RESULTS FROM CCR25: June 16, 2025

UK-ROX, TARGET-Protein, PRINCE, and more trial results announced and published

This is a different CCR

The Critical Care Reviews meeting has become a major annual event in critical care, and 2025 continues the tradition. Multiple important randomized trial results were announced at the June 11-13 meeting in Belfast, Ireland, and their papers were simultaneously published in top medical journals, including the New England Journal of Medicine, JAMA, and Circulation.

We’ll dig deeper into these, but here is an overview of some of the most significant trial results.

See if you detect a pattern.

UK-ROX

Among 16 ,500 mechanically ventilated patients treated in ICUs, a conservative oxygen strategy (SpO2 targeted at 90%) did not lead to lower mortality or improved outcomes compared to usual care.

—Martin et al, JAMA

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TARGET-Protein

Among 3,397 patients at 8 ICUs in Australasia, boosting enteral protein in tube feedings during critical illness did not result in improved outcomes (days alive outside the hospital).

—Summers et al, JAMA

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PRINCE

Remote ischemic preconditioning before major noncardiac surgery did not reduce the rates of myocardial infarction or improve other outcomes among 1,213 patients.

—Greco et al, Circulation

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PROMIZING

Among 573 mechanically ventilated patients, the use of proportional-assist ventilation with load-adjustable gain factors (PAV+) did not result in a shorter time to successful liberation from mechanical ventilation than pressure-support ventilation (PSV).

—Bosma et al, NEJM

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GASTROSAM

Among children age 6 to 12 in Africa with severe acute dehydration and malnutrition due to gastroenteritis, oral and intravenous rehydration treatment strategies led to similar survival rates.

—Maitland et al, NEJM

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FLUID

In a cluster-randomized, crossover trial at 7 hospitals in Canada, switching to hospital-wide use of lactated Ringer’s from normal saline did not result in lower mortality or readmission rates among 43,626 enrolled patients.

—McIntyre et al, NEJM

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ANH

Acute normovolemic hemodilution (preoperative blood collection with replacement by crystalloid, and reinfusion of the blood during surgery if necessary) did not reduce the need for transfusion among 2,010 patients undergoing cardiac surgery with cardiopulmonary bypass.

—Monaco et al, NEJM

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Remember: when the null hypothesis wins, that means you were already doing it right.

More to come! -Ed.