Tag: trial
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
Tele-ICU Leads to Overall Reduction in ICU Mortality
A new systematic review and meta-analysis has found that implementation of tele-ICU services was associated with an overall reduction in ICU mortality. Furthermore, in subgroup analysis, the pooled odds ratio for ICU mortality... read more
This Minimally Invasive Technique Could Reduce the Need for Open-Heart Surgery
Currently, the majority of individuals who undergo transcather aortic valve replacement (TAVR), a minimally invasive alternative to open-heart surgery—are elderly or subject to compounding complications such as kidney disease.... read more
A Non-Antibiotic Approach for Treating or Preventing Sepsis
Researchers at the Royal College of Surgeons in Ireland (RCSI) have tested a compound called cilengitide in a preclinical trial. The drug goes by the brand name InnovoSep. Researchers discover the drug has the potential to... read more
Early or Delayed Cardioversion in Recent-Onset Atrial Fibrillation
In patients presenting to the emergency department with recent-onset, symptomatic atrial fibrillation, a wait-and-see approach was noninferior to early cardioversion in achieving a return to sinus rhythm at 4 weeks. The presence... read more
Effect of Piperacillin-Tazobactam vs Meropenem on 30-Day Mortality for Patients With E coli or Klebsiella pneumoniae Bloodstream Infection and Ceftriaxone Resistance
Among patients with E coli or K pneumoniae bloodstream infection and ceftriaxone resistance, definitive treatment with piperacillin-tazobactam compared with meropenem did not result in a noninferior 30-day mortality. These... read more
Opioid-Induced Respiratory Depression Risk Prediction Tool
Ludwig H. Lin, MD, and Ashish K. Khanna, MD, FCCP, FCCM, discuss Dr. Khanna's top-rated abstract, Derivation and Validation of a Novel Opioid-Induced Respiratory Depression Risk Prediction Tool, from the Society of Critical... read more
