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Why Physiology Is Never Enough: The Siren Song of Critical Care
The Sirens of intensive care sing seductive physiology. Their song is beautiful: thin the mucus, recruit the lung, normalise the number, restore the pressure. The MARCH trial asks what happens when that music meets the whole patient. Carbocisteine and hypertonic saline made sense for difficult airway secretions, yet neither shortened mechanical ventilation, and both were associated with harm. That is why trials matter: they capture the effects we hoped for, and the ones we failed to imagine. Critical care is full of shipwrecked certainties — albumin, tight glycaemic control, renal-dose dopamine, oscillation. Physiology may start the voyage, but it cannot be allowed to steer alone. MARCH is the rope around the mast: the discipline that keeps patients safe from our most alluring ideas.
Added July 12th
After many months of preparation, we're delighted to release our Foundational Trials Collection.
250 critical care contemporary trials are summarised and critiqued in depth.
If you are new to the field, are undertaking exams, or just want to refresh your knowledge, this is an excellent place to start.
added February 17th
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added July 7th
