iiinova — where your digital self keeps evolving

Reposted by Dr Stephen T Webb

JAMA Network Open @jamanetworkopen.com · 12/06/2025

During the COVID-19 pandemic, variable proportions of agency nurses and higher nurse turnover in pediatric intensive care units were associated with increased complications and ventilator-associated pneumonia. #CCR25 #MedSky ja.ma/4jI7YK2

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Jonny Wilkinson @nottheflyhalf.bsky.social · 13/06/2025

PROMIZING Discover the impact of Proportional-Assist Ventilation vs. Pressure-Support Ventilation on extubation times in critically ill patients.

criticalcarenorthampton.com

PROMIZING

Discover the impact of Proportional-Assist Ventilation vs. Pressure-Support Ventilation on extubation times in critically ill patients.

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Reposted by Dr Stephen T Webb

NEJM.org @nejm.org · 13/06/2025

In the PROMIZING trial, proportional-assist ventilation with load-adjustable gain factors did not differ significantly from pressure-support ventilation with respect to the time to liberation from mechanical ventilation. Full trial results: nej.md/4kC2a67 @criticalcarereviews.com #CCR25

A graph showing the cumulative probability of successful liberation from ventilation and of death before successful liberation.

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Reposted by Dr Stephen T Webb

NEJM.org @nejm.org · 13/06/2025

Presented at #CCR25: A trial involving children with severe acute malnutrition and gastroenteritis showed no evidence of a difference in mortality at 96 hours between oral and intravenous rehydration strategies. Full GASTROSAM trial results: nej.md/3TjfSP7 @criticalcarereviews.com

A graph showing the primary end point, which was death at 96 hours.

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Reposted by Dr Stephen T Webb

Marion Campbell @marionkcampbell.bsky.social · 13/06/2025

Fantastic presentation of the #GASTROSAM trial at #CCR25 - IV rehydration strategies for children with severe acute malnutrition & gastroenteritis. Amazing commitment to generating evidence in the hardest of circumstances incl a coup and flooding. Bravo! www.nejm.org/doi/full/10....

nejm.org

Intravenous Rehydration for Severe Acute Malnutrition with Gastroenteritis | NEJM

International recommendations advise against the use of intravenous rehydration therapy in children with severe acute malnutrition because of the concern about fluid overload, but evidence to suppo...

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Reposted by Dr Stephen T Webb

Signa Vitae @signavitaejournal.bsky.social · 13/06/2025

👑Live from #CCR25 the #Princetrial 🫀Does remote ischemic preconditioning reduce troponin levels after surgery? A preview on the matter is in #signavitae 🔗 www.signavitae.com/articles/10.22514/sv.2024.151 @giovannilandoni.bsky.social @mmarmiere.bsky.social

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Reposted by Dr Stephen T Webb

Critical Care Reviews @criticalcarereviews.com · 13/06/2025

#PROMIZINGtrial results are in - no difference in time to successful liberation from mechanical ventilation between proportional-assist ventilation and pressure support ventilation #CCR25

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josh farkas 💊 @pulmcrit.bsky.social · 12/06/2025

Myburgh is going deep on the origin of balanced fluid. Debate continues 200 yrs later. LR was discovered by accident when tap water containing calcium was accidentally used in a lab experiment, causing greater muscle contractility. -Dr Myburgh #CCR25

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josh farkas 💊 @pulmcrit.bsky.social · 28/11/2024

how to quickly set up a useful MedSky account! 🦋 Mix of basic & more advanced stuff (eg designing user-curated hashtag feeds) 🦋 Take a look & add any useful tips you have in the comments section blog: emcrit.org/pulmcrit/blu... #MedSky

emcrit.org

PulmCrit: How to quickly create a useful professional account in BlueSky

I discussed the reasons for migrating to BlueSky here. I've received positive feedback from several FOAMed expats who migrated to Bluesky and enjoy it

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Reposted by Dr Stephen T Webb

Signa Vitae @signavitaejournal.bsky.social · 12/06/2025

🩸#ANHtrial results are live #CCR25 A survey from the authors: www.signavitae.com/articles/10.22514/sv.2025.076

