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It'll never be proven, because it isn't measurable, but the fall in NHS productivity is at least partly down to the loss of goodwill and discretionary effort from staff. The culture around working when unwell and staying behind (rightly IMO) is night and day from when I started.

Watching how people secure lines, drains etc there is a real need for anaesthetists/intensivists to learn the basic surgical skill of one handed knot tying Excellent video here: youtu.be/uFJbTbjeU4Y?si…

Unheard and unseen: The hidden impact of nocebo communication in the Intensive Care Unit Short review, makes you think before you start talking at the bedside journals.sagepub.com/doi/full/10.11…

Fascinating to hear results of the BLING III trial at #ccr24 More pts than all the other trials combined! No statistically significant diff in 90d mortality BUT SRMA published simultaneously demonstrates mortality benefit with NNT 26 to prevent 1 death 🤔 jamanetwork.com/journals/jama/…

#A2Btrial results provide lots of food for thought! No benefit on duration of MV. Increased agitation in alpha 2 agonist groups is a bit unexpected. Dex group extubated a day earlier than propofol group; not statistically significant but potentially clinically significant? #CCR24

Big takeaway from #A2Btrial : sedation trials are REALLY HARD TO DO! No clear benefit in using alpha 2 agonist routinely but big remaining question is whether these agents have a role in patients with agitated delirium (as in DAHLIA trial) #CCR24 pubmed.ncbi.nlm.nih.gov/26975647/

A lot to unpack in DEFENDER trial results. Need to get my head around the concept of win ratio! Perhaps not surprising that there was no benefit in a generally critically ill population. Most interesting thing for me is zero euglycaemic DKA cases! #CCR24 jamanetwork.com/journals/jama/…

We're aware that many doctors are being told their training is being automatically extended due to exceeding TOOT thresholds. This should NOT happen. GMC and NHS England confirm there should be no automatic extensions. See our guidance on TOOT 👇 bma.org.uk/toot-ia

Well done to the whole #CCR24 team for organising an excellent meeting! Enough research to keep our journal club busy for months yet Critical Care Reviews

Great thread! Reminds me of an old talk by Merv Singer about the misinterpretations of lactate where he said "lactate gets a bad rap but it's a good guy!"

#VExUS Score at Discharge as a Predictor of Readmission in Patients with Acute Decompensated #HeartFailure: A Cohort Study 🔗 scielo.br/j/abc/a/MQdGqP…

New favorite physiology paper: Central Venous Pressure in Space. So much space & cardio physiology to unpack here including: - effects of posture, 3g shuttle launch, & microgravity on CVP - change in the relationship between filling pressure (CVP) & LV size - Guyton curves! 1/