Tag: trial
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
Randomized Clinical Trial of an ICU Recovery Pilot Program for Survivors of Critical Illness
This randomized pilot trial found that a multidisciplinary ICU recovery program could deliver more interventions for post ICU recovery than usual care. The finding of longer time-to-readmission with an ICU recovery program... read more
Effect of Catheter Ablation vs Antiarrhythmic Drug Therapy on Mortality, Stroke, Bleeding, and Cardiac Arrest Among Patients With Atrial Fibrillation
The CABANA Randomized Clinical Trial. In this randomized clinical trial involving 2204 patients with atrial fibrillation, catheter ablation, compared with medical therapy, did not significantly reduce the primary composite... read more
Serum Chloride Levels in Critical Illness – The Hidden Story
Chloride is the principal anion of the extracellular fluid and vital for both serum electroneutrality and acid-base homeostasis. The aim of this review is to investigate the relevance of dyschloremia in the critically... read more
What should we stop doing in the ICU?
Intensive care is an interesting specialty. From all the early excitement in the 1970s, passing through two decades of intensive physiological use at the bedside, intensive care landed on the rough ground of modern randomized... read more
Early Goal-directed Therapy Using a Physiological Holistic View
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.... read more
A Core Outcome Set for Critical Care Ventilation Trials
The main objective for this study was to obtain international consensus on a set of core outcome measures that should be recorded in all clinical trials of interventions intended to modify the duration of ventilation for... read more
Stress Ulcer Prophylaxis with Proton Pump Inhibitors or Histamin-2 Receptor Antagonists in Adult Intensive Care Patients
In this updated systematic review, we were able to refute a relative change of 20% of mortality. The occurrence of GI bleeding was reduced, but we lack firm evidence for a reduction in clinically important GI bleeding. The... read more
Effective Goal-Directed Therapy in TBI Patients May Improve Outcomes
The purpose of this study was to estimate the impact of goal-directed therapy on outcome after traumatic brain injury (TBI). Goal-directed therapy was applied to standardize care in patients with moderate to severe traumatic... read more
Core Outcome Measures for Critical Care Ventilation Trials
The main objective for this study was to obtain international consensus on a set of core outcome measures that should be recorded in all clinical trials of interventions intended to modify the duration of ventilation for... read more
Systemic Early Neuromuscular Blockade in ARDS – The ROSE Trial
The early use of neuromuscular blocking agents in the setting of moderate-to-severe acute respiratory distress syndrome (ARDS) was previously understood to confer a survival advantage at 90 days, based on the outcomes of... read more
Fragility Index Calculator
The fragility index is a measure of the robustness (or fragility) of the results of a clinical trial. The fragility index is a number indicating how many patients would be required to convert a trial from being statistically... read more
Effect of an ICU Diary on PTSD Symptoms Among Patients Receiving Mechanical Ventilation
Keeping a diary for patients while they are in the intensive care unit (ICU) might reduce their posttraumatic stress disorder (PTSD) symptoms. Among 657 patients who were randomized completed the trial. At 3 months, significant... read more
