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    The author declares that he does not have any potential conflict of interest in relation to this manuscript
  • References
    1. Costa-Pinto R, Jones DA, Udy AA, et al. Midodrine use in critically ill patients: a narrative review. Crit Care Resusc 2022; 24: 298-308.

    2. Anstey M, Shaefi S, Wibrow B. Midodrine — why don’t you just work better? Crit Care Resusc 2022; 24: 296-7
    3. Wigmore G, Deane AM, Anstey J, et al; HAS FLAIR-II Trial Investigators. Study protocol and statistical analysis plan for the 20% Human Albumin Solution Fluid Bolus Administration Therapy in Patients after Cardiac Surgery-II (HAS FLAIR-II) trial. Crit Care Resusc 2022; 24: 309-18
    4. Russo G, Harrois A, Anstey J, et al; TBI Collaborative Investigators. Early sedation in traumatic brain injury: a multicentre international observational study. Crit Care Resusc 2022; 24: 319-29
    5. Skovbye M, Mølgaard J, Rasmussen SM, et al. The association between vital signs abnormalities during post-anaesthesia care unit stay and deterioration in the general ward following major abdominal cancer surgery assessed by continuous wireless monitoring. Crit Care Resusc 2022; 24: 330-40
    6. Sadana D, Kaur S, Sankaramangalam K, et al. Mortality associated with acute respiratory distress syndrome, 2009–2019: a systematic review and meta-analysis. Crit Care Resusc 2022; 24: 341-51
    7. McIntyre ML, Chimunda T, Murray J, et al. The prevalence of post-extubation dysphagia in critically ill adults: an Australian data linkage study. Crit Care Resusc 2022; 24: 352-9
    8. Yeates J, Miles L, Blatchford K, et al. AntiPORT: adaptation of a transfusion prediction score to an Australian cardiac surgery population. Crit Care Resusc 2022; 24: 360-8
    9. Jones D, Carty P, Karalapillai D. A four-step model to aid teaching, clinical assessment and communication of circulatory disorders among junior clinicians. Crit Care Resusc 2022; 24: 294-5
The pursuit of effective oral vasoconstrictive agents that can be used to transition from intravenous vasopressor therapy to oral vasopressor therapy, maintain adequate blood pressure, and allow for safer patient discharge from the intensive care unit (ICU) has been of interest to intensive care clinicians for many years. Among such potentially useful agents, midodrine has been more systematically investigated than others. In this issue of Critical Care and Resuscitation, the evidence behind its use and the accruing data of limited efficacy in the ICU population are presented in a narrative review 1 and commented upon by the associated editorial. 2 Such assessment of current knowledge about midodrine is of clear relevance to all practising intensivists. The choice of fluid to provide intravascular volume expansion after cardiac surgery is being addressed in a multicentre randomised controlled clinical trial comparing 20% albumin with crystalloids. The protocol and statistical analysis plan for this trial are presented in this issue of CCR. 3 The choice and dose of sedative drugs in patients with traumatic brain injury may be important to patient outcomes, but very little is known on current practice. In this issue of CCR, the findings of a multicentre international study of patients with traumatic brain injury are presented. 4 Assessment of vital signs by continuous wireless monitoring offers the opportunity to understand deviations from normal values in the post-anaesthesia care unit (PACU) and subsequent physiological deviations after discharge to the ward and/or serious adverse events. In this issue of CCR, Danish investigators provide the first robust evidence of the link between circulatory instability in the PACU and subsequent circulator instability in the ward. 5 The mortality of acute respiratory distress syndrome may have changed over the past decade, and understanding such changes is vital to designing and interpreting trials. In this issue, Cleveland Clinic investigators report the results of a systematic review of more than 100 manuscripts and provide evidence of only marginal improvements in mortality. 6 Post-extubation dysphagia is anecdotally observed in quite a few patients in the ICU. However, systematic assessment and data and have been missing. McIntyre and colleagues 7 show that, on discharge, coding for dysphagia appears to have been present in 7.3% of patients who received mechanical ventilation. They also demonstrate that such dysphagia is associated with greater risk of aspiration pneumonia and hospital stay, providing a rationale for more careful assessment of swallowing function after endotracheal intubation. Risk scoring systems exist to predict perioperative blood transfusion risk in cardiac surgery, but they have not been validated in Australian or New Zealand patients. The ACTA-PORT score was developed in the United Kingdom for this purpose. In this study, Australian and New Zealand investigators aimed to validate and recalibrate the ACTA-PORT score in a large Australian and New Zealand database. The recalibrated AntiPORT showed significantly improved calibration in both development sets and validation sets without compromising discrimination. 8 Finally, teaching young doctors how to deal with circulatory disturbances in hospital wards may help improve medical emergency team performance. A model for such teaching is presented in this issue of CCR. 9