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JAMA @jama.com · 12/06/2025

Conservative oxygen therapy with a target SpO2 of 90% did not reduce 90-day all-cause mortality compared to usual oxygen therapy in mechanically ventilated adult patients. #CCR25 @criticalcarereviews.com ja.ma/4kOIA6w

Figure 2. Oxygen Exposure and Arterial Oxygenation by Treatment Group in Patients With Enhanced Data Collection

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Reposted by Dr Stephen T Webb

Critical Care Reviews @criticalcarereviews.com · 12/06/2025

Last trial of day 2 Crystalloid FLUID Choices for Resuscitation of Hospital Patients Always a hot topic! #CCR25

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Reposted by Dr Stephen T Webb

NEJM.org @nejm.org · 12/06/2025

Presented at #CCR25: In the ANH phase 3 trial involving adult patients undergoing elective cardiac surgery, acute normovolemic hemodilution did not reduce the number of patients receiving allogeneic red-cell transfusion. Full trial results: nej.md/3FxdMrW @criticalcarereviews.com

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Jonny Wilkinson @nottheflyhalf.bsky.social · 12/06/2025

ICU-acquired weakness and cardiogenic shock in patients requiring mechanical support, highlighting biomarkers and outcomes. @criticalcarereviews.com #FOAMed #POCUS #FOAMcc #CCR25 criticalcarenorthampton.com/2025/06…

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Dr Stephen T Webb @stephen-t-webb.bsky.social · 12/06/2025

A big moment for Royal Papworth Hospital Clinical Trials Unit ! The first RPH trial to be presented at the Critical Care Reviews Conference - Andy Klein CI of the NOTACS Trial presented the results today 👏👏 @criticalcarereviews.com @royalpapworth.bsky.social #CCR25 #NOTACS #NOTACSTrial

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Reposted by Dr Stephen T Webb

Critical Care Reviews @criticalcarereviews.com · 12/06/2025

Andrew Klein highlights the value of working with patient and family members throughout the lifecycle of a clinical trial #NOTACStrial #CCR25

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Dr Stephen T Webb @stephen-t-webb.bsky.social · 12/06/2025

Never fails to impress every year… the venue and the conference! 😄👏@criticalcarereviews.com #CCR25

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Reposted by Dr Stephen T Webb

JAMA @jama.com · 12/06/2025

Editorial: The UK-ROX trial demonstrates that targeting lower oxygen saturation in critically ill patients is safe but does not improve outcomes. #CCR25 @criticalcarereviews.com ja.ma/4ngdtmn

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Reposted by Dr Stephen T Webb

JAMA @jama.com · 12/06/2025

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Reposted by Dr Stephen T Webb

JAMA Network Open @jamanetworkopen.com · 11/06/2025

A multifaceted anemia prevention and treatment bundle improved hemoglobin recovery up to 3 months after hospital discharge compared to standard care in critically ill adults. #CCR25 #MedSky ja.ma/4kGGw0I

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JAMA Network Open @jamanetworkopen.com · 11/06/2025

Intravenous hydrocortisone was associated with a reduced need for new kidney replacement therapy in patients with septic shock. #CCR25 #MedSky ja.ma/3SLC3xg

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Reposted by Dr Stephen T Webb

JAMA @jama.com · 11/06/2025

Augmenting enteral protein did not improve outcomes for critically ill patients compared with standard protein levels in the intensive care setting. #CCR25 @criticalcarereviews.com ja.ma/4kuYRxv

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Reposted by Dr Stephen T Webb

Critical Care Reviews @criticalcarereviews.com · 11/06/2025

Slightly late, and to be updated with the results of today's TTM2 biomarker results, today's Paper of the Day is: Biomarkers for neuroprognostication after out-of-hospital cardiac arrest criticalcarereviews.com/latest-evid…

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Reposted by Dr Stephen T Webb

JAMA @jama.com · 11/06/2025

Augmenting enteral protein did not improve outcomes for critically ill patients compared with standard protein levels in the intensive care setting. #CCR25 @criticalcarereviews.com ja.ma/4mUjFQr

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New Economics Foundation @neweconomics.bsky.social · 21/02/2025

From landslide to loveless - has the public turned on the Labour government? In the latest episode of New Economics Podcast, we discuss with @graceblakeley.bsky.social and @davidedgerton.bsky.social about whether the government is delivering on its promises. neweconomics.org/2025/02/is-t...

neweconomics.org

Is the Labour government delivering on its promises?

