eCritCare Podcast

The cytokine storm, arising from a dysregulated host response, has captivated mainstream and scientific media in recent times with its possible role leading to poor outcomes in COVID-19. It is characterized by the release of mediators, including chemokines, interleukins, interferons, and tumor necrosis factors. In this podcast, we discuss the available evidence on this topic.

Tranexamic acid has been thought to be the wonder drug for stopping the active bleeding and has recently been proven life-saving in certain subgroups of patients. HALT_IT is another landmark trial that has evaluated the benefit of tranexamic acid in patients with acute GI bleeding. In this podcast, we discuss the implications of this landmark trial.

Recently published RCT in NEJM has raised more questions on the use of HCQ for post-exposure prophylaxis in COVID-19. This trial is more provocative than definitive.  In this podcast, we discuss this trial in-depth and present our views on this topic.

The majority of guidelines for COVID-19 recommended against the use of steroids. However, RECOVERY trial has challenged this opinion by proving that low dose dexamethasone can actually improve the outcomes by both decreasing the mortality and facilitating early discharge from the hospital. In this podcast, we discuss the implications of this landmark trial on the future of this deadly pandemic.

The routine use of Vit D in critically ill patients is debatable. The VIOLET trial published in NEJM in December 2019 has given us some clear answers on this topic. In this podcast, we discuss this trial in-depth to outline future directions on this topic. 

Management of ARDS comprises of multi-modal approach that includes pharmacological and non-pharmacological interventions. The evidence on non-pharmacologic interventions is consistent. However, the benefit of pharmacological interventions is still debatable. In this podcast, we critically evaluate the role of neuromuscular blockade in ARDS.

The recently published trial in JAMA has suggested that the treatment with convalescent plasma in COVID-19 is feasible and can be used as a potential treatment option in this devastating pandemic.

In this episode, we discuss another landmark trial published in NEJM on the use of Remdesivir in COVID-19. This trial has raised more questions than providing answers. 

In this podcast, we discuss multi-national registry data on the efficacy of chloroquine, hydroxychloroquine with or without macrolides in COVID-19 patients. This study has added significant information to our understanding of COVID-19 and has warned us against the use of the combination of HCQ and macrolides.

COVID-19 pandemic has posed a very difficult challenge to the entire ICU community i.e. how to prevent transmission to health care workers while performing routine interventions in critically ill patients. This has forced us to unlearn the traditional ways and learn new ways of performing certain interventions in ICU. In this podcast, we discuss specific modifications that every ICU staff need to...

Remdesisvir has thought to be the new CURE for COVID-19. In this podcast, we discuss the recent evidence available on the efficacy of Remdesivir in COVID-19.

The literature published from various countries has helped us to understand the disease pattern in COVID-19 pandemic. In this podcast, we discuss the key literature from New York, Italy, China and the UK.

In this episode, we summarise the key literature published in last week w.r.t novel therapies in COVID-19.

In this podcast, we discuss current controversies w.r.t treatment of COVID -19 patients and summarise the literature available till date.

In this podcast, we discuss how to manage critically ill patient diagnosed with COVID-19. This podcast based on current recommendations from various societies and the expressed views may change as recommendations change over time.

Vasopressor administration to maintain higher map in patients >65 years of age has become a dogma. In this podcast, we discuss recently published 65 trial which not only challenges this dogma but will definitely change our practices. 

Oxygen is the most commonly used drug in Intensive care. However, the targets for oxygen therapy titration are arbitrary. In this podcast, we discuss the significance of hyperoxemia in intensive care patients.

Sedation in ICU is practised so commonly that thinking of any mechanically ventilated patient without sedation is impossible. This trial published in NEJM has challenged that dogma and showed us that Non-sedation in mechanically ventilated patients is feasible. 

The accumulation of a positive fluid balance is a frequent occurrence in critically ill patients. As Paracelsus said, " All things are poisons, nothing is without poison. Only the dose permits something not to be poisonous." Like other drugs, it is the dose of fluids which makes them poisonous. In this podcast, we discuss the significance of de-resuscitation in ICU.

This Randomised controlled trial explored the role of HAT therapy in patients with septic shock admitted to ICU.

Lung protective ventilation has become the cornerstone of the management of ARDS patient. As a consequence, hypercapnia is inevitable. However, permissive hypercapnia is not without its own problems. In this podcast, we discuss this dogma and challenge traditional practices. 

In this podcast, we discuss the landmark PEPTIC study, which compared PPIs vs H2 Receptor antagonists in mechanically ventilated patients.

Recently there has been a growing interest in driving pressure as a significant parameter for titration in mechanical ventilation for ARDS patients. It has challenged our dogma of 6-8 mls/kg tidal volume ventilation. In this podcast, we discuss the current evidence and future of mechanical ventilation in ARDS.

The malnutrition in hospitalised patients has a potentially severe impact on their overall outcomes. EFFORT trial, published in Lancet explored whether early intervention in medical inpatients is feasible and whether it alters the outcomes by commencing early individualised nutritional therapy.

The role of thrombolysis in submassive PE remains controversial to date. In this podcast, Dr Chacko & I dive deeper to explore the current evidence on this topic.