The tagline of the @CuringComa Campaign is #AwakeningHope

So now it’s time to start a conversation. What does #CuringComa mean to you?

Please tell us…
@caseyalbin @almuftifawaz @drdangayach @aartisarwal @WesElyMD @ClaudeHemphill @Menon_Cambridge @fabio_taccone @Dr_Cit To me, #AwakeningHope means this: I explain The diagnosis And proposed treatment plan. I then explain the range of possible outcomes. I explain the most likely scenario, the worst case scenario, and the best case scenario.

1/ This is a very important and courageous study. Forever cardiologists have shunned emergency PCI for cardiac arrest because it will mess up their numbers. Even with STEMI.

nejm.org/doi/full/10.10… 2/ Interventional cardiologists are graded by mortality rates. So OHCA patients have always been a PCI do-not-touch scenario. Even though we know that many arrests result from ACS.

1/ So now it's the cataclysmic TTM -2 trial, just published in @NEJM. How can a world changing trial like HACA published in 2002 now be effectively reversed almost 20 years later? I will explain.

nejm.org/doi/full/10.10… 2/ Lots of head scratching. Hard to understand. But I am not surprised. It's a pattern that we have seen before with goal directed therapy for sepsis and intensive insulin therapy for hyperglycemia. The answer is that a trial's results depend very much on the clinical milieu