Does early hypothermia improve outcomes after traumatic brain injury? This review of the 2018 POLAR trial examines its patient selection, cooling strategy and six-month neurological outcomes. It discusses the absence of demonstrated benefit in this population and why the findings cannot answer every question about rescue cooling.
JC: Hypothermia in brain injury: The POLAR trial. St Emlyn’s. Read More
What does ‘massive’ pulmonary embolism really tell us about a patient’s risk? In this case-based 2018 review, Dan Horner examines physiology, clot burden, clinical trajectory and bleeding risk, arguing for a fuller assessment and shared decisions rather than reliance on a single blood-pressure threshold.
Pulmonary Embolism – We call it massiiiiiiivve Read More
Does tranexamic acid improve recovery after spontaneous intracerebral haemorrhage? This 2018 appraisal of TICH-2 examines death and dependence, haematoma expansion and the uncertainty around the results. It explores why a possible effect on bleeding does not necessarily establish a meaningful improvement in patients’ longer-term outcomes.
JC: TICH TICH BOOM? TXA in ICH. St Emlyn’s Read More
How should clinicians balance bleeding and thrombosis when anticoagulation causes problems? This 2018 RCEM CPD discussion covers haemorrhage, reversal strategies, adverse reactions, treatment failure and monitoring. It emphasises individual risk, practical delivery of care and making complex pathways usable, reflecting the drugs and evidence available at the time.
Complications of anticoagulation and how to manage them. St Emlyn’s Read More
SALT-ED compared balanced crystalloids with saline in adults admitted from the emergency department to non-critical-care beds. This 2018 appraisal distinguishes the neutral primary outcome from the signal in kidney outcomes, examining pragmatic trial design, follow-up and the limits of applying one centre’s findings more widely.
JC: So long Salt and Saline? St Emlyn’s Read More
Did hydrocortisone improve outcomes in septic shock in the ADRENAL trial? This 2018 appraisal examines the absence of a demonstrated 90-day mortality benefit alongside secondary findings on shock resolution and time in intensive care. It explores trial design, patient selection and the limits of subgroup interpretation.
JC: The End of the ‘Roid? ADRENAL Read More
A report from the first two days of the Intensive Care Society’s 2017 State of the Art meeting in Liverpool. Topics include trauma, early mobilisation, transfusion, pulmonary embolism and tracheostomy care, alongside debates about service standards, robotics and translating evidence into everyday critical care.
Dan does part of State of the Art #ICSSOA2017. St.Emlyn’s Read More
Who should receive thromboprophylaxis after lower-limb immobilisation? This RCEM 2017 update introduces the TiLLI project, reviews the uncertainty around risk prediction and outlines how evidence synthesis, expert consensus and economic modelling could inform more consistent decisions.
RCEM ASC 2017 – Update on the TiLLI study Read More
