Tag: trial
Prehospital Antibiotics Improved Some Aspects of Sepsis Care
Training EMS personnel in early recognition of sepsis improved some aspects of care within the acute care chain, but did not reduce mortality, according to results of a randomized trial. Emergency medical service (EMS) personnel... read more
Outcomes in Patients with Vasodilatory Shock and RRT Treated with Intravenous Angiotensin II
Acute kidney injury (AKI) requiring renal replacement therapy in severe vasodilatory shock is associated with an unfavorable prognosis. Angiotensin II treatment may help these patients by potentially restoring renal function... read more
Decision-making in the detection and management of patients with sepsis in resource-limited settings
We read with interest the study by Andrews et al. and the related correspondence from Shrestha et al. We share the concern that clinical examination (and observations) appear(s) to be perceived as relatively unimportant in... read more
Too Much SALT on the ICU?
There has a been a little flutter of activity in the #FOAMed world this week about two trials published in the NEJM on the subject of balanced fluids in the care of critically ill patients, and also on admitted patients in... read more
Combined Intravenous Thrombolysis and Thrombectomy vs Thrombectomy Alone for Acute Ischemic Stroke
The results indicate that treatment of patients experiencing AIS due to a large vessel occlusion with IVT before MT does not appear to provide a clinical benefit over MT alone. A randomized clinical trial seems warranted.... read more
Haloperidol Prophylaxis in Critically Ill Patients with a High Risk for Delirium
The use of the delirium prevention protocol seems to result in improvement of several delirium outcome measures. Prophylactic treatment with low dose haloperidol in critically ill patients with a high risk of delirium likely... read more
Pressure Injuries and Sedation: Are they related?
Critically ill patients inherently have most of the risk factors for the development of pressure injuries. One of the key factors is immobility, which is very frequent in ICUs. This lack of mobility is enhanced by the administration... read more
Effect of the Pulmonary Embolism Rule-Out Criteria on Subsequent Thromboembolic Events Among Low-Risk Emergency Department Patients
Does use of the pulmonary embolism rule-out criteria (PERC) in emergency department patients with low clinical probability of pulmonary embolism (PE) safely exclude the diagnosis of PE? Among very low-risk patients with suspected... read more
Bike Rehab is Helping Critical Care Patients Along the Road to Recovery
Getting on the bike is a stepping stone into rehabilitation - you see that bike and you know then that you're getting better. You know you're not just going to lie in that bed and vegetate. So successful was the exercise... read more
Effect of a Multifaceted Performance Feedback Strategy on Length of Stay Compared With Benchmark Reports Alone
In the context of ICUs participating in a national registry, applying a multifaceted activating performance feedback strategy did not lead to better patient outcomes than only receiving periodical registry reports. The extent... read more
An Exploratory Reanalysis of the Randomized Trial on Efficacy of Corticosteroids as Rescue Therapy for the Late Phase of ARDS
During active intervention, methylprednisolone was safe and effective in achieving disease resolution. Our findings support rapid glucocorticoid discontinuation post extubation as likely cause of disease relapse. Gradual... read more
Noninvasive Ventilation in Hypercapnic COPD
Recently, Murphy and colleagues reported findings from a clinical trial designed to evaluate the effect of home noninvasive ventilation (NIV) with oxygen on time to readmission or death in patients with persistent hypercapnia... read more
REPROVE: Ceftazidime-avibactam Noninferior to Meropenem for Nosocomial Pneumonia
Ceftazidime-avibactam was noninferior to meropenem for nosocomial pneumonia including ventilator-associated pneumonia (VAP) from gram-negative organisms, results from the REPROVE trial demonstrated. Nosocomial or hospital-acquired... read more
Is Overall Mortality the Right Composite Endpoint in Clinical Trials of ARDS?
Most deaths in acute respiratory distress syndrome (ARDS) patients are not directly related to lung damage but to extrapulmonary multisystem organ failure. It would be challenging to prove that specific lung-directed therapies... read more
Music as Therapy in the ICU
Music has been shown to reduce respiratory, cardiac and blood pressure frequencies in response to the reduction of stress hormones. In a randomized clinical trial, it was shown to reduce anxiety and sedation doses/intervals... read more
Long-term Outcomes Associated With Implantable Cardioverter Defibrillator in Adults With CKD
In a large, contemporary, noninterventional study of community-based patients with heart failure and Chronic Kidney Disease (CKD), ICD placement was not significantly associated with improved survival but was associated with... read more
Polymyxin B‑immobilised Hemoperfusion and Mortality in Critically Ill Patients with Sepsis/Septic Shock
Sepsis and septic shock originate from a dysregulated immune response to pathogens and cause millions of deaths worldwide. Endotoxin, a principal component of the outer membrane of Gram-negative bacteria, is a potent trigger... read more
Long-term Recovery Following Critical Illness in an Australian Cohort
Almost all data on 5-year outcomes for critical care survivors come from North America and Europe. The aim of this study was to investigate long-term mortality, physical function, psychological outcomes and health-related... read more
Adjuvant Therapies in Critical Care: Music Therapy
Emerging from the perioperative and oncology fields, music therapy (MT) and patient-directed music interventions (PDMI) have recently garnered interest in the area of critical care. The main goal of these music-based adjuvant... read more
Inspiratory Muscle Training Does Not Improve Clinical Outcomes in 3-week COPD Rehabilitation
The value of inspiratory muscle training (IMT) in pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) is unclear. The RIMTCORE (Routine Inspiratory Muscle Training within COPD Rehabilitation) randomised... read more
Stress Ulcer Prophylaxis in ICU Patients Receiving Enteral Nutrition
Our results suggested that in patients receiving enteral feeding, pharmacologic SUP is not beneficial and combined interventions may even increase the risk of nosocomial pneumonia. We searched PubMed, Embase, and the Cochrane... read more
Do We Need New Trials of Procalcitonin-Guided Antibiotic Therapy?
Using biomarkers as a guide to tailor the duration of antibiotic treatment in respiratory infections is an attractive hypothesis assessed in several studies. Recent work aiming to summarize the evidence assessed the effect... read more
