The liver is awesome. Yet its vocabulary is ... limited. We can all tell when it is upset - high ALT, AST. But that could mean anything! So what's your specific patient's specific reason for high ALT?

90 pts enrolled (terminated after 2nd interim analysis) Median Injury Severity Score: 41 90-day mortality: 54% vs 42% 86.9% of mortality increase when REBOA was added to standard of care #CCR23 #UKREBOAtrial

Late breaking at #CCR23: In the PATCH-Trauma trial involving adults with major trauma, treatment with tranexamic acid did not result in a greater number of patients surviving with a favorable functional outcome at 6 months than placebo. nej.md/43zNuMj

The PATCH Team, led by Russell Gruen, a study of pre-hospital TXA for severe trauma in adults at high risk of acute traumatic coagulopathy treated in advanced trauma systems, has been published today in NEJM. #CCR23 Here’s a summary of what we did... nejm.org/doi/full/10.10…

Have I got this right? #CCR23 #PedsICU Critical Care Reviews #PATCH Oxy-PICU #AIDICU #MERCY #CLOVERS #CRYOSTAT2trial #PROCOAG #DEVICE remap-cap #TAMEtrial UKREBOATrial #Trauma #CriticalCareTrials #EmergencyMedicine

#Opioid pain relievers do not reduce acute lower back and neck pain, new study suggests: hubs.li/Q01W2WC90

in case you use an RSS feed: the new IBCC chapters will be going up on a *separate* IBCC RSS feed. to subscribe, click the link shown below & copy the text that shows up into your RSS reader. and if you've achieved this peak level of nerdiness, I honestly salute you 🫡

Very excited to have the voice and brains behind IBCC podcast and Crackcast, Adam Thomas co-instruct this year's Podcast CAMP Nov 30th, Dec 7th, Dec 14th. Plus keynote speaker Salim R. Rezaie, MD of REBELCast Details @ podcastcamp.org

Thanks to CHEST for the opportunity to present high risk #PE data from #FLAME 🔥 at #CHEST2023! (Finally have a good reason to use that emoji!) FT pts w significant decreased primary outcome and in-hospital mortality (1/3) Rachel Rosovsky Robert A Lookstein MD, MHCDL

STRATUS Trial published JAMA 🩸Cluster trial 25 ICUs >27,000 patients 🩸Switch to “small-volume” tubes that⬇️blood drawn for lab tests may⬇️RBC transfusion↔️effect on testing 🩸Available, cost-neutral, compatible with analyzers – will you switch? jamanetwork.com/journals/jama/…

OK here's a run down of why cryostat2 trial results will mark a turning point in the treatment of trauma-induced coagulopathy (TIC) Paper in JAMA: jamanetwork.com/journals/jama/… and some additional resources on our CommsC4TS web pages: c4ts.qmul.ac.uk/research-progr… Firstly...

fresh blog: why the new brain death guidelines are unacceptable 🧠guidelines rec urine tox screen & time-based clearance of intoxicants, *ignoring* toxicology guidelines & toxicologists 🧠arbitrary ranges are required for labs (iCal must be 1 -1.3 mM😳) emcrit.org/pulmcrit/bdgui…

New IDSA/SCCM guidelines on evaluation of new fever in ICU! 🤒 bladder/esophageal > rectal > oral > axillary/ear 🤒CRP and/or procal rec for patients with low/intermediate risk of infection😳 🤒consider test for COVID, resp viruses Fresh blogitorial: emcrit.org/pulmcrit/idsa-…

Great #AHA23 so far: AHA Research 🥸8 Trials: 8 take aways below Read the read👇👇 1/ATRESIA: Patients with subclinical atrial fibrillation can benefit from apixaban to reduce the risk of stroke and systemic thromboembolism.

True story There have been 15 trials of tooth brushing in the ICU and those trials have demonstrated fewer pneumonias and icu deaths In JAMA Internal Medicine jamanetwork.com/journals/jamai…

Single-dose cefreiaxone to prevent VAP in ventilated acute brain injury patients Multicenter RCT with 345 pts🇫🇷 Compared to placebo, CTRX reduced VAP (14% vs 32%; HR 0·60 [0·38–0·95], p=0·03) thelancet.com/journals/lanre… SCCM Ashish K. Khanna, MD,MS,FCCP,FCCM,FASA Jose L. Pascual, MD, PhD, FRCS(C), FACS, FCCM #SCCM2024

Hot Take on PROPHY-VAP trial: 🔥Prophylactic 2g ceftriaxone among patients intubated for airway protection reduced pneumonia & ICU/hospital length of stay 🔥Prophylaxis *reduced* total antibiotic exposure 🔥Consistent w/ SuDDICU & ANTHARTIC trials Blog emcrit.org/pulmcrit/proph…

🚨 🏥 Please Retweet! Early enteral #nutrition (EN) w/in 3 d of ICU admit/intubation improves outcomes! ⬇️ Hospital MORTALITY ⬆️ D/C to Home ⬇️ ICU & Hosp LOS ⬇️ Vent Days ⬇️ Costs 🙋‍♂️Data from >27800 pts in real world practice 🔗 sciencedirect.com/science/articl… #ICUNutrition #FOAMcc

2 RCTs testing IV vs IO vascular access in OHCA patients just published in the NEJM and concomitantly presented at #RESUS24 ERC - European Resuscitation Council ➡️ No difference in 30d survival in both trials ➡️ Higher rate of ROSC with IV access in the #PARAMEDIC3 trial 🇬🇧 nejm.org/doi/full/10.10… 🇩🇰