Tag: trial

Upvote Story 7
Despite having a powerful effect on restoring spontaneous circulation after out-of-hospital cardiac arrest, epinephrine produced only a small absolute increase in survival with no increase in favorable functional recovery as compared with placebo. We now must ponder whether additional treatments after a return of spontaneous circulation could improve functional recovery, whether drug use should differ on the basis of cardiac rhythm, and whether lower doses... Read More | Comment
Upvote Story 5
If peripheral perfusion-targeted resuscitation improves 28-day mortality, this could lead to simplified algorithms, assessing almost in real-time the reperfusion process, and pursuing more physiologically sound objectives. At the end, it might prevent the risk of over-resuscitation and lead to a better utilization of intensive care unit resources. ANDROMEDA-SHOCK is a randomized controlled trial which aims to determine if a peripheral perfusion-targeted resuscitation is associated with... Read More | Comment
Upvote Story 5
Among critically ill patients, haloperidol administration compared with placebo does not significantly affect short-term mortality, incidence of delirium, ICU length of stay, or delirium or coma-free days. Additionally, there was no increased risk of adverse events. Six RCTs representing 2552 patients. There was no significant difference between haloperidol and placebo-treated patients in short-term all-cause mortality, incidence of delirium, ICU length of stay, or delirium/coma-free days.... Read More | Comment
Upvote Story 5
In light of emerging data from clinical trials, the place of high-frequency oscillatory ventilation (HFOV) in the management of acute respiratory distress syndrome (ARDS) is uncertain. Although not first-line, HFOV remains a tool in the armamentarium of the intensivist managing the patient with severe ARDS and refractory hypoxemia. A refinement in the approach to delivering HFOV is warranted, with more attention paid to its adverse... Read More | Comment
Upvote Story 5
This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the non-inferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in pregnant women and outside the operating room. Although this study failed to demonstrate non-inferiority of sham cricoid pressure to cricoid pressure the data does not show any hint that cricoid pressure is the better approach.... Read More | Comment
Upvote Story 6
This trial provides evidence that a strategy of avoiding continuous sedation as early as possible, in the absence of residual neuromuscular blockade and hypothermia, compared with usual sedation care, resulted in improvements in several important clinical outcomes in critically ill postoperative patients. Given the clinical and economic burden of critical illness, postoperative morbidity, and the substantial number of patients who could benefit from this strategy,... Read More | Comment
Upvote Story 7
ICU admissions are ever increasing across the United States. Following critical illness, physical functioning (PF) may be impaired for up to 5 years. We performed a systematic review of randomized controlled trials evaluating the efficacy of interventions targeting PF among ICU survivors. The objective of this study was to identify effective interventions that improve long-term PF in ICU survivors. The only effective intervention to improve... Read More | Comment
Upvote Story 8
In this multicentre, randomised, double‑blinded trial, we observed no difference in mortality between terlipressin and NE infusion in patients with septic shock. Patients in the terlipressin group had a higher number of serious adverse events. Patients with septic shock recruited from 21 intensive care units in 11 provinces of China were randomised (1:1) to receive either terlipressin (20–160 µg/h with maximum infusion rate of 4... Read More | Comment
Upvote Story 6
In a randomized trial, the routine use of bougies on every DL intubation led to a higher rate of first-pass intubation success. And even allowing for the two-step technique (bougie insertion followed by ET tube insertion), the bougie technique required less total time to intubate the patient, on average, by reducing the time spent guiding the ET tube into the airway. Read More | Comment
Upvote Story 9
In this dose-finding, phase 2 adaptive randomized trial, patients with septic shock and moderate organ dysfunction were treated early in the course of illness with low (6 g), medium (12 g), or high (18 g) doses of levocarnitine or an equivalent volume of saline placebo administered as a 12-hour infusion. None of the tested doses of levocarnitine meaningfully reduced cumulative organ failure at 48 hours.... Read More | Comment
Upvote Story 4
Use of initial tidal volumes less than 8 ml/kg PBW is common at hospitals participating in the NHLBI PETAL Network. After considering the size and budgetary requirement for a cluster-randomized trial of LTVV vs. usual care in acute respiratory failure (ARF), the PETAL network deemed the proposed trial infeasible. A rapid observational study and simulations to model anticipated power may help better design trials. We... Read More | Comment
Upvote Story 6
Only half of patients who are hemodynamically unstable will respond to a fluid bolus. There are no historical or physical examination findings that can help us decide whether a patient is a fluid responder, but we must treat hypotension, as we do know that a mean arterial pressure (MAP) less than 60 mmHg increases the risk of death and acute kidney injury (AKI). Empirical fluid... Read More | Comment
Upvote Story 5
The effect of short-term caloric restriction on gene expression in critically ill patients has not been studied. In this sub-study of the PermiT trial, we examined gene expression patterns in peripheral white blood cells (buffy coat) associated with moderate caloric restriction (permissive underfeeding) in critically ill patients compared to standard feeding. The present study shows that different caloric intake via enteral nutrition lead to differential... Read More | Comment
Upvote Story 4
This systematic review and meta-analysis, which included only high-level evidence from randomized, controlled trials (RCTs) conducted in intensive care settings, revealed that crystalloids were less effective than colloids at stabilizing hemodynamic resuscitation endpoints such as CVP, MAP, and cardiac index. There is a possibility that saline is more effective than balanced crystalloids at reaching resuscitation endpoints; however, the evidence for this was not conclusive and... Read More | Comment
Upvote Story 9
In a single-site randomized clinical trial of patients hospitalized due to Chronic obstructive pulmonary disease (COPD), a 3-month program that combined transition and long-term self-management support resulted in significantly fewer COPD-related hospitalizations and emergency department visits and better health-related quality of life at 6 months after discharge. Further research is needed to evaluate this intervention in other settings. Among 240 patients who were randomized, 203... Read More | Comment