• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 •

Why working in the NHS is a worthwhile endeavour. Thanks @doublebandfilms & @BBCnireland for giving us the chance tell these stories in The Hospital from the Inside series. bbc.co.uk/programmes/p07…

Central line simulation trainers - recommendations please!

It’s a wrap! Another great @CritCareReviews meeting. #CCR25

Could hear a 📌 drop during the Johns Hinds lecture by John Myburgh celebrating humanity, integrity and excellence. Fantastic! @CritCareReviews #CCR25 @DocJohnsMum

#CCR25 #PRINCEtrial Is it possible that any potential benefit of RIPC was offset by a longer duration of general anaesthesia ?

🔎 The #PRINCEtrial: 👥 1,100 pts undergoing non-cardiac surgery 💡Remote Ischemic Preconditioning (3x5 min cuff inflation/deflation) 💉 Comparison: Sham RIPC (cuff placed, not inflated) 🎯 Outcome: Postop cardiac troponin release #CCR25 @CritCareReviews

@YukiKotani5 @Wilkinsonjonny @CritCareReviews @IM_Crit_ @PARADicmSHIFT @RCoANews @ICS_updates @Assoc_Anaes @yourICM @iceman_ex @stephen_t_webb @FedericoMOliva @Manoj_Wickram @giovannilandoni @md_monaco Possibly in the ICU journey, but not for the anaesthetist doing the case ..

@Wilkinsonjonny @CritCareReviews @IM_Crit_ @PARADicmSHIFT @RCoANews @ICS_updates @Assoc_Anaes @yourICM @iceman_ex @stephen_t_webb @LJMottram @FedericoMOliva @Manoj_Wickram Rapid and concise review of the trial! One question: Is it feasible to evaluate the efficacy of ANH in a blind manner? @giovannilandoni @md_monaco

Did acute normovolaemic haemodilution prior to cardiac surgery improve morbidity? #CCR25 @CritCareReviews #FOAMed #POCUS #FOAMcc #Medx criticalcarenorthampton.com/2025/06/12/anh… @IM_Crit_

Did high flow nasal oxygen therapy after cardiac surgery improve outcomes? NOTACS trial #FOAMed #POCUS #FOAMcc #Medx #CCR25 @smythm86 @HawkmoonHEMS @DogICUma

Another super cluster crossover trial at #CCR25 - the FLUID trial (looking at Ringers lactate vs normal saline - at the system level). 1/3 See paper here … nejm.org/doi/full/10.10…

@HawkmoonHEMS Borrowing this for journal club

🩸Among adults undergoing cardiac surgery, ANH did not reduce the number of patients receiving allogeneic red-cell transfusion. These are the findings of the #ANHtrial, our latest multicenter RCT, just presented at #CCR25 and published in @NEJM. 📎 nejm.org/doi/full/10.10…

ICU-acquired weakness and cardiogenic shock in patients requiring mechanical support, highlighting biomarkers and outcomes. @CritCareReviews #FOAMed #POCUS #FOAMcc #CCR25 #Medx criticalcarenorthampton.com/2025/06/12/bio…

Comparison of lactated Ringer’s solution and normal saline for IV therapy on ICU. #FOAMed #POCUS #FOAMcc #CCR25 #MedX criticalcarenorthampton.com/2025/06/12/har… @CritCareReviews @IM_Crit_

Presented at #CCR25: In a cluster-randomized, crossover trial, hospital-wide use of lactated Ringer’s solution as compared with normal saline did not alter the incidence of death or hospital readmission within 90 days. Full trial results: nej.md/45SaEBs @CritCareReviews

@nialldferguson thanks for these insights. A really great editorial. Pragmatic and entertaining #CCR25

#CCR25 #NOTAC Niall Ferguson There is a Venn diagram of ✅patient important outcomes ✅clinically important outcomes and ✅outcomes that are responsive to the therapy in question. #CCR25 We need to find the sweet spot in critical care trials.

@CritCareReviews Perhaps not long enough for the ‘adjusted’ 90 day outcome….. #CCR25

Was 90 days long enough for the primary outcome? The conversation continues with the panel discussion! #CCR25 #NOTACStrial

#CCR25 #NOTACs In general, have we over-adopted HFNO in critical care, leaning heavily on its physiological benefits?

Is Days alive AND at home AND without support too complex a primary outcome (and despite being highly relevant to patients) would it be responsive to the intervention at question ? #CCR25 #NOTACS