A September 2020 appraisal of REMAP-CAP’s hydrocortisone results in critically ill patients with COVID-19. Dan Horner and Simon Carley explain adaptive trials, Bayesian analysis and organ support outcomes, weighing the findings against early stopping, treatment crossover and the wider corticosteroid evidence.
The ‘Roid’ to Recovery? REMAP-CAP @ St Emlyn’s Read More
Dan Horner examines the difficulties of diagnosing and treating venous thromboembolism in COVID-19 in May 2020. The review considers D-dimer, imaging, screening effects and possible immunothrombosis, weighing uncertain treatment benefits against bleeding risks while randomised trial results were still awaited.
Diagnosis and Treatment of VTE in the COVID-19 era Read More
Dan Horner reviews the 2020 NICE guidance on diagnosing and managing venous thromboembolism. The article discusses PERC, age-adjusted D-dimer, outpatient pulmonary embolism care and anticoagulant choices, including cancer-associated VTE, with attention to patient selection, bleeding risk and questions outside the guideline’s scope.
New NICE Guidelines on diagnosis and management of venous thromboembolism Read More
An April 2020 podcast and accompanying notes following patients with COVID-19 from the emergency department into critical care. Dan Horner discusses respiratory support, proning, ventilation physiology and equipment problems, alongside the practical and emotional pressures of working in intensive care during the first wave.
Beyond the ED: COVID-19 and Critical Care Read More
An April 2020 critical appraisal of early reports linking COVID-19 with thrombosis and raised D-dimer. Dan Horner questions incidence estimates, composite outcomes and claims about heparin, explaining why observational associations alone could not settle the benefits and harms of intensified anticoagulation.
COVID-19 and Blood Clots: Diagnosis, D-dimers and Dilemmas Read More
The final day of the 2019 Intensive Care Society State of the Art meeting, with discussions of cardiogenic shock services, sepsis treatment debates and recovery after critical illness. The report also explores blood cultures, oxygen exposure and the challenges of interpreting emerging research.
St Emlyn's in Brum #ICSSOA – Day 3 Read More
Day two of the 2019 Intensive Care Society State of the Art meeting explores fluids, blood-pressure targets and vasoactive treatment, alongside sustainability and staff wellbeing. Later sessions consider trauma systems, bleeding control, chest injury and the needs of older patients with major trauma.
St Emlyns in Brum #ICSSOA – Day 2 Read More
Can clinical probability guide D-dimer thresholds and reduce imaging for suspected pulmonary embolism? Dan Horner appraises the PEGeD management study, examining follow-up outcomes, assay units, possible selection bias and the limited evidence for moderate-risk patients, with a perspective on applying the findings in different settings.
JC: Pulmonary Embolism – The PEGeD study Read More
