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

Stress Ulcer Prophylaxis with Proton Pump Inhibitors or Histamin-2 Receptor Antagonists in Adult Intensive Care Patients

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

Effective Goal-Directed Therapy in TBI Patients May Improve Outcomes

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

Core Outcome Measures for Critical Care Ventilation Trials

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

Systemic Early Neuromuscular Blockade in ARDS – The ROSE Trial

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

Fragility Index Calculator

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

Effect of an ICU Diary on PTSD Symptoms Among Patients Receiving Mechanical Ventilation

High-flow Oxygen Therapy for Treating Bronchiolitis in Infants

Bronchiolitis is the most common reason for hospitalization in infants worldwide. Current recommendations by the American Academy of Pediatrics are for supportive care including maintenance of hydration and oxygen support... read more

High-flow Oxygen Therapy for Treating Bronchiolitis in Infants

Randomized Controlled Trial of Health Coaching for Vulnerable Patients with COPD

These results help inform expectations regarding the limitations and benefits of health coaching for patients with Chronic Obstructive Pulmonary Disease (COPD). They may be useful to health policy experts in assessing the... read more

Randomized Controlled Trial of Health Coaching for Vulnerable Patients with COPD

Procalcitonin-Guided Antimicrobial Therapy in Critical Care

Procalcitonin guidance for antibiotic cessation improves short-term mortality in ICU patients. Previous meta-analyses showed that procalcitonin-guided antimicrobial management, compared with standard care, resulted in less... read more

Procalcitonin-Guided Antimicrobial Therapy in Critical Care

Sepsis: Personalization vs. Protocolization?

The history of intensive care has been littered with too many false dawns. Old management dogma, now derided, have been replaced by new and equally resolute convictions, many of which will, in time, undoubtedly follow a similar... read more

Sepsis: Personalization vs. Protocolization?

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery

Intravenous lidocaine administered during and after cardiac surgery did not reduce postoperative cognitive decline at 6 weeks. Among the 420 allocated subjects who returned for 6-week follow-up, there was no difference in... read more

Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery

Defining Sepsis on the Wards

The aim of this study is to look at the prevalence (commonness) of sepsis across acute hospitals (hospitals with an emergency department) across Wales using the currently used and new definitions of sepsis. Sepsis is a major... read more

Defining Sepsis on the Wards

Positive Outcomes, Mortality Rates, and Publication Bias in Septic Shock Trials

Out of 65 eligible septic shock trials, 14 did not have a clearly defined control group (two standards of care were compared) and were excluded. For the 51 remaining trials, control-group mortality ranged between 15.9%... read more

Positive Outcomes, Mortality Rates, and Publication Bias in Septic Shock Trials

Impact of Hypophosphatemia on Outcome of Patients in ICU

Hypophosphatemia at admission is an independent risk factor for 28-day mortality in general ICU patients. The cohort included 946 patients with a median phosphate concentration of 0.77 mmol/L. Patients with hypophosphatemia... read more

Impact of Hypophosphatemia on Outcome of Patients in ICU

Who May Benefit Most From Future Vitamin D Intervention Trials

High-dose vitamin D3 supplementation was associated with a reduction of 28-day mortality in a mixed population of critically ill adults with vitamin D deficiency when excluding patients who died or were discharged within... read more

A Trial of Goal-oriented Hemodynamic Therapy in Critically Ill Patients

Hemodynamic therapy aimed at achieving supranormal values for the cardiac index or normal values for mixed venous oxygen saturation does not reduce morbidity or mortality among critically ill patients. A total of 10,726 patients... read more

A Trial of Goal-oriented Hemodynamic Therapy in Critically Ill Patients

Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes

In this systematic review that included 93 reports of Randomized Clinical Trials (RCTs) from 6 high-impact journals, positive spin of statistically nonsignificant primary outcomes was found in 57% of abstracts and 67% of... read more

Level and Prevalence of Spin in Published Cardiovascular Randomized Clinical Trial Reports With Statistically Nonsignificant Primary Outcomes

Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in ICU Patients Without ARDS

In patients in the Intensive Care Unit (ICU) without acute respiratory distress syndrome (ARDS) who were expected not to be extubated within 24 hours of randomization, a low tidal volume strategy did not result in a greater... read more

Effect of a Low vs Intermediate Tidal Volume Strategy on Ventilator-Free Days in ICU Patients Without ARDS