Tag: trial

Interventions for Preventing Critical Illness Polyneuropathy and Critical Illness Myopathy

There is moderate quality evidence from two large trials that intensive insulin therapy reduces CIP/CIM, and high quality evidence that it reduces duration of mechanical ventilation, ICU stay and 180-day mortality, at the... read more

Added Benefit of Noninvasive Ventilation to High-Flow Nasal Oxygen to Prevent Reintubation in Higher-Risk Patients

Liberating patients from ongoing invasive mechanical ventilation is typically a 3-step process. First, clinicians must recognize that patients may no longer require mechanical ventilation, when the reasons for intubation... read more

Effect Sizes in Ongoing Randomized Controlled Critical Care Trials

For some of the largest ongoing critical care trials, many clinicians regard prior probabilities as low and consider that plausible effects on absolute mortality are less than 5%. Further work is needed to determine whether... read more

What Should You Know About Evidence-Based Guidelines?

As healthcare professionals we want to provide patients the best possible medical care. Prehospital care, like the rest of medicine, is constantly changing, since the research performed today will shape the medical care we... read more

Low-dose Atrial Natriuretic Peptide for Prevention or Treatment of AKI

Theoretically, atrial natriuretic peptide (ANP), especially low-dose ANP, is beneficial in acute kidney injury (AKI). In this study, we examined whether low-dose ANP is effective in preventing or treating AKI by conducting... read more

Improving Outcomes for ICU Survivors

In response to the many challenges faced by ICU survivors today, there has been an increasing need to relieve this burden. Despite that many clinical trials have been implemented to find new strategies, post-intensive care... read more

Enteral vs. Parenteral Nutrition in Septic Shock

The strong paradigm of favoring the enteral over the parenteral route in critically ill patients has been challenged. As a consequence, updated guidelines recommend withholding enteral nutrition in patients with uncontrolled... read more

Noninvasive Ventilation in Pneumonia-induced Early Stage Mild ARDS

Treatment with noninvasive ventilation (NIV) did not reduce the need for intubation among patients with pneumonia-induced early mild acute respiratory distress syndrome (ARDS), despite the improved PaO2/FIO2 observed with... read more

Automated vs. Non-automated Weaning for Reducing Mechanical Ventilation Duration for Critically Ill

Automated systems may result in clinically meaningful reduced durations of weaning, ventilation and ICU stay. Overall, these systems appear to be safe and can be considered a reasonable approach in the management of ventilator... read more

Critically Ill Patients Show a Differential Contractile Response to Neuromuscular Electrical Stimulation

This retrospective sub-analysis aimed to outline the characteristics of, as well as predictors for, a contractile response to Neuromuscular Electrical Stimulation (NMES), and also potential clinical benefits resulting from... read more

Oxygen Treatment in Intensive Care and Emergency Medicine

Hypoxemia should certainly be avoided, but the fact that the liberal administration of oxygen to patients in intensive care units and emergency rooms tends to increase morbidity and mortality implies the advisability of a... read more

Determinants of Citation Impact in Large Clinical Trials in Critical Care

Clinical trials conducted by investigator-led research groups are significantly more frequently cited than industry-led trials in critical care medicine. In addition, costs appear to be substantially lower with investigator-led... read more

Hydration for Infants with Bronchiolitis

Bronchiolitis is the most common lower respiratory tract infection in infants and the leading cause of hospital admission. Hydration is a mainstay of treatment, but insufficient evidence exists to guide clinical practice.... read more

Impact of Vasoactive Medications on ICU-Acquired Weakness in Mechanically Ventilated Patients

In mechanically ventilated patients enrolled in a randomized clinical trial of early mobilization, the use of vasoactive medications was independently associated with the development of ICU-acquired weakness. Prospective... read more

Early Norepinephrine Has Potential for Septic Shock

Standard sepsis algorithms have suggested completing a fluid bolus before starting vasopressors in patients with septic shock, but multiple observational trials have shown an association between early vasopressor use and... read more

Physical Rehabilitation in the ICU

Survivors of critical illness frequently experience poor physical outcomes, including persistent impairments in muscle strength, exercise capacity and physical function. In this article, we review these impairments and... read more

Ineffectiveness of Procalcitonin-Guided Antibiotic Therapy in Severely Critically Ill Patients

Procalcitonin-guided (PCT) antibiotic therapy fails to decrease the mortality or length of stay (LOS) of critically ill patients with suspected or confirmed sepsis. PCT-guided cessation of antibiotic therapy could reduce... read more

Balanced Crystalloids vs. Saline in Critically Ill Adults

Among critically ill adults, the use of balanced crystalloids for intravenous fluid administration resulted in a lower rate of the composite outcome of death from any cause, new renal-replacement therapy, or persistent renal... read more

Adjunctive Corticosteroid Treatment in Septic Shock

Interest in the role of the adrenal cortex in the recovery from an infection dates back nearly 100 yr. More than six decades of research on the role of corticosteroid supplementation as an adjunctive treatment for sepsis... read more

Implications of Heterogeneity of Treatment Effect for Reporting and Analysis of Randomized Trials in Critical Care

Randomized clinical trials (RCTs) are conducted to guide clinicians' selection of therapies for individual patients. Currently, RCTs in critical care often report an overall mean effect and selected individual subgroups.... read more

More Precise Sepsis Therapy with Distinct Clinical Phenotypes

In this retrospective analysis of data sets from patients with sepsis, 4 clinical phenotypes were identified that correlated with host-response patterns and clinical outcomes, and simulations suggested these phenotypes may... read more

A Compression Method to Reduce Fluid Balance of Septic Shock Patients

This article presents a close look at the Corporeal Compression at the Onset of Septic shock (COCOONs). Fluid overload in septic intensive care unit (ICU) patients is common and strongly associated with poor outcome. There... read more