1
1
0
0
Hashtag
#CCRdownunder24
Advertisement · 728 × 90
Primary outcome
Secondary outcomes
90-day mortality was lower in screening group
NNT= 206
#CCRdownunder
#CCRdownunder24
2
0
1
0
Alert information
N=60'055 (!) included in analysis
Baseline difference of COVID-19 5% in control vs. 12% in treatment groups
Both groups received many alerts 🤔
#CCRdownunder
#CCRdownunder24
1
0
1
0
Trial design and impact of COVID-19 in orange
Importantly, the alert is a tool initiating detailed assessment 🩺🥼
45 wards were randomised, concealed until one month before start over 10 periods (from period 3: impacted by COVID-19)
#CCRdownunder
#CCRdownunder24
1
0
1
0
Title slide
Sepsis alert when 2 of 3 criteria met
Example of alert workflow
Lastly, the SCREEN trial
🏥 electronic early recognition of sepsis in hospitalised patients
📝 stepped-wedged RCT
🎯 90-day in-hospital mortality
⚠️ sepsis alert based on GCS, RR, SBP
#CCRdownunder
#CCRdownunder24
2
1
1
0
1
0
0
0
Inferiority margins
Methodology was quite complicated, further explanation on inferiority during editorial 👍
#CCRdownunder
#CCRdownunder24
1
0
1
0
2
0
2
1
Primary outcome
Conclusion slide
Results & conclusions 👇
HFNC was noninferior to NIV
Adverse events were very similar btw groups
#CCRdownunder
#CCRdownunder24
1
0
1
0
1
0
1
0
Also, clear failure definitions 👌 (⚠️ included NIV for the HFNC group)
As with all previous trials, COVID impacted the trial...
N=1800 randomised
#CCRdownunder
#CCRdownunder24
1
0
1
0
Title slide
Pros and Cons of NIV
Pros and Cons of HFNC
RENOVATE trial is coming up now
🩻 HFNC vs. NIV in ARF
📝 multicentre, adaptive RCT in Brazil
🎯 endotracheal intubation or death at day 7
I like that they included a step-down procedure along with initiation protocol 👌
#CCRdownunder
#CCRdownunder24
9
4
1
0
Outcome table
Half of pts were intubated, 1/3 went to the ICU, 22% received surgery
No difference in primary outcome, tendency to more death in restricted O2
#CCRdownunder
#CCRdownunder24
5
1
2
0
🏥 trauma patients
🫧 liberal vs restrictive oxygen
🎯 composite outcome 30-day of death & 🩻
#CCRdownunder
#CCRdownunder24
1
0
1
0
Title slide
Current studies, most in ICU, not in trauma patients
Foto of the Yarra River Park with the skyline in the background
Good morning Melbourne, we start with the #traumox2 trial
#CCRdownunder
#CCRdownunder24
6
2
1
0
Summary slide
Summary and link to publication 👇
www.nejm.org/doi/full/10....
#CCRdownunder
#CCRdownunder24
6
3
0
0
N=742
80% were female in both groups
Clear separation between groups
No difference for mRS
#CCRdownunder
#CCRdownunder24
3
1
1
0
Title slide
Overview of the condition from short to long-term outcomes
Why anaemia is important
SAHaRA trial comes up
🏥Subarachnoid hemorrhage
50% have anaemia (associated with poorer outcomes)
🩸liberal vs. restrictive red blood transfusion
📝 RCT
🎯 modified Rankin Scale + FIM, 5EuroQOL at 12mth
#CCRdownunder
#CCRdownunder24
8
4
2
1
4
2
1
0
Participants characteristics
Graphical results
N=214 randomised
🎯 no effects for time to first infection-reated rehospitalisation
#CCRdownunder
#CCRdownunder24
2
1
1
0
Immune impairments in sepsis survivors
Why PCV13
Aims & objectives
Next up VACRiSS trial
Can a vaccine (PCV13) reverse immune impairments in sepsis survivors?
#CCRdownunder
#CCRdownunder24
3
3
0
0
Immune impairments in sepsis
Uncertainty
Why PCV13?
Aims & objectives
Next VACRiSS trial
Rationale & background:
Sepsis survivors suffer from poor health, immune impairments common.
Can a vaccine (PCV13) reverse this?
Particularly, t-cell function?
#CCRdownunder24
#CCRdownunder
3
1
1
0
First up at #ccrdownunder24 ADAPTSepsis with Paul Dark Biomarker guided antibiotic duration in hospitalised patients with sepsis.
Does treatment protocol using CRP or PCT reduce total 28day use of antibiotics- and safely (28day mortality)?
3
1
2
0
2
0
0
0
Absolutely fantastic work from @darknatter.bsky.social and team. Looking forward to a deep dive into the paper!
#ccrdownunder24
6
1
1
0
ADAPT-Sepsis results from CCR Down Under.
1ry outcomes: Standard care vs PCT shows improved significant reduction in antibiotic duration, but not for Standard vs CRP.
No difference in 90D mortality.
#CCRdownunder24
10
3
2
1
ADAPT-Sepsis results from CCR Down Under.
1ry outcomes total duration of antibiotics and safety of all-cause mortality up to D28.
2ry outcomes: escalation of care/re-admission; infection re-lapse/recurrence; antibiotic dose; LoS, level of critical care stay.
#CCRdownunder24
1
0
1
1
ADAPT-Sepsis results from CCR Down Under in Melbourne.
Paul Dark presents the results of the trial comparing standard Care vs. daily monitoring of CRP and daily monitoring of PCT.
#CCRdownunder24
5
0
0
0
Rob MacSweeney and Andrew Udy give the opening remarks from CCR Down Under in Melbourne.
#CCRdownunder24
2
0
0
0
Opening ceremony and Acknowledgement of Country kicks off CCR Down Under 24 bought to from beautiful Melbourne.
Results from the trials to follow...
#CCRdownunder24
1
0
0
0