Tag: trial
Effect of Vitamin C, Hydrocortisone, and Thiamine vs Hydrocortisone Alone on Time Alive and Free of Vasopressor Support Among Patients With Septic Shock
In patients with septic shock, treatment with intravenous vitamin C, hydrocortisone, and thiamine, compared with intravenous hydrocortisone alone, did not significantly improve the duration of time alive and free of vasopressor... read more
Compliance With Evidence-Based Processes of Care After Transitions Between Staff Intensivists
No significant impact of transitions of care observed between individual staff physicians on evidence-based processes of care for mechanically ventilated adult patients. However, transitions were associated with a lower likelihood... read more
Study Suggests Benefits of Vitamin C for Severe Sepsis
More than 1.7 million Americans develop sepsis every year and incidence of the condition is on the rise. In severe cases, widespread inflammation leads to multiorgan failure and death. Results of a new study hold... read more
Enteral Nutrition Can Be Given to Patients on Vasopressors
Most all recent studies show Enteral Nutrition (EN) can be delivered safely to patients on vasopressors. In fact, many studies show an outcome benefit of early EN (EEN) in ICU patients who are receiving vasopressors. It... read more
Early Identification of Patients at High Risk of Streptococcus-associated Necrotizing Infections
Two simple and available upon admission clinical predictors of group A streptococcus (GAS) documentation identified among a large cohort of surgically proven necrotizing soft tissue infections (NSTIs). The results show... read more
Tailoring Nutrition Therapy to Illness and Recovery
Without doubt, in medicine as in life, one size does not fit all. We do not administer the same drug or dose to every patient at all times, so why then would we live under the illusion that we should give the same nutrition... read more
Differential Gene Expression in Peripheral White Blood Cells with Permissive Underfeeding and Standard Feeding in Critically Ill Patients
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... read more
Bougies for all intubations led to high success rates, even on difficult airways
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),... read more
Prehospital Rapid Sequence Intubation Improves Functional Outcome for Patients with Severe TBI
In adults with severe traumatic brain injury (TBI), prehospital rapid sequence intubation by paramedics increases the rate of favorable neurologic outcome at 6 months compared with intubation in the hospital. A total of... read more
The Fragility and Reliability of Conclusions of Anesthesia and Critical Care Randomized Trials With Statistically Significant Findings
Statistically significant results in anesthesia and critical care randomized controlled trials are often fragile, and study conclusions are frequently affected by spin. Routine calculation of the Fragility Index in medical... read more
Epidemiology of Pediatric Severe Sepsis in Main PICU Centers in Southwest China
This multicenter study demonstrates that pediatric severe sepsis is common and is a factor in the high mortality rate that is observed in PICUs in Southwest China. The mortality rate remains high; therefore, improved... read more
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
