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Chris Nickson

@precordialthump.bsky.social
861 followers 111 following 53 posts

Intensivist, ECMO specialist, Clinician Educator. Calm amid a #FOAMed storm: LITFL.com & INTENSIVEblog.com

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Chris Nickson @precordialthump.bsky.social · 27/08/2026
Generalisability analyses of the CICM Second Part examination: Theory meets practice In response to: The CICM second part viva reliability coefficient: Which index, for which decision, against which benchmark? The conversation continues! www.sciencedirect.com/science/arti...
sciencedirect.com
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Chris Nickson @precordialthump.bsky.social · 30/04/2026
“Catalyst - critical ideas in action” is happening in Melbourne 23 July 2026. Early bird registrations is closing at midnight today. Spots still available for advanced ECMO but FBI is sold out. web.cvent.com/event/5028ae...
web.cvent.com
Summary - CATALYST, FBI & Advanced ECLS- Critical Care Ideas in Action
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Chris Nickson @precordialthump.bsky.social · 24/06/2026
Airway foreign bodies | LITFL CCC #foamed #foamcc litfl.com/airway-forei...
litfl.com
Airway Foreign Bodies
Airway foreign bodies (AFBs): Causes/risk factors, pathophysiology, complications, clinical features, investigations, and management.
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Chris Nickson @precordialthump.bsky.social · 16/06/2026
Alfred ICU’s Brooke Riley presents a short, sharp overview of recent cardiac arrest guideline updates (video) | INTENSIVE #foamed #foamcc intensiveblog.com/cardiac-arre...
intensiveblog.com
Cardiac arrest guidelines update at the CARDIAC symposium - INTENSIVE
Brooke Riley, Intensivist and ECMO Consultant at the Alfred ICU, delivers a succinct and informative update based on the 2024 ILCOR-ESICM cardiac arrest guidelines.
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Chris Nickson @precordialthump.bsky.social · 16/06/2026
New to ICU? This is for you… Intro to tracheostomy emergencies | INTENSIVE #foamed #foamcc intensiveblog.com/introduction...
intensiveblog.com
Introduction to Tracheostomy Emergencies - INTENSIVE
Authors: Chris Nickson and Lloyd Roberts
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Andy Conway Morris @andymoz78.bsky.social · 12/06/2026
Once again, for those at the back, the effort to refute bulls*t is 10x that required to produce it. Can we please stop doing high dose Vit C trials in critical care now?
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NEJM.org @nejm.org · 10/06/2026
Among patients who were unresponsive after cardiac arrest, conservative oxygen therapy did not increase 180-day survival with favorable function as compared with liberal oxygen therapy. Full LOGICAL trial results: nej.md/4x7TavY #CCR26 | @criticalcarereviews.com
A chart comparing GOS-E results for conservative and liberal oxygen treatments. Both bars display percentages of patients across categories: death (dark gray), vegetative state (red), lower severe disability (orange), upper severe disability (tan), lower moderate disability (dark green), upper moderate disability (green), lower good recovery (blue), and upper good recovery (light blue).
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Chris Nickson @precordialthump.bsky.social · 10/06/2026
Sacha Richardson -prehospital ECMO lead at the Alfred Hospital - discusses the rationale for prehospital ECPR at the CARDIAC symposium 2026 #foamed #foamcc #foamecmo intensiveblog.com/prehospital-...
intensiveblog.com
Prehospital ECPR - do we need it? - INTENSIVE
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Chris Nickson @precordialthump.bsky.social · 05/06/2026
Hugh Burrill, one of our prehospital ECPR survivors, and his wife Meridee shared their experience at the recent CARDIAC symposium. You can watch the video here: intensiveblog.com/surviving-an... It is a rare and valuable insight into the patient experience. #foamed #foamecmo #foamcc
intensiveblog.com
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Segun Olusanya (He/Him) @drfreeze.bsky.social · 12/05/2026
Great work by @precordialthump.bsky.social et al on the reliability of the CICM exam www.sciencedirect.com/science/arti... Lots of questions about SMITHSEx remains @drnavsidhu.bsky.social
sciencedirect.com
The reliability of the College of Intensive Care Medicine of Australia and New Zealand viva examination
Examinations used to credential trainees for independent specialist practice in intensive care medicine should be evaluated to demonstrate their level…
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Chris Nickson @precordialthump.bsky.social · 22/05/2026
If only all prehospital ECPR had commentary by Sacha Richardson - great demo by the Alfred / ambulance victoria team! #FOAMed #FOAMcc #FOAMecmo intensiveblog.com/prehospital-...
