Tag: trial
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
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
