Tag: trial
Newer Drug Fails Quick Prehospital Intubation
Among patients undergoing endotracheal intubation in an out-of-hospital emergency setting, rocuronium, compared with succinylcholine, failed to demonstrate noninferiority with regard to first-attempt intubation success rate. Among... read more
Failure of Non-invasive Ventilation in Patients with Acute Lung Injury
A high failure rate of the initial non-invasive positive pressure ventilation (NIPPV) therapy has been observed in medical critically ill patients with acute lung injury (ALI). Unless the underlying shock, metabolic acidosis... read more
Effect of Depth of Sedation in Older Patients Undergoing Hip Fracture Repair on Postoperative Delirium
In the primary analysis, limiting the level of sedation provided no significant benefit in reducing incident delirium. However, in a pre-specified subgroup analysis, lighter sedation levels benefitted reducing postoperative... read more
Evidence is stronger than you think: a meta-analysis of vitamin C use in patients with sepsis
Despite varying degrees of statistical significance between the original studies, this meta-analysis reveals a positive correlation between incorporating vitamin C in the treatment of sepsis and favorable patient outcomes,... read more
Update to the Vitamin C, Thiamine and Steroids in Sepsis (VICTAS) Protocol
The analyses described here are those necessary to answer the trial's primary question of whether combined treatment with vitamin C, thiamine and steroids is more effective than placebo in increasing days alive and free from... read more
Is Tranexamic Acid Going to CRASH the Management of TBI?
In the recent CRASH-3 randomized trial, early administration of tranexamic acid (TXA) was associated with a non-significant reduction of head injury-related 28-day mortality in patients with isolated traumatic brain injury... read more
Timing of Tracheostomy in Pediatric Patients
In children on mechanical ventilation, early tracheostomy may improve important medical outcomes. However, our data demonstrate the urgent need for high-quality, randomized controlled trials in the pediatric population. Data... read more
Corticosteroids as Adjunctive Therapy in the Treatment of Influenza
Corticosteroid treatment in influenza is associated with increased mortality and hospital-acquired infection, but the evidence relates mainly to high corticosteroid doses and is of low quality with potential confounding by... read more
Critical Care Doctors Placed Humans in Suspended Animation For The First Time
Critical care doctors have placed humans in suspended animation for the first time, as part of a trial in the US that aims to make it possible to fix traumatic injuries that would otherwise cause death. Samuel Tisherman,... read more
Temporal Trends in the Use of Therapeutic Hypothermia for Out-of-Hospital Cardiac Arrest
The use of therapeutic hypothermia decreased in a large US registry of patients with out-of-hospital cardiac arrest soon after the publication of a study supporting more lenient temperature thresholds. Concurrent with... read more
Effect of Flexible Family Visitation on Delirium Among Patients in the ICU
In this cluster-crossover randomized clinical trial that involved 1,685 patients in the intensive care unit (ICU), the incidence of delirium was 18.9% in the flexible family visitation group compared with 20.1% in the standard... read more
Pilot Randomized Trial of a Recovery Navigator Program for Survivors of Critical Illness With Problematic Alcohol Use
A Recovery Navigator intervention was feasible and acceptable for delivering high-fidelity brief interventions to ICU patients. Changes in alcohol-related problems with motivational interviewing and shared decision-making... read more
Venoarterial Extracorporeal Membrane Oxygenation in Cardiogenic Shock
Temporary circulatory support (TCS) have become the cornerstone of the management of patients with cardiogenic shock, although the evidence supporting their efficacy is limited. VA-ECMO is considered the first-line option,... read more
Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Weaning on Time to Liberation From Mechanical Ventilation Among Patients With Respiratory Failure
Among patients requiring mechanical ventilation in whom a spontaneous breathing trial had failed, early extubation to noninvasive ventilation did not shorten time to liberation from any ventilation. Among 364 randomized... read more
Population Enrichment for Critical Care Trials
Enrichment reduces heterogeneity and will enhance the sensitivity of future trials. However, enrichment, even when it identifies more homogenous populations, may not be efficient to deploy in trials or clinical practice. Many... read more
Infusion of Prostacyclin vs Placebo for 72-hours in Patients With Septic Shock Suffering From Organ Failure
The purpose of this trial is to investigate the efficacy and safety of continuous intravenous administration of low dose iloprost versus placebo for 72-hours, in up to a total of 380 patients with septic shock suffering from... read more
Effects of Neuromuscular Block Reversal with Sugammadex vs. Neostigmine on Postoperative Respiratory Outcomes After Major Abdominal Surgery
No differences found in pulmonary function in patients reversed with sugammadex or neostigmine in a high-risk population. 126 patients were included in the main analysis. In the neostigmine group (n = 64), mean (95%... read more
Effect of Protocolized Weaning With Early Extubation to Noninvasive Ventilation vs Invasive Ventilation
This complex randomized, controlled trial failed to demonstrate that early extubation to non-invasive ventilation reduced the total time of mechanical ventilation. I will continue to extubate early and will use non-invasive... read more
Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm
Among patients with coma who had been resuscitated from cardiac arrest with nonshockable rhythm, moderate therapeutic hypothermia at 33°C for 24 hours led to a higher percentage of patients who survived with a favorable... read more
Vitamin C for Sepsis
Dr. Alpha A. Fowler of Virginia Commonwealth University presented findings from the CITRIS-ALI trial that studied the role of vitamin C in patients with septic ARDS. The findings were presented @ESICM in Berlin and have just... read more
Short-term vs. Conventional Glucocorticoid Therapy in Acute Exacerbations of COPD
In patients presenting to the emergency department with acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD), 5-day treatment with systemic glucocorticoids was noninferior to 14-day treatment with regard to... read more
Transfusions Stuck in an Endless Cycle of Denial
Each publication from Maitland, et al., gives us a glimpse of a greater medical truth, but our view is obstructed by questions about external validity. This group published the landmark FEAST trial that questioned the... read more