intensiveblog.com
Prehospital ECPR at the CARDIAC Symposium 2026 - INTENSIVE
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Chris Nickson @precordialthump.bsky.social · 30/04/2026
“Catalyst - critical ideas in action” is happening in Melbourne 23 July 2026. Early bird registrations is closing at midnight today. Spots still available for advanced ECMO but FBI is sold out. web.cvent.com/event/5028ae...
web.cvent.com
Summary - CATALYST, FBI & Advanced ECLS- Critical Care Ideas in Action
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Chris Nickson @precordialthump.bsky.social · 20/02/2026
Great work led by Dr Ken Hoffman on the CICM second part exam vivas www.sciencedirect.com/science/arti...
sciencedirect.com
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Chris Nickson @precordialthump.bsky.social · 14/12/2025
RSI: Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults – The Bottom Line #foamed #foamcc www.thebottomline.org.uk/summaries/ic...
thebottomline.org.uk
RSI: Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults
Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults Casey. NEJM. 2025. doi: 10.1056/NEJMoa2511420 Clinical Question Among adults with non‑traumatic critical illness undergoing emerg...
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Chris Nickson @precordialthump.bsky.social · 13/12/2025
Etomidate • LITFL Critical Care Compendium #foamed #foamcc Comprehensive overview of etomidate pharmacology for critical care clinicians including implications from the RSI trial litfl.com/etomidate/
litfl.com
Etomidate
Pharmacology of etomidate (Critical Care Compendium entry)
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Dr Michael Clifford @drmikeclifford.bsky.social · 10/12/2025
Pity they massively overdosed the ketamine arm - significant percentage > 2mg/kg / no ceiling dose ("rule of 1 ampoule") / dose per total body weight / and who gives > 0.5 mg/kg to a "sick" patient - great trial / wrong pharmacology / wrong conclusion = drugs are equivalent at equipotent doses
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Dr Michael Clifford @drmikeclifford.bsky.social · 09/12/2025
The Worlds Best Intensive Care Meeting is up and running - Critical Care Reviews Down Under - triallist, editorialist, statistician, expert panel - an hour - not 10 mins - and that is the outside behind them - Naarm (Melbourne)
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Segun Olusanya (He/Him) @drfreeze.bsky.social · 07/12/2025
media.tenor.com
a little girl with blonde hair is making a funny face while sitting in a car seat .
ALT: a little girl with blonde hair is making a funny face while sitting in a car seat .
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Critical Care Reviews @criticalcarereviews.com · 10/12/2025
Co-Chief Investigators Jonathan Casey and Matthew Semler share their insights from the #RSI trial after presenting at #CCRdownunder Livestream -> www.criticalcarereviews.com @jama.com
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NEJM.org @nejm.org · 10/12/2025
In a randomized trial involving critically ill patients undergoing intubation in EDs or ICUs, the use of ketamine for the induction of anesthesia did not lead to significantly lower in-hospital mortality than etomidate. Full trial results: nej.md/44EOlxB @criticalcarereviews.com
CCR Down Under 2025 
Original Article | Dec. 9, 2025 | NEJM.org 
Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults 

Figure 1. In-Hospital Death, According to Trial Group. 

The NEJM identity sits at the bottom.
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Critical Care Reviews @criticalcarereviews.com · 10/12/2025
Chief Investigator Arthur Kwizera shares an overview of the #ARISEAFRICA trial after presenting at #CCRdownunder and highlights what clinicians can take away from the results. Livestream -> www.criticalcarereviews.com @jama.com
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Critical Care Reviews @criticalcarereviews.com · 09/12/2025
Co-Chief Investigators Brenda O'Neill and Danny McAuley share the results of the #iRehab trial after presenting at #CCRdownunder Livestream -> www.criticalcarereviews.com @jama.com
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Emma Ridley, PhD @icunutrition.bsky.social · 09/12/2025
#ARISEAFRICAtrial is a stepped wedge cluster- this design is useful for interventions delivered at the ICU/hospital level and individual randomisation is difficult. Clusters transition from control to intervention at different times www.bmj.com/content/350/... #ccrdownunder @criticalcarereviews.com
bmj.com
The stepped wedge cluster randomised trial: rationale, design, analysis, and reporting
#### Summary points
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Critical Care Reviews @criticalcarereviews.com · 10/12/2025
RSI trial now starting ➡️ Etomidate vs Ketamine for RSI ➡️ Jonathan Casey & Matthew Semler presenting ➡️ Chris Nickson editorialising ➡️ Join the livestream - criticalcarereviews.com #ccrdownunder
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Emma Ridley, PhD @icunutrition.bsky.social · 10/12/2025
Congratulations to the RSI trial team #CCRdownunder
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Goodishintent @omnintensivist.bsky.social · 10/12/2025
Wow wow wow Beautiful trial. Nice editorial. Worth watching if you intubate patients.
