eCritCare Podcast

About eCritCare Podcast

The landscape of Intensive care is changing. In the era of evidence based medicine, we try to make best possible decision for our patients based on best available evidence. Every fortnight, Dr Swapnil Pawar & Dr Jose Chacko will bring you one hot topic in Critical care. If you want to stay up to date with recent evidence or learn how to critically evaluate the literature in critical care, this podcast is for you.

Publisher

Swapnil Pawar

Category

education · health & fitness

Language

en

Explicit

No

First episode

16 Dec 2019

Latest episode

6 Oct 2026

Latest episodes

111 episodes in the feed.

1. 

   6 Oct 2026

   #Epi 133 - The Green ICU: Cutting the Environmental Footprint of Intensive Care with Dr Nicole Hunfeld

   More than one box of gloves per patient, per day. Glass bottles of IV paracetamol filling the waste room. Intensive care saves lives, but at what cost to the planet? In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Dr Nicole Hunfeld, ICU pharmacist and Chief Sustainability Officer at Erasmus University Medical Centre, Rotterdam, associate professor in sustainable healthcare, chair of the Dutch Green ICU Network and co-chair of the ESICM Environmental Sustainability Committee. Nicole shares how a COVID-era frustration became the Green ICU movement, now spread across all 70 ICUs in the Netherlands and beyond. In this conversation: How overflowing plastic waste during COVID sparked the Green ICU project The material flow hotspot analysis, published in Intensive Care Medicine, that gave the team data and a narrative 108 gloves per patient per day, and the journey of a single nitrile glove from Spain to Malaysia to Rotterdam Low hanging fruit: swapping blueys for towels, the "No risk, no glove" campaign, and IV to oral switches Why the paper recycling idea failed completely, and what it taught the team about going slow The paracetamol challenge: a giant tablet, 40 hospitals signing up in one day, and around 18,000 euros saved in a year on one drug Measuring what matters: carbon, cost and nurse workload Building a national network with a mixed nurse and intensivist committee Keeping momentum: green leaf icons in protocols and "oral first" prompts in the EHR Corporate anthropology and why you should embrace the no Where to start in your own ICU Read this episode on Substack: https://critcareedu.substack.com/p/green-icu-sustainable-intensive-care Please send us your feedback @ icuprimaryprepcast@gmail.com

2. 

   27 Sept 2026

   #Epi 132 - TRICYCLE Trial: Early Triple Vasopressor Therapy in Septic Shock with Prof Giovanni Landoni & Dr Žiga Kalamar

   Norepinephrine first, titrate up, add vasopressin when the dose gets high, reach for a third agent when things get desperate. That stepwise approach is how most of us treat septic shock. What if all three went in together, early? In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Professor Giovanni Landoni (San Raffaele Hospital, Milan) and Dr Žiga Kalamar (Medical ICU, University Medical Centre Maribor, Slovenia) to discuss the TRICYCLE trial, published in Critical Care in 2026. TRICYCLE randomised 79 patients with septic shock to early simultaneous norepinephrine, vasopressin and angiotensin II at balanced starting doses, or to conventional stepwise vasopressor escalation. In this conversation: Why septic shock involves several broken vasoconstrictor pathways at once, and why one drug titrated to high doses may not be the answer Why a phase II mechanistic trial chose renin, not blood pressure or mortality, as its primary outcome The results: faster falls in renin and lactate, a 3-point SOFA improvement at 72 hours, and numerically lower mortality The striking drop in tachyarrhythmias, and the beta-adrenergic explanation behind it What went hard: strict inclusion criteria and running three infusion pumps to protocol A post hoc hint that high-renin patients may benefit most, and why phenotyping is still a long way off Angiotensin II cost and access, and what that means for resource-limited settings Next steps: a bigger trial powered on AKI or arrhythmias, and the idea of a meta-trial run across many small sites Read this episode on Substack: https://critcareedu.substack.com/p/tricycle-trial-multimodal-vasopressors-septic-shock Paper: Kalamar Ž, Landoni G, Gorenjak M, et al. Early multimodal vasopressor strategy in septic shock: results of the TRICYCLE randomized controlled trial. Crit Care. 2026. doi:10.1186/s13054-026-06323-z

3. 

   22 Sept 2026

   #Epi 130 - T4P Trial: Platelet Transfusion Thresholds Before ICU Procedures with Prof Peter Watkinson & Prof Simon Stanworth

   A platelet count of 40 and a central line to put in. Transfuse first, or go ahead? Right now the answer depends on which ICU you work in, and nobody actually knows which is right. In this episode of the eCritCare Podcast, Dr Swapnil Pawar is joined by Professor Peter Watkinson (Professor of Intensive Care Medicine, University of Oxford, and Chief Investigator) and Professor Simon Stanworth (Professor of Haematology and Transfusion Medicine, University of Oxford) to discuss the T4P trial, Threshold for Platelets. T4P is a Bayesian adaptive randomised trial across five platelet transfusion thresholds, from below 10 to below 50, in critically ill patients undergoing low bleeding risk invasive procedures. It is recruiting 2,550 patients across the UK, Australia and Canada and has just passed the halfway mark. In this conversation: Why platelet transfusion practice in critical care was borrowed from blood cancer patients, and why the evidence never caught up The UK survey that showed thresholds anywhere from under 10 to under 50 for the same procedure The risks side of the ledger: a biological product, transfusion reactions, unknown effects, and around £290 per unit before lab and administration costs Why five thresholds instead of two: drawing the threshold-response curve so the optimum does not have to be one of the arms Which procedures are specified (central lines, pleural aspiration, paracentesis) and which are at clinician discretion The adherence question, and why even the below-10 arm is being followed The haematology confusion: why a patient's daily platelet threshold does not stop them being in T4P Rotating trainees, cross-specialty equipoise, and asking clinicians to step outside a comfort zone they have practised in for years Operator experience, ultrasound-guided lines, and what PACER did and did not show in critical care What success looks like: the biggest platelet transfusion study in critical care, and a practice-changing curve Read this episode on Substack: https://critcareedu.substack.com/p/t4p-trial-platelet-transfusion-thresholds Trial registration: ISRCTN79371664. Funded by the NIHR Health Technology Assessment Programme (NIHR131822).

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Apple Podcasts (US)

4.5 / 5

4 ratings

Spotify

4.9 / 5

7 ratings

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