Tag: trial
Obesity Improves Short-term Survival in Sepsis
In a large cohort study of 55,038 adults hospitalized with sepsis, short-term mortality (death or hospice) was lower in overweight and obese patients compared with those with normal body mass indices (both unadjusted and... read more
The EXACT Protocol
The EXACT protocol: a multi-centre, single-blind, randomised, parallel-group, controlled trial to determine whether early oxygen titration improves survival to hospital discharge in adult OHCA patients. This study will determine... read more
A Randomized Trial of Glutamine and Antioxidants in Critically Ill Patients
Critically ill patients have considerable oxidative stress. Glutamine and antioxidant supplementation may offer therapeutic benefit, although current data are conflicting. In this blinded 2-by-2 factorial trial, we randomly... read more
Running an RCT – A Conversation With the Investigators of the REGAIN Trial
It is easy for armchair activists to bash randomized controlled trials (RCTs) with clever methodological critiques. However, it takes a lot of effort and coordination to pull off an RCT successfully. In this episode of Radiology... read more
Use of the Confusion Assessment Method in Multi-center Delirium Trials
Delirium occurs commonly in older adults and is associated with adverse outcomes. Multi-center clinical trials evaluating interventions to prevent delirium are needed. The Confusion Assessment Method (CAM) is a validated... read more
CRRT for Sepsis-induced Acute Kidney Injury
Sepsis-induced acute kidney injury (SI-AKI) represents the first cause of AKI in ICUs, and renal replacement therapy (RRT) is frequently applied in advanced AKI stages. The debate between 'rescue' indications for RRT start... read more
Evidence Backs Giving Probiotics with Antibiotics
So much of what we're told to do calls for sweeping practice changes or titanic additions to our routine approach. My own articles have advocated for tremendous shifts in typical techniques, and one need not look far to find... read more
Hyperinvasive approach to out-of hospital cardiac arrest using mechanical chest compression device
Authors introduce and offer a protocol of a proposed randomized study enrolling patients with witnessed OHCA presumably of cardiac origin planned to be initiated in Prague in 2012. Study will compare hyperinvasive approach... read more
Procalcitonin does not curb antibiotic use for lower respiratory tract infection
In the Procalcitonin Antibiotic Consensus Trial (ProACT), the use of a procalcitonin-guided antibiotic prescription guideline did not result in less exposure to antibiotics than did usual care among patients presenting to... read more
To transfuse or not transfuse: an intensive appraisal of red blood cell transfusions in the ICU
A restrictive transfusion threshold is recommended in nearly all critically ill patients. This is at least noninferior to more liberal transfusion practice; in addition, a restrictive threshold has shown improved outcomes... read more
Resuscitation of Endotheliopathy and Bleeding in Thoracic Aortic Dissections
In this randomized, clinical pilot trial of patients undergoing emergency surgery for thoracic aorta dissections, we found that OctaplasLG reduced glycocalyx and endothelial injury, reduced bleeding, transfusions, use of... read more
Ascorbic Acid, Corticosteroids, and Thiamine in Sepsis
The combination of thiamine, ascorbic acid, and corticosteroids is a promising new therapy for sepsis resuscitation but currently lacks robust evidence to support its widespread use. The potential effectiveness of this medication... read more
Occupational Therapy for Delirium Management in Elderly Patients without Mechanical Ventilation in an ICU
Delirium has negative consequences such as increased mortality, hospital expenses and decreased cognitive and functional status. This research aims to determine the impact of occupational therapy intervention in duration,... read more
Low-dose Nocturnal Dexmedetomidine Prevents ICU Delirium
Dexmedetomidine is associated with less delirium than benzodiazepines, and better sleep architecture than either benzodiazepines or propofol; its effect on delirium and sleep when administered at night to patients requiring... read more
A Protocol of No Sedation for Critically Ill Patients Receiving Mechanical Ventilation
Standard treatment of critically ill patients undergoing mechanical ventilation is continuous sedation. Daily interruption of sedation has a beneficial effect, and in the general ICU of Odense University Hospital, Denmark,... read more
Prolonged acute and post-acute care recovery of physical function in survivors of acute respiratory failure
The proportion of survivors of acute respiratory failure is growing; yet, many do not regain full function and require prolonged admission in an acute or post-acute care facility. Patients who require prolonged admission... read more
Corticosteroids for Treating Pneumonia
Pneumonia remains a major cause of morbidity and mortality in the United States.1 There is both theoretical and laboratory evidence that corticosteroids may have beneficial effects in pneumonia through local pulmonary and... read more
Critical Care Controversies: The REBEL vs The SKEPTIC at #SMACC 2019
On the last day of the last SMACC conference, Dr. Ken Milne (The SGEM) and I had a cage match debating four critical care controversies. It was all done in good fun with both of us taking our opportunities to poke a little... read more
Dysphagia in the ICU: Epidemiology, Mechanisms, and Clinical Management
In the light of the fact that the clinical consequences of ICU-acquired dysphagia (e.g., aspiration-induced pneumonitis/pneumonia) can often be observed on ICUs, more data on underlying mechanisms and/or risk factors seems... read more
Indications and Outcomes of Extracorporeal Life Support in Trauma Patients
Data from the largest registry of critically ill trauma patients receiving extracorporeal life support (ECLS) demonstrates reasonable survival. With growing experience and improved safety profile, trauma should not be considered... read more
Pooled Analysis of Higher vs Lower Blood Pressure Targets for Vasopressor Therapy Septic and Vasodilatory Shock
Targeting higher blood pressure targets may increase mortality in patients who have been treated with vasopressors for more than 6h. Lower blood pressure targets were not associated with patient‑important adverse events... read more
