 2022 2:49


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

    Episode 97- CLASSIC Trial - Liberal vs Restrictive fluid in Septic Shock

    Play Episode Listen Later Jul 9, 2022 24:29


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

    Episode 96: LOVIT Trial - final nail in the coffin for Vit C in Septic Shock?

    Play Episode Listen Later Jun 25, 2022 24:22


    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. 

    Episode 95: Resuscitation targets in Septic Shock

    Play Episode Listen Later Jun 9, 2022 25:26


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

    Episode 94: ICU Journal Club - eCPR in OOHCA

    Play Episode Listen Later Apr 18, 2022 28:39


    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. 

    Episode 93: ICU Journal Club - Noradrenaline vs Adrenaline in OHCA patients

    Play Episode Listen Later Mar 16, 2022 21:47


    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). 

    Episode 92: NIV in COVID-19

    Play Episode Listen Later Mar 3, 2022 34:24


    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.

    Episode 91: ICU journal Club - Long term outcomes in COVID- MONITOR-IC Study

    Play Episode Listen Later Feb 22, 2022 19:14


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

    Episode 90: ICU journal Club - PLUS Study

    Play Episode Listen Later Feb 8, 2022 32:24


    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.

    Episode 89: ICU journal Club - MICHELLE Trial

    Play Episode Listen Later Jan 30, 2022 22:00


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

    Episode 88: Omicron Variant - Facts and Challenges

    Play Episode Listen Later Jan 12, 2022 39:28


    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. 

    Episode 87: ICU journal Club - COVID HighFlow Trial

    Play Episode Listen Later Dec 28, 2021 24:44


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

    Episode 86: Glycemic Control in ICU

    Play Episode Listen Later Nov 30, 2021 28:54


    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.

    Episode 85: ICU Journal Club - Controlling Study

    Play Episode Listen Later Nov 23, 2021 30:34


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

    Episode 84: Early Vs Delayed RRT

    Play Episode Listen Later Nov 8, 2021 24:59


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

    Episode 83: ICU Journal Club - COVID Steroid 2

    Play Episode Listen Later Oct 26, 2021 23:04


    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. 

    Episode 82: Surviving Sepsis Campaign Guidelines 2021

    Play Episode Listen Later Oct 22, 2021 41:04


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

    Episode 81: Role of Hyperventilation in ICP Control

    Play Episode Listen Later Oct 8, 2021 24:52


    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. 

    Episode 80: ICP monitoring in TBI

    Play Episode Listen Later Sep 28, 2021 30:15


    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. 

    Episode 79: ICU Journal Club - Low vs high oxygenation Targets

    Play Episode Listen Later Sep 19, 2021 29:39


    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.

    Episode 77: Long COVID- Long road ahead ?

    Play Episode Listen Later Aug 29, 2021 31:05


    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. 

    Episode 77: ICU Journal Club- BASIC Study

    Play Episode Listen Later Aug 18, 2021 32:54


    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.

    Episode 76: Remdesivir & Tocilizumab in COVID-19 - have we gone too far?

    Play Episode Listen Later Aug 1, 2021 42:38


    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. 

    Episode 75: Stopping Nasogastric Feeds in ICU- Time for a CHANGE

    Play Episode Listen Later Jul 14, 2021 33:04


    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.

    Episode 74: Mechanical Power - Paradigm Shift in ARDS

    Play Episode Listen Later Jul 4, 2021 29:40


    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. 

    Episode 73: ICU Journal Club- TTM 2 trial

    Play Episode Listen Later Jun 22, 2021 27:19


    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. 

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