• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 •

Jobbing intensivist | thoracic anaesthesia | Mama x 4 | Grace recipient | Trying to #lfe | ‘All the treats’ | Norn Iron 🌦🌧🌨🌪

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

Why working in the NHS is a worthwhile endeavour.

Thanks @doublebandfilms & @BBCnireland for giving us the chance tell these stories in The Hospital from the Inside series.

https://t.co/YNKG1bfGe6

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

Central line simulation trainers - recommendations please!

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

It’s a wrap! Another great @CritCareReviews meeting.
#CCR25

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

Could hear a 📌 drop during the Johns Hinds lecture by John Myburgh celebrating humanity, integrity and excellence.
Fantastic!
@CritCareReviews
#CCR25 @DocJohnsMum

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

#CCR25 #PRINCEtrial Is it possible that any potential benefit of RIPC was offset by a longer duration of general anaesthesia ?

[Simone Vietri @s_vietri]

🔎 The #PRINCEtrial:
👥 1,100 pts undergoing non-cardiac surgery
💡Remote Ischemic Preconditioning (3x5 min cuff inflation/deflation)
💉 Comparison: Sham RIPC (cuff placed, not inflated)
🎯 Outcome: Postop cardiac troponin release
#CCR25 @CritCareReviews

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

@YukiKotani5 @Wilkinsonjonny @CritCareReviews @IM_Crit_ @PARADicmSHIFT @RCoANews @ICS_updates @Assoc_Anaes @yourICM @iceman_ex @stephen_t_webb @FedericoMOliva @Manoj_Wickram @giovannilandoni @md_monaco Possibly in the ICU journey, but not for the anaesthetist doing the case ..

[Jonny Wilkinson @Wilkinsonjonny]

Did high flow nasal oxygen therapy after cardiac surgery improve outcomes? NOTACS trial #FOAMed #POCUS #FOAMcc #Medx #CCR25 @smythm86 @HawkmoonHEMS @DogICUma

[Marion Campbell @MarionKCampbell]

Another super cluster crossover trial at #CCR25 - the FLUID trial (looking at Ringers lactate vs normal saline - at the system level). 1/3 See paper here …
https://t.co/2qRqOo1LVz

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

@HawkmoonHEMS Borrowing this for journal club

[San Raffaele Anesthesia and Intensive Care @SRAnesthesiaICU]

🩸Among adults undergoing cardiac surgery, ANH did not reduce the number of patients receiving allogeneic red-cell transfusion.

These are the findings of the #ANHtrial, our latest multicenter RCT, just presented at #CCR25 and published in @NEJM.

📎 https://t.co/coFhvR2VGm

[Jonny Wilkinson @Wilkinsonjonny]

ICU-acquired weakness and cardiogenic shock in patients requiring mechanical support, highlighting biomarkers and outcomes.

@CritCareReviews #FOAMed #POCUS #FOAMcc #CCR25 #Medx

https://t.co/b5QKS2Utli

[Jonny Wilkinson @Wilkinsonjonny]

Comparison of lactated Ringer’s solution and normal saline for IV therapy on ICU. #FOAMed #POCUS #FOAMcc #CCR25 #MedX

https://t.co/3NJgrkSppp @CritCareReviews @IM_Crit_

[Jonny Wilkinson @Wilkinsonjonny]

Did acute normovolaemic haemodilution prior to cardiac surgery improve morbidity? #CCR25 @CritCareReviews #FOAMed #POCUS #FOAMcc #Medx

https://t.co/DndepYqXW4 @IM_Crit_

[NEJM @NEJM]

Presented at #CCR25:

In a cluster-randomized, crossover trial, hospital-wide use of lactated Ringer’s solution as compared with normal saline did not alter the incidence of death or hospital readmission within 90 days. Full trial results: https://t.co/iF0oy3RrDf

@CritCareReviews

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

@nialldferguson

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

#CCR25 #NOTAC
Niall Ferguson

There is a Venn diagram of ✅patient important outcomes
✅clinically important outcomes and
✅outcomes that are responsive to the therapy in question. #CCR25

We need to find the sweet spot in critical care trials.

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

@nialldferguson thanks for these insights. A really great editorial. Pragmatic and entertaining #CCR25

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

@CritCareReviews Perhaps not long enough for the ‘adjusted’ 90 day outcome….. #CCR25

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

#CCR25 #NOTACs
In general, have we over-adopted HFNO in critical care, leaning heavily on its physiological benefits?

[• 𝗟𝗝 𝗠𝗼𝘁𝘁𝗿𝗮𝗺 • @LJMottram]

Is Days alive AND at home AND without support too complex a primary outcome (and despite being highly relevant to patients) would it be responsive to the intervention at question ? #CCR25 #NOTACS