Prof Tamas Szakmany MBEPlenaries, concurrent sessions, crosstalks, roundtables were all part of the diverse educational programme of #SCCM2023 One of the best parts I enjoyed participating in were the RST theatres. Super proud of Elsa, a med student who worked with us last year presenting 2! Posters.
The best feeling is helping others to realise their potential, this is what #BetterTogether means to me on the research front #SCCM2023
And that awake proning in #covid19 reduces the risk of intubation, but not the risk mortality. This last finding now has been published in full in @[email protected] https://www.mdpi.com/2077-0383/12/3/926 #SCCM2023
Awake Prone Positioning for Non-Intubated COVID-19 Patients with Acute Respiratory Failure: A Meta-Analysis of Randomised Controlled Trials
Introduction: Awake prone positioning (APP) has been widely applied in non-intubated patients with COVID-19-related acute hypoxemic respiratory failure. However, the results from randomised controlled trials (RCTs) are inconsistent. We performed a meta-analysis to assess the efficacy and safety of APP and to identify the subpopulations that may benefit the most from it. Methods: We searched five electronic databases from inception to August 2022 (PROSPERO registration: CRD42022342426). We included only RCTs comparing APP with supine positioning or standard of care with no prone positioning. Our primary outcomes were the risk of intubation and all-cause mortality. Secondary outcomes included the need for escalating respiratory support, length of ICU and hospital stay, ventilation-free days, and adverse events. Results: We included 11 RCTs and showed that APP reduced the risk of requiring intubation in the overall population (RR 0.84, 95% CI: 0.74β0.95; moderate certainty). Following the subgroup analyses, a greater benefit was observed in two patient cohorts: those receiving a higher level of respiratory support (compared with those receiving conventional oxygen therapy) and those in intensive care unit (ICU) settings (compared to patients in non-ICU settings). APP did not decrease the risk of mortality (RR 0.93, 95% CI: 0.77β1.11; moderate certainty) and did not increase the risk of adverse events. Conclusions: In patients with COVID-19-related acute hypoxemic respiratory failure, APP likely reduced the risk of requiring intubation, but failed to demonstrate a reduction in overall mortality risk. The benefits of APP are most noticeable in those requiring a higher level of respiratory support in an ICU environment.
that shorter course of ABx in VAP are not affecting mortality, but may lead to more recurrence https://journals.lww.com/ccmjournal/Fulltext/2023/01001/937__SHORT_VERSUS_PROLONGED_COURSE_OF_ANTIBIOTICS.902.aspx #SCCM2023
@[email protected] and his team of residents working in Pakistan prepared 3 meta-analyses and found that steroids in bronchopulmonary dysplasia in neonates likely reduce mortality https://journals.lww.com/ccmjournal/Fulltext/2023/01001/966__LATE____7_DAYS__SYSTEMIC_POSTNATAL.931.aspx #SCCM2023
Ouch π€ twisted ankle, amazing care received from #SCCM2023 friends @[email protected] my sightseeing plans went up in the smoke π’ and the planned early morning run with @[email protected] wonβt happen either π
Itβs a wrap for #SCCM2023 @[email protected] @[email protected] @[email protected] put together an awesome educational program! They will be a hard act to follow, but Challenge accepted! See you all in Phoenix next year! Yours truly, the #SCCM2024 Co-chairs @[email protected] @[email protected]
https://www.atsjournals.org/doi/full/10.1164/rccm.201710-2006OC @[email protected] https://journals.lww.com/shockjournal/Fulltext/2014/10000/Innate_Immune_Function_Predicts_the_Development_of.5.aspx this technique works across multiple cohorts and can have a turn around time of ~24h #SCCM2023