Ayeisha Thomas-Smith is joined by Grace Blakeley and David Edgerton

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Dr Stephen T Webb @stephen-t-webb.bsky.social · 22/02/2025

neweconomics.org/2025/02/why-... So good I listened to it twice! Great explanations from ⁦‪@AyeishaTS‬⁩ ⁦‪@DominicCaddick‬⁩ Seb Mang… and directly related to health policy… 👏 ⁦‪@NEF‬⁩

neweconomics.org

Why should the left care about central banks?

Ayeisha Thomas-Smith is joined by Dominic Caddick and Sebastian Mang

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Reposted by Dr Stephen T Webb

Trisha Elliott @trishaelliott.bsky.social · 16/02/2025

Every system delivers the results that it is built to do. (Whether intentional or not). @mancunianmedic.bsky.social in this month’s @bmj.com on how the hospital overcrowding we see today is an inevitable consequence of the actions we (or rather, our politicians) have taken over the last few years.

Article by Dr David Oliver.

Excerpt:

In recent decades we've surely lost too many hospital beds, without creating sufficient alternative capacity elsewhere. This has resulted in entirely predictable risks and harms.
Serious shortages in bed capacity are a major contributor to our current crisis in urgent and emergency care. They lead to long waits and overcrowding in emergency departments, the risks and indignities of
"corridor care", and ambulance handover delays. Performance against four hour and 12 hour targets to "assess, discharge, or admit" has worsened dramatically since 2010, when we were still hitting the 95% target for four hour waits— whereas now NHS England has set a target of just 78% for March 2025. Performance against ambulance handover and response time indicators has also worsened dramatically.
The effects of bed shortages don't end there. We know from analyses reported by the Royal College of Emergency Medicine (RCEM), and more recently by the Office for National Statistics, that such long waits are associated with increased patient mortality. For staff working in such hostile environments every day, moral distress and burnout are major risks, and overcrowding throughout a hospital puts patients at greater risk of hospital acquired infection.
The UK is already second bottom of the league table of hospital beds per 1000 people (just above Sweden), with around 2.3 beds against a median of 5.3 beds in EU nations. In England that figure is lower still, with only 100 000 general and acute beds for a population of 57 million. These beds run very hot, with midnight occupancy routinely at well over 90%. This leaves little flexibility when demand surges.

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Reposted by Dr Stephen T Webb

@IM_Crit_ @imcrit.bsky.social · 15/02/2025

ICU Pharmacology Secrets: Dexmedetomidine (D) (Precedex in 🇺🇸) is one of my favorite ICU drugs. It is a highly selective α-2 adrenoreceptor agonist, w sedative/analgesic/ anxiolytic properties & minimal resp depression. Its main side effects are hypotension & bradycardia

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Dr Stephen T Webb @stephen-t-webb.bsky.social · 03/02/2025

John Geddes: early pioneer and advocate of rapid pre-hospital defibrillation www.bmj.com/content/388/...

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Reposted by Dr Stephen T Webb

Critical Care Reviews @criticalcarereviews.com · 30/01/2025

The 10th presentation at #CCR25 is RESCUE 3 Temporary Transvenous Diaphragm Pacing vs Standard of Care for Weaning From Mechanical Ventilation Register via the QR code or on the CCR website Critical Care Reviews Meeting 2025 The Best Critical Care Trials in the World

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Reposted by Dr Stephen T Webb

Critical Care Reviews @criticalcarereviews.com · 30/01/2025

Ventilator-Associated Pneumonia After Cardiac Arrest and Prevention Strategies CCR Journal Watch criticalcarereviews.com/latest-evide... Get the latest critical care literature every weekend via the CCR Newsletter - subscribe at criticalcarereviews.com/newsletters/...

