How much oxygen should critically ill patients receive? This January 2021 review of HOT-ICU examines lower versus higher oxygen targets in adults with hypoxic respiratory failure, the absence of a 90-day mortality difference and uncertainty about applying the findings to different patient groups.
Journal ClubEvidence-Based Medicine
Why did COVID-19 cause such different outcomes in different people? John McDermott reviews the December 2020 GenOMICC findings, explaining genetic associations with severe illness, their potential to guide research and why they cannot predict an individual patient's fate on their own.
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.
Journal ClubCommunication Skills
A June 2020 appraisal of the RECOVERY dexamethasone preprint in hospitalised patients with COVID-19. The review examines mortality findings in patients receiving oxygen or ventilation, recruitment and generalisability, and the difficulties of assessing important research first announced through a press release.
Writing in April 2020, Simon Carley argues for evidence-based medicine despite the pressure to try unproven COVID-19 treatments. He examines the weaknesses of uncontrolled reports and explains how coordinated UK research, including RECOVERY, offered a route to more reliable answers.
Could arginine vasopressin reduce blood-product requirements after major traumatic haemorrhage? This appraisal reviews a small single-centre randomised trial, examining reduced transfusion use alongside the lack of a demonstrated mortality benefit and the limits of applying its findings to a broader trauma population.
Practical perspectives on trauma care and team leadership.
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