Tag: trial
Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient?
In this multicentre study, we could not demonstrate any difference between Lp299 and CHX used in oral care procedures regarding their impact on colonisation with emerging potentially pathogenic enteric bacteria in the oropharynx... read more
No more antipsychotics for delirium? Not so fast!
Recently the MINDS-USA trial evaluated the use of haloperidol or ziprasidone for delirium in critical illness. Before jumping into the results of this study, it will help to establish a couple of foundational principles.... read more
The Impact of Frailty on ICU Outcomes
Functional status and chronic health status are important baseline characteristics of critically ill patients. The assessment of frailty on admission to the intensive care unit (ICU) may provide objective, prognostic information... read more
Angiotensin converting enzyme defects in shock: implications for future therapy
Patients who develop vasodilatory shock, particularly when caused by an inflammatory condition like sepsis or pancreatitis, have evidence of significant endothelial injury as manifested by coagulation disorders and increased... read more
The Precogs Take On Sepsis
It seems like every week there’s another publicized instance of our impending replacement by artificial intelligence. Big Data, they say, is going to free us of the cognitive burdens of complex thought while maximizing... read more
Positive Topline Results for Novel Alzheimer’s Drug
A novel drug is showing promise for helping improve cognition in patients with mild to moderate Alzheimer's disease (AD), according to new topline results. A phase 3 trial of more than 800 patients showed that those who were... read more
Oxygen Therapy for Acutely Ill Medical Patients
It is a longstanding cultural norm to provide supplemental oxygen to sick patients regardless of their blood oxygen saturation. A recent systematic review and meta-analysis has shown that too much supplemental oxygen increases... read more
Proton-Pump Inhibitor Prophylaxis in the ICU
Critical illness can disrupt local and systemic mechanisms that protect against upper gastrointestinal bleeding, a condition that may be associated with increased mortality, particularly among patients receiving extracorporeal... read more
Chasing Mortality Endpoints is a Fool’s Errand
"There is no mortality benefit for that." How many times have you heard that? The implication is usually the same: that intervention is a waste of time. A smart, evidence-based clinician wouldn't bother with it. But, what... read more
Dopamine Antagonists in ICU Delirium
Perhaps the most vexing problem in a patient in an intensive care unit (ICU) is an unexpected change in mental status. Historically, "acute encephalopathy" was the term used to encompass such alterations, but "delirium" is... read more
Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia
This large randomized clinical trial performed in patients undergoing anesthesia with RSI failed to demonstrate the noninferiority of the sham procedure in preventing pulmonary aspiration. Further studies are required in... read more
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness
The use of haloperidol or ziprasidone, as compared with placebo, in patients with acute respiratory failure or shock and hypoactive or hyperactive delirium in the ICU did not significantly alter the duration of delirium.... read more
Effect of Dexmedetomidine on Mortality and Ventilation in Sepsis Patients
Dexmedetomidine provides sedation for patients undergoing ventilation; however, its effects on mortality and ventilator-free days have not been well studied among patients with sepsis. This randomized clinical trial compares... read more
Effect of Bronchodilation, Exercise Training, and Behavior Modification on Symptoms and Physical Activity in COPD
Tiotropium/olodaterol, with or without ExT, improved EET in patients with Chronic Obstructive Pulmonary Disease (COPD) taking part in an SMBM program. Combination bronchodilation, with or without ExT, did not provide additional... read more
Stronger evidence for vitamin C use in sepsis treatment
A new meta-analysis reveals a positive correlation between incorporating vitamin C in the treatment of sepsis and favorable patient outcomes. Results of the meta-analysis showed a marked reduction in mortality and duration... read more
Clinical Trial Testing Vitamin and Steroid Combination in Sepsis Patients Underway at Emory
A new clinical trial at Emory University and 45 other sites around the U.S. will test a combination of vitamins and steroids in patients diagnosed with sepsis. Sepsis is caused by the body's overwhelming and life-threatening... read more
Triiodothyronine Replacement in Critically Ill Adults with Non-thyroidal Illness Syndrome
This study suggests that with triiodothyronine (T3) supplementation there was evidence of serum free T3 normalization without evidence of associated harms. A definitive trial is needed to evaluate clinical effectiveness.... read more
Magnesium Sulfate for Rapid Atrial Fibrillation?
Currently, several medications are recommended for the management of atrial fibrillation with rapid ventricular response in the emergency department including calcium channel blockers, beta blockers and digoxin (the optimal... read more
Effects of Patient-Directed Music Intervention on Anxiety and Sedative Exposure in Critically Ill Patients Receiving Mechanical Ventilatory Support
Among ICU patients receiving acute ventilatory support for respiratory failure, patient-directed music (PDM) resulted in greater reduction in anxiety compared with usual care, but not compared with NCH. Concurrently, PDM... read more
Using music to stabilize NICU babies as well as their parents
When music therapist Christine Vaskas works with babies in the neonatal intensive care unit, the effect of her interventions are almost always immediately apparent. In 2013, a study led by Joanne Loewy, the Armstrong Center's... read more
Lumping or Splitting in Pediatric ARDS
Improvements in acute respiratory distress syndrome (ARDS) outcomes in adults have been achieved along-side demonstration of the superiority of low-tidal volume ventilation, the relative advantage of a restrictive fluid strategy... read more
Time-limited Trial of Intensive Care Treatment
In critically ill patients, it is frequently challenging to identify who will benefit from admission to the intensive care unit and life-sustaining interventions when the chances of a meaningful outcome are unclear. In addition,... read more
