eCritCare Podcast

Few areas of critical care have changed as much over four decades as hemodynamic monitoring. In this episode, Dr Swapnil Pawar is joined by Professor Michael Pinsky, Professor of Critical Care Medicine, Bioengineering, Cardiovascular Diseases, and Clinical and Translational Science at the University of Pittsburgh, and one of the world's leading voices on cardiovascular physiology and shock. Prof P...

When should you add vasopressin in septic shock? It comes up on almost every ward round, and the answer still depends on which ICU you work in. In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Dr Ithan Peltan, intensivist, Associate Professor and Senior Medical Director for Acute Care Research at Intermountain Health in Utah, and lead investigator of the VASSPR trial, publis...

You pick up a new ICU trial in a top journal. Before you even look at the result, what should you be checking? And when the headline says "no difference", what does that actually mean for the patient in front of you? In the second episode of Beyond the P Value, the eCritCare sub-series on interpreting RCTs in critical care, Dr Swapnil Pawar and Professor Paul Young, intensivist and clinical triali...

IV paracetamol or two tablets? The answer looks the same on the drug chart. In the waste bin and the carbon ledger, it can be six to sixty times different. In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Dr Nicole Hunfeld, ICU pharmacist and Chief Sustainability Officer at Erasmus University Medical Centre, Rotterdam, to open a new pharmacology series. Nicole unpacks the en...

A patient in shock, on noradrenaline, with a pH of 7.22 and a base excess of minus 8. Do you give bicarbonate? Depending on which ICU you work in, the answer ranges from almost never to almost always. In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Professor Ary Serpa Neto of Monash University, lead investigator of the SODa-BIC trial, published in the New England Journal of...

Draw back the stomach contents, measure, and hold the feed if the number looks big. It has been routine in paediatric intensive care for decades. But does gastric residual volume tell us anything useful? In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Professor Lyvonne Tume, Professor of Critical Care Nursing and Chief Investigator of the GASTRIC-PICU trial, published in JA...

More than one box of gloves per patient, per day. Glass bottles of IV paracetamol filling the waste room. Intensive care saves lives, but at what cost to the planet? In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Dr Nicole Hunfeld, ICU pharmacist and Chief Sustainability Officer at Erasmus University Medical Centre, Rotterdam, associate professor in sustainable healthcare,...

Norepinephrine first, titrate up, add vasopressin when the dose gets high, reach for a third agent when things get desperate. That stepwise approach is how most of us treat septic shock. What if all three went in together, early? In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Professor Giovanni Landoni (San Raffaele Hospital, Milan) and Dr Žiga Kalamar (Medical ICU, Univer...

A platelet count of 40 and a central line to put in. Transfuse first, or go ahead? Right now the answer depends on which ICU you work in, and nobody actually knows which is right. In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Professor Peter Watkinson (Professor of Intensive Care Medicine, University of Oxford, and Chief Investigator) and Professor Simon Stanworth (Profes...

Randomised controlled trials shape almost everything we do in the ICU. So why do so many of them seem to show nothing? And when a trial says "no benefit," what does that actually mean for the patient in front of you? This is the first episode of Beyond the P Value, a new eCritCare sub-series on interpreting RCTs in critical care with Professor Paul Young, intensivist and clinician researcher from...

Conventional platelets last five to seven days. Cryopreserved platelets last two years. So why aren't we using them everywhere? In this episode of the eCritCare Podcast, Dr Swapnil Pawar sits down with Professor Michael Reade, intensivist, researcher and chief investigator of the CLIP-II trial, published in JAMA in 2026. CLIP-II randomised 388 high-risk cardiac surgical patients across 11 Australi...

In this episode, Dr Swapnil Pawar sits down with Professor Ian Seppelt, intensivist at Nepean Hospital, Sydney, and one of the lead investigators of the SuDDICU trial, to unpack the decades-long story of Selective Digestive Decontamination (SDD) in intensive care. Ian traces SDD from its haematology origins in the 1970s, through its adoption in the Netherlands, to the extraordinary behind-the-scen...

In this episode, Dr Swapnil Pawar is joined by Dr Ary Serpa Neto to discuss the GUARDS trial, which is testing whether dexamethasone reduces 60-day mortality in patients with moderate to severe ARDS. We cover the rationale for steroids in ARDS, the choice of drug and dose, the expanded eligibility criteria including non-intubated patients, how the sample size was calculated, and the funding and de...

Dr Swapnil Pawar is joined by Dr Jose Chacko to discuss the LOGICAL trial, published in the New England Journal of Medicine in June 2026. Does limiting oxygen after cardiac arrest protect the brain from reperfusion injury? LOGICAL (the largest randomised trial of oxygen therapy after cardiac arrest to date) randomised 1,840 patients across 53 ICUs in Australia, New Zealand and Ireland to conservat...

In this episode, we discuss the SOHO trial, a large multicentre randomised controlled trial comparing high-flow nasal oxygen with conventional oxygen therapy in patients with acute hypoxaemic respiratory failure. We cover the trial methodology, the key findings on 28-day mortality and intubation rates, and what the results mean for practice in both ICU and ward settings.

In this episode, Dr Swapnil Pawar is joined by Dr Jose Chacko to discuss the 2026 American Heart Association and American College of Cardiology guidelines on the management of pulmonary embolism. We cover the new A to E classification, evaluation and diagnostic algorithms, acute management including the role of PERT teams, advanced reperfusion therapies, and the updated recommendations on anticoag...

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.

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

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.

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.

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. 

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. 

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. 

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.

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