ICU physician-scientist and fan of good science across translational spectrum.
Birmingham, AL
Joined June 2022
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When someone is critically ill and needs a breathing machine, doctors commonly choose between ketamine and etomidate to put them to sleep. Which is better? We are excited to finally share the results of the RSI trial! @UABNews @PCCRG @UABPulmonary
Original Article: Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults nej.md/44EOlxB
@CritCareReviews
ALT A figure showing in-hospital death, according to trial group.
Derek W. Russell, MD retweeted
🔬@UABPulmonary Drs. @SGandotraMD, @DerekRussellMD
David Page, and Micah Whitson report in @NEJM that preoxygenation with noninvasive ventilation, as opposed to O2 mask, results in lower incidence of hypoxemia in adults undergoing tracheal intubation.
📕loom.ly/ZisAp9Y
Derek W. Russell, MD retweeted
EMCrit 377 - Breaking News - The PREOXI Trial changes everything for Preoxygenation in Intubations in the Critically Ill! I interview the lead authors and give my RECs.
[#FOAMed]
I've been advocating for this for years and now we have a beautiful trial...
emcrit.org/377
Derek W. Russell, MD retweeted
Since @CritCareReviews and #CCR24 have had a couple of win ratio analyses, here’s a little plug for a video I made with @CMichaelGibson a few years back that is meant to be an accessible explainer of how it works.
Please excuse my hair. It was a different time.
The Win Ratio is being used as the primary endpoint in many ongoing and upcoming randomized trials.
@ADAlthousePhD and I demystify the Win Ratio in this short video
clinicaltrialresults.org/dr-…
RT is VERY busy during RSI of critically ill adults... is it worthwhile to routinely ask them to also get a mask for NIPPV during preoxygenation? Prior smaller studies suggested NIV preox might safely reduce hypoxemia, but data mixed/inconclusive. Excited for PREOXI trial!
Our friends from @PCCRG are back too!
Our 5th major trial result presentation at #CCR24 is PREOXI:
Non-invasive ventilation vs facemask oxygen for preoxygenation in the critically ill
@JonathanCaseyMD & @KevinGibbsMD presenting the results
Register at criticalcarereviews.com/meet…
ALT Flyer for the PREOXI trial results at CCR24
Derek W. Russell, MD retweeted
What is the PREOXI study?
Our methods 🔬 are hot 🔥 off the press 📃.
In the DoD-funded PRagmatic trial Examining OXygenation prior to Intibation (PREOXI), patients undergoing emergency intubation will be randomized to a standardized NRB mask versus a pressure mask (CPAP, BPAP) for preoxygenation.
Keep your eyes peeled this spring as we will answer this best-practices question.
sciencedirect.com/science/ar…
#emergency #emergencymedicine #icu #criticalcare #airway #ems #ambulance #sick #trauma #medic #combat #combatmedic #military #army #navy #airforce #foamed #foamcc #science #research #data #armyemdoc #medtwitter #medx – at Colorado, USA
Derek W. Russell, MD retweeted
Miss the @PCCRG DEVICE trial, presented by Matthew Semler & Matthew Prekker at the Critical Care Reviews Meeting #CCR23 last week?
It was simultaneously published in @NEJM
doi.org/10.1056/NEJMoa230160…
Here, the trialists briefly explain the results
Derek W. Russell, MD retweeted
The results from our DEVICE trial are out in the @NEJM . In this RCT, direct laryngoscopy was inferior to video laryngoscopy for first-pass success.
In fact, it was so inferior that we had to stop the trial early after DSMB review due to the clear benefit of VL.
This is the 🔨 nail in the ⚰️ for DL. While it's an important skill, VL should be the standard when it's available. If it's not available, we need to make it available.
nejm.org/doi/full/10.1056/NE…
#emergency #emergencymedicine #icu #criticalcare #airway #military #war #trauma #data #science #research #armyemdoc #medtwitter #foamcc #foamed
Check out our @PCCRG trial just published in @NEJM and presented at #CCR23… VL found to be much better than DL for first pass success across spectrum of airway and device experience (NNT=7), though effect size biggest with learners. nejm.org/doi/full/10.1056/NE…
@UABPulmonary @UABDeptMed @SGandotraMD @brian_driver @KevinGibbsMD @JonathanCaseyMD Proud that UAB ICU and ED teams contributed to DEVICE… our relationships with partner sites within the @PCCRG make work like this possible.
The model varies by site. @HennepinEM has a pretty amazing system with all sorts of support (@brian_driver?). But key to this and our other trials has been to train and truly integrate trial procedures and roles into clinical care processes.
#DEVICETRIAL @CritCareReviews How did the investigators budget and staff for 24h independent observer? Impressive rigorous research and curious to learn more #ccr23
Derek W. Russell, MD retweeted
#CCR23: In the DEVICE trial, the use of video laryngoscopy in critically ill patients undergoing intubation in the ED or ICU resulted in a higher incidence of successful intubation on the first attempt than direct laryngoscopy. nej.md/43H2t79
Derek W. Russell, MD retweeted
Lots of great discussion at CCR23 @CritCareReviews about the trial, results, clinical implications, & future areas for research. The trial really opens question of whether VL should be the standard for all emergent intubations in the ED/ICU. Thanks for joining us, Matt Prekker.
Off schedule but super excited to have the opportunity to sit down with Matt Prekker from the @PCCRG who just presented the DEVICE trial published in @NEJM today and presented at the @CritCareReviews meeting 2023
DEVICE: nejm.org/doi/full/10.1056/NE…
Derek W. Russell, MD retweeted
Coming up in a few minutes, Matt Prekker and Matt Semler present the #DEVICEtrial at #CCR23. The @PCCRG conducted the largest randomized trial of video vs direct laryngoscopy in critically ill adults. Answer to this question in a few minutes criticalcarereviews.com/
It was a blast! Hope that it was helpful to everyone.
@DerekRussellMD kicking off clinical year in review at #ATS2023 with overview of ARDS … @ATSCritCare … Join us now in Hall D/E
It's a challenge to keep up with the literature. If you're coming to DC for #ATS2023 , consider attending my talk, 2023 Clinical Year in Review: ARDS, on Sunday, 5/20, in which we will cover the most impactful research of the past year. @ats @UABPulmonary @UABDeptMed
Derek W. Russell, MD retweeted
In this Friday's PCT Grand Rounds, Matthew Semler of @VUMCLHS will present a cluster-crossover trial of oxygen saturation targets for critically ill patients receiving mechanical ventilation. Join us! #pctGR bit.ly/3Nh3o98