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JAMA @jama.com · 08/12/2025
Editorial by JAMA Senior Editor Derek Angus: The ImmunoSep RCT demonstrates the feasibility of biomarker-guided treatment, while highlighting ongoing challenges in immune classification and broader clinical application. #CCRdownunder ja.ma/3Kg3qz3
JAMA article "Precision Therapy for Sepsis The End of the Beginning?" by Derek C. Angus, MD, MPH. Article discusses sepsis treatment, host response, and clinical trials.
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Emma Ridley, PhD @icunutrition.bsky.social · 08/12/2025
Second at #ccrdownunder - #IREHABtrial Post your questions at #ccrdownunder and #IREHABtrial or at the livestream: criticalcarereviews.com
criticalcarereviews.com
Home
The most up-to-date critical care website in the world
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Chris Nickson @precordialthump.bsky.social · 08/12/2025
Precision Therapy for Sepsis: The End of the Beginning? | Critical Care Medicine | JAMA | JAMA Network #ccrdownunder 2025 jamanetwork.com/journals/jam...
jamanetwork.com
Precision Therapy for Sepsis
Sepsis is a macabre dance between host and pathogen.1 With development of germ theory by Lister, Semmelweis, Pasteur, and Koch, pathogen eradication was the focus. Only in recent decades, with observa...
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JAMA @jama.com · 08/12/2025
RCT: Among patients with #sepsis, a precision immunotherapy strategy targeting macrophage activation-like syndrome and sepsis-induced immunoparalysis improved organ dysfunction by day 9 compared to placebo.#CCRdownunder ja.ma/3MkSb95
JAMA graph titled 'Figure 2. Primary End Point'. 'Change from the baseline SOFA score' is plotted for precision immunotherapy (orange) and placebo (blue). SOFA scores range from 0 to 20; x-axis is 1 to 145.
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JAMA @jama.com · 08/12/2025
📊 Research Summary: The ImmunoSep trial demonstrates the potential for biomarker-guided immunotherapy in a subset of patients with sepsis. #CCRdownunder ja.ma/4pMi8wt
JAMA research summary on precision immunotherapy to improve sepsis outcomes.The trial assessed whether immunotherapy could improve organ function in sepsis-3 patients.35.1% in precision immunotherapy vs 17.9% in placebo groups.
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Emma Ridley, PhD @icunutrition.bsky.social · 08/12/2025
ImmunoSep uses a double-dummy design. What is this? It is a design to maintain blinding when 2 treatments can't be made identical- all participants receive 2 treatments- one which is active and the other which is placebo #ccrdownunder
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Chris Nickson @precordialthump.bsky.social · 08/12/2025
IMMUNOSEP trial - JAMA jamanetwork.com/journals/jam... #ccrdownunder 2025
jamanetwork.com
Precision Immunotherapy to Improve Sepsis Outcomes
This randomized trial assesses whether precision immunotherapy tailored to macrophage activation–like syndrome or sepsis-induced immunoparalysis improved organ dysfunction compared with placebo among ...
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Emma Ridley, PhD @icunutrition.bsky.social · 08/12/2025
Looking forward to #ccrdownunder- if you are following along please include this hashtag in any posts and I can moderate your questions online- enjoy the live!!!
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Emma Ridley, PhD @icunutrition.bsky.social · 08/12/2025
Up first at #ccrdownunder - #IMMUNOSEPtrial Post your questions at #ccrdownunder and #IMMUNOSEPtrial or at the livestream: criticalcarereviews.com
criticalcarereviews.com
Home
The most up-to-date critical care website in the world
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Critical Care Reviews @criticalcarereviews.com · 19/10/2025
Struggling to keep up with the critical care literature? ➡️ We search it daily & curate the best papers ➡️ Delivered to your inbox each weekend ➡️ Try our Newsletter - there's nothing else like it Sample - criticalcarereviews.com/newsletters/... Subscription - criticalcarereviews.com/newsletters/...
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Critical Care Reviews @criticalcarereviews.com · 21/10/2025
There are now just under 50 days to CCR Down Under 2025. The programme is out - 8 superb trial results coming up. Join us in Melbourne, in person or virtually, to discuss the best critical care trials in the world! criticalcarereviews.com/meetings/ccr...
