December 2025; papers of the month
The Resus Room
Simon Laing
4.9 • 708 Ratings
🗓️ 1 December 2025
⏱️ 30 minutes
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Summary
December brings us to the final Papers of the Month for 2025 and we're finishing the year with three studies that challenge assumptions across critical care and resuscitation! This time questioning the role of arterial lines in shock, looking at the true prognostic value of end-tidal CO₂ in cardiac arrest and finally to airway management in neonates.
We start in the ICU with the EVERDAC trial, a large multicentre RCT exploring whether early arterial catheterisation in shock truly changes outcomes. This challenges some of the papers we've recently looked at recently which champion the benefit of early arterial line insertion! The EVERDAC trial looks at the effect they have on mortality and the results are pretty striking.
Next, we move into the world of cardiac arrest with a systematic review and meta-analysis examining end-tidal CO₂ as a prognostic tool for ROSC. ETCO₂ is firmly embedded in ALS practice, but its real predictive power isn't completely clear, as we've seen in the recent ERC guidelines. This review pulls together studies with more than 3,000 patients and helps us understand more how much weight we should give to ETCO₂ and the way in which it's best utilised.
Finally, we finish with a neonatal focus: a systematic review and meta-analysis comparing video versus direct laryngoscopy for urgent neonatal intubation. Success rates in NICU and delivery room intubation are notoriously low. This paper looks at the impact of video laryngoscopy on first pass success with some dramatic results, which raises important questions around training and resource allocation.
Three papers, three very different patient groups, and three opportunities to reflect on how evidence continues to challenge our practice.
Once again we'd love to hear any thoughts or feedback either on the website or via X @TheResusRoom!
Simon & Rob
Transcript
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| 0:00.0 | Welcome to the recess room podcast. |
| 0:03.5 | Five, four, three, two, one, fire. |
| 0:12.4 | So hi and welcome back to the recess room podcast. |
| 0:15.6 | I'm Simon Lang. |
| 0:17.1 | And I'm Rob Fenwick. |
| 0:18.3 | And this is December 2025's Papers of the Month. Yes, it is. And I mistakenly when I was sound checking earlier, introduced it as December 20203's Papers of the Month, so I've regressed somewhat. But yes, it's definitely 2025. And man, it is so cold up here in the Midlands. Ah, it is disastrous. Honestly, I've got one of those little |
| 0:38.7 | dewdrops on the end of my nose, bass monkeys, as they say. In fact, I might have to start |
| 0:44.2 | doing a few push-ups and squats to generate some heat during this recording, but I bet, of course, |
| 0:48.9 | at Langtowers it's running at its usual 27, 28 degrees, isn't it in there, Simon? |
| 0:53.9 | Yeah, topless yet again for the podcast. Don't worry. Any audio, not video, we're fine. |
| 0:58.8 | That is the only medium to see Simon Langtopless. Anyway, shush now. Three papers. So here we go. |
| 1:04.6 | We've got can we delay putting an A-line into patients with shock? So is that non-invasive BP cuff actually okay? |
| 1:13.9 | Goodness me, how old school, and that is, of course, old school with a K, clearly, and obviously. |
| 1:18.4 | I'm then going to be taking us through a systematic review and meta-analysis to see if we can give you the exact number on Entidal CO2 when it is futile to carry on those resuscitation attempts |
| 1:30.3 | at three different time points during a rest. So initially 10 minutes and 20 minutes, |
| 1:35.5 | really potentially useful that paper. And finally, of course, video laryngoscopy should we be |
| 1:42.1 | using it for neonatal intubation? |
| 1:44.6 | So some great topics here, but please, let's get cracking on this podcast so I can then get |
| 1:50.0 | the papers onto my log burner to keep me warm for the rest of the day. |
| 1:53.7 | No disrespect to any of the work of the authors, by the way. |
| 1:56.6 | Yeah, and before we get into it, a huge thanks to Zol Medical Corporation for collaborating with us on the podcast and making this all free open access and available to you. |
| 2:07.2 | And it looks like quite a lot of you, not just our extended family this time, have been listening to the recent recess guidelines update podcast. |
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