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Reposted by Dr Stephen T Webb

Lucy Fisher @lucyfisher.ft.com · 17/01/2025

Rachel Reeves vs the markets📈📉 This week on Political Fix, we ask who’s in charge here: the Chancellor or the bond vigilantes? Plus we examine how Kemi Badenoch & Ed Davey have kicked off 2025 @robertshrimsley.bsky.social, @stephenkb.bsky.social & @katie0martin.bsky.social are on the pod 📻🎧

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Reposted by Dr Stephen T Webb

M Velia Antonini @foamecmo.bsky.social · 10/01/2025

Right ventricular Injury in VV #ECMO 🔍 scoping review 📚 30 studies reported on RVI 📚 23 studies on (heterogeneous) definition 📚 13 studies reported on management, including VP & VA ECMO, positive inotropes, pulmonary vasodilators, ultra-lung-protective MV, PEEP optimization 🔗 bit.ly/4fT9MxG

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Reposted by Dr Stephen T Webb

JAMA @jama.com · 08/01/2025

This JAMA Clinical Guidelines Synopsis summarizes the 2024 Society of Critical Care Medicine guidelines on use of corticosteroids in sepsis, acute respiratory distress syndrome, and community-acquired pneumonia. ja.ma/42bw8Y2

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Reposted by Dr Stephen T Webb

Trisha Elliott @trishaelliott.bsky.social · 11/01/2025

In the news section of the @bmj.com it’s good to see that Martha’s Rule is doing some of what it’s supposed to do. If you are worried about someone in hospital and feel you’re not being listened to, you can seek a second opinion. But how many hospitals are signed up? #MedSky #PatientSafety

Patient safety
Martha's rule prompts treatment changes
Almost one in eight phone calls made to NHS
hospitals underthe Martha's rule programme, which allows patients and families to seek an urgent care review, have led to changes in a patient's treatment, said NHS England. Data from 136 hospitals show that in September and October a total of 573 calls were made to escalate concerns about a patient's condition, around half
(286) ofwhich required a clinical review. Some 57 reviews led to a change in care such as patients receiving antibiotics, oxygen, or other treatment, and a further 14 patients were transferred to intensive care.

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Reposted by Dr Stephen T Webb

Anna Batchelor @annabatchelor.bsky.social · 11/01/2025

Pretty crisp out there this morning

A garden and field covered in frost. Frozen pond and standing water

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Critical Care Reviews @criticalcarereviews.com · 11/01/2025

Today's Paper of the Day is mechanical support in early cardiogenic shock: what is the role of intra-aortic balloon counterpulsation criticalcarereviews.com/latest-evide... Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2025

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Reposted by Dr Stephen T Webb

Josie Glausiusz @josiegz.bsky.social · 10/01/2025

Thousands of miles of footpaths could now be saved after the UK government committed to lifting a deadline for all rights of ways in England to be mapped. There are estimated to be more than 40,000 miles of rights of way in England which are not officially recorded. www.bbc.com/news/article...

bbc.com

Deadline to record historic footpaths to be scrapped

Walking campaigners welcome the move, which the government says will help prevent paths from being lost.

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Sam Freedman @samfr.bsky.social · 11/01/2025

A nice quirky story but also one that illustrates just how much the extremely wealthy could do for the public sphere if they had any real interest in it.

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Dr Stephen T Webb @stephen-t-webb.bsky.social · 09/01/2025

Today in Focus @theguardian.com : thoughtful and balanced as always 👏 from @helenpidd.bsky.social & @samfr.bsky.social (DoI: late 80s/early 90s product of a non-fee paying Northern Irish grammar school) podcasts.apple.com/gb/podcast/t...

podcasts.apple.com

Are private schools losing their grip on the British elite?

Podcast Episode · Today in Focus · 08/01/2025 · 29m

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