TOWAR RCT replicates SWIFT finding no benefit of whole blood vs components for trauma shock. Quick meta-analysis of 30d mortality gives RR 1.17 (0.98-1.40), close to showing *harm* by whole blood. Huge credit to those who ran these RCTs; another physiology-based hype cycle falls

We have a new study in JAMA IM asking: do all 'hypomagnesemic' patients need supplementation? Many reflexively prescribe Mg when the number is below the reference range, but is this indicated? We used a quasi-experimental design to find out. jamanetwork.com/journals/jam...

Epidemiologic methods are increasingly difficult for clinicians and policy makers (and epidemiologists?) to understand. Are they at least getting us closer to uncovering causal relationships? My argument in this new piece: we don't know, because we haven't checked: academic.oup.com/ije/article-...

Less is more wins again. RCT of high MAP target in older adults with sepsis (50% w/underlying HTN), stopped early for harm, 39% mortality MAP 80-85 vs. 29% mortality MAP 65-70 link.springer.com/article/10.1.... Recall also that the 65 Trial hinted that MAP60 may be better than 65. How low can we go?

New WTA resus thoracotomy (RT) algorithm. 2 new/key points: -Now incorporates POCUS: if no organised cardiac rhythm and no tamponade on POCUS, no RT (regardless of time since arrest / mechanism). -RT if pulse but refractory SBP <60 plus {blunt/penetrating thoracic injury OR tamponade on POCUS}

Do diuretics ⬇️mortality in heart failure? UpToDate, quoting Cochrane, says yes OR 0.24 (0.07-0.83). Looking at the 3 small RCTs this is based on suggests an important error in the meta-analysis, and an implausible mechanism of the diuretic benefit (1/4)

Dr Adnan al-Bursh was an orthopedic surgeon who heroically served his patients in the most impossible circumstances; this new report suggests he was beaten to death by Israeli prison guards. He is 1 of around 1000 healthcare workers killed in Israel's war on Gaza www.youtube.com/shorts/iM6pa...

2 big new RCTs on IO vs IV access in cardiac arrest -> another chance to check on the utility of conventional observational studies. Relative risk/odds of IO vs IV for survival in the RCTs: 1.16 (0.87-1.56), 0.93 (0.72-1.21). What about the most recent observational studies? 1/