eCritCare Podcast

The landscape of Intensive care is changing. In the era of evidence based medicine, we try to make best possible decision for our patients based on best available evidence. Every fortnight, Dr Swapnil Pawar & Dr Jose Chacko will bring you one hot topic in Critical care. If you want to stay up to date with recent evidence or learn how to critically evaluate the literature in critical care, this podcast is for you.

#Epi 123 - SWITCH Trial - Decompressive Craniectomy with Medical treatment Vs Best medical treatment for Deep intra-cerebral haemorrhage

In this episode, we discuss the recently published SWITCH trial which compared the efficacy of decompressive craniectomy with best medical treatment vs best medical treatment alone for deep intra-cerebral hemorrhage.

06-13
26:14

#Epi 122 - Diaphragmatic Dysfunction in Critically Ill patients

In this episode, we discuss the etiology of diaphragmatic dysfunction, its management and strategies for prevention. 

03-16
20:08

# Epi 121 - AMIKINHAL Trial - Inhaled Amikacin to prevent Ventilator associated pneumonia

In this episode, we discuss the recently published RCT AMIKINHAL, which tested the efficacy of inhaled amikacin in preventing VAP in ICU patients who were ventilated for> 72 hours. Although, this trail demonstrated reduced incidence of VAP in intervention arm, it's premature to adopt these practices widely in intensive care.

02-27
27:10

#Epi 120 - NICO Trial - Intubation in Acute Drug Overdose - Does GCS matter?

In this episode, we discuss recently published RCT in JAMA "NICO trial", which evaluated the role of GCS based intubation vs non-invasive airway management. It is important to understand the nuances before generalising the conclusion of this trial.

12-23
22:13

#Epi 119 - The role of IV Thyroxine in Brain Dead Organ Donor

In this episode, we discuss the recently published RCT in NEJM, which challenged the current dogma regarding the role of IV thyroxine in potential organ donor patient population. 

12-17
17:48

#Epi 118 - ECLS Shock Trial - Extra-corporeal support in Cardiogenic shock post-MI

In this episode, we discuss the recently published RCT "ECLS-Shock" trial in NEJM. This trial tested the benefit of instituting early extra-corporeal support in cardiogenic shock and suggested more harm in intervention arm compared to control arm. 

10-29
23:42

#Epi 117 - ELAN Trial - Early Vs Late Anticoagulation in Ischaemic stroke post -AF

In this episode, we discuss recently published landmark RCT which compared the timing for initiation of oral anticoagulation in patients who presented with ischaemic stroke with rapid AF. 

10-04
25:29

#Epi 116 - Steroids in Community Acquired Pneumonia

In this episode, we discuss the controversy surrounding the usage of steroids in Community-acquired pneumonia. This controversy arose after the CAPE-COD trial was published recently in NEJM. We discuss the pros and cons of administering steroids as a blanket treatment. We recommend caution and suggest considering the external validity of this trial before changing your practices.

08-21
26:33

#Epi 115 - ICU Journal Club - MERCY Trial

In this episode, we discuss recently published RCT "MERCY Trial" which evaluated the efficacy of continuous infusion vs intermittent dosing strategy of Meropenem.

08-08
22:40

#Episode 114- ICU Journal Club - PATCH Trial

In this episode, we discuss the recently published RCT "PATCH Trial", which evaluated the efficacy of pre-hospital tranexamic acid in patients with severe trauma. This trial confirmed the results of CRASH-2 trial, which demonstrated 28-day mortality benefit with the use of tranexaic acid in trauma if administered in < 3 hours. However, it failed to demonstrate any significant benefit with favourable neurological output at 6 months. This highlights the importance of Post-ICU care which at this stage is not standardised and varies across the globe.

07-17
23:11

#Episode 113- ICU Journal Club - RESCUE-ASDH Trial

In this episode, we discuss recenetly published RCT, which compared the role of craniotomy vs decompressive craniectomy in managing acute SDH.

06-27
26:33

#Episode 112- ICU Journal Club - PACER Trial

In this episode, we discuss the recently published non-inferiority RCT "PACER Trial", which evaluated the efficacy of prophylactic platelet transfusion in thrombocytopenic patients requiring CVC insertion.

06-06
24:27

#Episode 111- Selective Digestive Decontamination - To be or Not to be

In this episode, Prof Ian Seppelt, one of the lead investigators of SuDDICU, shares his insights and talks about the rationale for SDD in ICU. He also explains the reasons behind the failure to change practices despite the evidence of mortality benefit from the recent meta-analysis. He discusses the future of SDD and the strategy for its widespread adaptation.

05-24
34:35

#Episode 110- High Flow Nasal Cannula Vs NIV in High risk patients

In this episode, we dive deeper into the controversy surrounding using high-flow nasal cannula vs NIV in high-risk patients to prevent reintubation. The recently published trial raised some crucial questions and forced us to reconsider our overall approach to extubation in this subset of patients. 

05-06
23:57

#Episode 109- CAPE-COD Trial - Hydrocortisone in Community Acquired Pneumonia

In this episode, we discuss recently published RCT, which demonstrated the mortality benefit in Community-acquired pneumonia.

04-03
25:49

#Episode 108- INCEPTION Trial - ECMO CPR in OHCA due to Shockable Rhythm

In this episode, we discuss the recently published RCT in NEJM, which evaluated the efficacy of ECMO CPR ( eCPR) in patients with OHCA secondary to a shockable rhythm. 

02-16
26:32

#Episode 107- CLOVERS Trial - Restrictive fluid with early vasopressors vs liberal fluid in Septic shock

In this episode, we discuss the recently published CLOVERs trial, which compared fluid dominant vs vasopressor-dominant resuscitation strategies for patients in septic shock. 

01-29
25:09

#Episode 106- BOX Trial - Oxygenation targets in OHCA Comatose Survivors

In this podcast, we discuss another RCT which evaluated the efficacy of restrictive Vs liberal oxygenation targets in comatose OHCA survivors.  The trial showed no difference between the two groups w.r.t 90-day mortality or discharge from hospital 

01-12
22:48

#Episode 105- DOSE VF Trial - Double Sequential Early Defibrillation in OHCA

In this episode, we discuss the recently published DOSE VF trial, which evaluated the efficacy of early double sequential defibrillation strategy over vector change and standard defibrillation strategies. This trial has demonstrated that this innovative strategy has the potential to improve mortality and is likely to change our practices.

01-01
28:08

#Episode 104- TEAM Trial - Early Mobilisation in Intensive care patietns

In this episode, we discuss the recently published RCT "TEAM trial", which evaluated the role of early mobilisation in mechanically ventilated intensive care patients. 

12-16
26:38

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