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Critical Care Reviews @criticalcarereviews.com · 10/08/2025
The 5th trial to be announced for CCR Down Under 2025 is ACTiVE Effect of automated closed-loop ventilation versus conventional ventilation on duration and quality of ventilation in critically ill patients Join us in Melbourne, either in-person or online criticalcarereviews.com/meetings/ccr...
criticalcarereviews.com
CCR Down Under 2025
Critical Care Reviews Meeting Down Under - The Edge, Federation Square, Melbourne, December 9th - 10th, 2025
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Chris Nickson @precordialthump.bsky.social · 22/07/2025
CCR Down Under 2025 - december 9th & 10th 2025 Melbourne is the place to be! Registrations are open 😁: criticalcarereviews.com/meetings/ccr... See you there! @criticalcarereviews.com
criticalcarereviews.com
CCR Down Under 2025
Critical Care Reviews Meeting Down Under - The Edge, Federation Square, Melbourne, December 9th - 10th, 2025
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Critical Care Reviews @criticalcarereviews.com · 24/07/2025
🚩The 3rd trial result for CCR Down Under 2025 is ARISE-AFRICA🚩 ➡️Standard low flow oxygen vs nasal high flow oxygen vs CPAP in hypoxaemic respiratory failure ➡️Presenter Arthur Kwizera ➡️Join us in Melbourne criticalcarereviews.com/meetings/ccr... @precordialthump.bsky.social
criticalcarereviews.com
CCR Down Under 2025
Critical Care Reviews Meeting Down Under - The Edge, Federation Square, Melbourne, December 9th - 10th, 2025
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Chris Nickson @precordialthump.bsky.social · 22/07/2025
CCR Down Under 2025 - december 9th & 10th 2025 Melbourne is the place to be! Registrations are open 😁: criticalcarereviews.com/meetings/ccr... See you there! @criticalcarereviews.com
criticalcarereviews.com
CCR Down Under 2025
Critical Care Reviews Meeting Down Under - The Edge, Federation Square, Melbourne, December 9th - 10th, 2025
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Chris Nickson @precordialthump.bsky.social · 21/07/2025
Looking forward to this!
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Chris Nickson @precordialthump.bsky.social · 17/07/2025
Dobutamine litfl.com/dobutamine/ I don’t often use dobutamine, but when I do I make sure I know about its cool racemic pharmacology (and the major clinical trials) #foamed #foamcc
litfl.com
Dobutamine
Pharmacology of dobutamine, a synthetic catecholamine used as an inotrope as it is a direct-acting moderately selective β1 adrenergic agonist
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Chris Nickson @precordialthump.bsky.social · 17/07/2025
Suspended animation litfl.com/suspended-an... Ok, not really a core crit care topic and not coming to an ICU near you anytime soon… #foamcc #foamed
litfl.com
Suspended animation
Suspended animation is defined as the therapeutic induction of a state of tolerance to temporary complete systemic ischaemia
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Chris Nickson @precordialthump.bsky.social · 17/07/2025
Airway assistant (ala airway ally) litfl.com/airway-assis... the forgotten role in airway management in ED, ICU, and the wards… but an important one! #foamed #foamcc
litfl.com
Airway Assistant
Description of the airway assistant role in the ANZ critical care setting: responsibilities, tips, pitfalls for newcomers to the role
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Chris Nickson @precordialthump.bsky.social · 17/07/2025
Unrecognised esophageal intubation litfl.com/unrecognised... Largely derived from the superb PUMA guidelines by @chrimesy.com et al #foamed #foamcc
litfl.com
Unrecognised oesophageal intubation
Unrecognised oesophageal intubation: frequency, causes, prevention, recognition, actions, and confounders. Derived from PUMA guidelines.
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Chris Nickson @precordialthump.bsky.social · 17/07/2025
Metaraminol litfl.com/metaraminol/ A very commonly used drug in UK/ ANZ crit care - but one there is surprisingly little known about… #foamed #foamcc
litfl.com
Metaraminol
Pharmacology of metaraminol, peripherally administered vasopressor used for direct & indirect sympathomimetic effects (esp alpha-1 agonism)
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Chris Nickson @precordialthump.bsky.social · 17/07/2025
Semaglutide litfl.com/semaglutide/ Not a core ICU drug but we need know about GLP1R agonists! #foamed #foamcc
litfl.com
Semaglutide
Pharmacology of Semaglutide, the Glucagon-like peptide-1 (GLP-1) receptor agonist. Incretin mimetic and Antidiabetic agent
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Chris Nickson @precordialthump.bsky.social · 17/07/2025
Continuous beta-lactam infusions litfl.com/continuous-b... Is this the way to “make antibiotics great again”? #foamed #foamcc
litfl.com
Continuous beta-lactam infusions
Critical evaluation of continuous infusion of beta-lactam antibiotics (rather than intermittent dosing) in critically ill patients.
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Jack Iwashyna @iwashyna.bsky.social · 26/06/2025
“On Not Betraying Our Trainees, Especially Now” I won an Extraordinary Achievement Award from the Critical Care Assembly last month The @atscommunity.bsky.social premier journal @atsblueeditor.bsky.social TODAY published the remarks I made on that occasion www.atsjournals.org/doi/10.1164/...
atsjournals.org
On Not Betraying Our Trainees, Especially Now | American Journal of Respiratory and Critical Care Medicine | Articles in Press
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