A Dutch randomised trial tests extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest. This appraisal examines survival with favourable neurological outcomes, patient selection and delays to treatment, asking how much the result reflects the system delivering ECPR.
Journal ClubEvidence-Based Medicine
A December 2022 appraisal of RECOVERY preprint results comparing higher-dose steroids with usual care in hospitalised COVID-19 patients receiving simple oxygen or none. It examines the mortality harm signal, early stopping and why these findings did not cover patients receiving ventilatory support.
A 2022 appraisal of a randomised trial comparing double sequential, vector-change and standard defibrillation for refractory ventricular fibrillation. It examines survival outcomes, the limitations of a trial stopped early and the practical challenges of introducing alternative defibrillation strategies.
Can head-up positioning combined with mechanical CPR and an impedance threshold device improve cardiac arrest outcomes? This 2022 appraisal examines an observational comparison, explaining why differences between cohorts and exploratory analyses limit the conclusions it can support.
A 2022 overview of severe traumatic brain injury, centred on preventing secondary injury before and during specialist transfer. Dan Horner discusses tiered management and unresolved questions about osmotherapy, blood-pressure targets and brain tissue oxygen monitoring.
A 2022 review of UK prehospital blood-product and calcium replacement protocols. The article explores variation between services, the limits of survey evidence and unanswered questions about calcium timing and dose, distinguishing associations with poor outcomes from evidence of treatment benefit.
Practical perspectives on trauma care and team leadership.
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