Critical Care

A 2020 appraisal of PEPTIC, comparing proton pump inhibitors with H2 receptor blockers for stress-ulcer prophylaxis in intensive care. The review examines mortality and gastrointestinal bleeding outcomes, treatment crossover and competing interpretations of a large pragmatic trial whose clinical implications were debated.

Day-one highlights from Critical Care Reviews 2020, including TRACT, COACT, SPICE III, HYPERION and ICU-ROX. The report brings together discussions of transfusion, cardiac arrest, sedation and oxygen therapy, alongside questions about trial design and how clinicians interpret research.

A first look at the 65 trial as presented at Critical Care Reviews 2020. The review examines lower blood-pressure targets in older intensive care patients with vasodilatory hypotension, reduced vasopressor exposure and uncertainty around mortality, with a discussion of interpretation beyond statistical significance.

Why can a satisfying day of emergency procedures be a patient's worst day? Simon Carley's DFTB talk and accompanying reflection examine that tension, the motives behind interventions and the emotional support clinicians and learners need when a resuscitation becomes difficult or ends badly.

A 2019 appraisal of rocuronium versus suxamethonium for prehospital rapid-sequence intubation. The review examines first-pass success, the interpretation of a non-inferiority trial and the limits of detecting rare complications, while considering how airway choices depend on the wider clinical setting and available resources.

A review of the first UK Resuscitology course in Manchester, using challenging cases to examine how teams think and act during resuscitation. The article introduces STEPS and GPAS analysis, connects them with the Zero Point Survey and shares visual summaries of the learning.