Tag: trial
Early goal-directed nutrition in ICU patients (EAT-ICU)
Extensive weight loss has been documented in intensive care unit (ICU) survivors, primarily as the result of muscle loss, leading to impaired physical function and reduced quality of life. The aim of the EAT-ICU trial is... read more
Balanced Crystalloids vs Saline for Critically Ill Adults
Among critically ill adults, use of balanced crystalloids for intravenous fluid administration reduced the composite of death, new renal replacement therapy, and persistent renal dysfunction compared with use of saline. Patients... read more
Pilot Feasibility Study of Therapeutic Hypothermia for Moderate to Severe ARDS
Neuromuscular blockade alone does not cause hypothermia but allowed acute respiratory distress syndrome patients to be effectively cooled. Results support conducting a randomized clinical trial of hypothermia in acute respiratory... read more
Effect of Antibiotic Prophylaxis on Surgical Site Infections Following Removal of Orthopedic Implants
In this randomized clinical trial that included 470 patients who were undergoing surgery for removal of orthopedic implants used for treatment of below-the-knee fractures, surgical site infection occurred in 12.9% of patients... read more
Top 10 Critical Care Trials for 2017
We held a poll within our editorial group, rating all 36 of the published trials from 2017 that we have summarised and critiqued. We considered the importance of the clinical question, how game changing the conclusion was... read more
The Future of Mechanical Ventilation
The adverse effects of mechanical ventilation in acute respiratory distress syndrome (ARDS) arise from two main causes: unphysiological increases of transpulmonary pressure and unphysiological increases/decreases of pleural... read more
Meta-Analysis Shows Mixed Results with Palliative Care
Palliative care was tied to some improvements in quality of life (QOL) in critically ill patients, but the impact on caregiver outcomes was mixed, and there was no significant association between palliative care delivery... read more
Guidelines for the Content of Statistical Analysis Plans in Clinical Trials
While guidance on statistical principles for clinical trials exists, there is an absence of guidance covering the required content of statistical analysis plans (SAPs) to support transparency and reproducibility. Recommendations... read more
Treating Acid–Base Abnormalities in the ICU
Acidemia has both harmful and beneficial biological effects. Sodium bicarbonate is generally ineffective in raising pH when ventilation is limited, as in patients with ARDS. Even when alkalinizing agents can correct the pH,... read more
Is Simvastatin the Miracle Drug We Think It Is?
Evaluation of early administration of simvastatin in the prevention and treatment of delirium in critically ill patients undergoing mechanical ventilation. This well designed and conducted trial demonstrates that there is... read more
Strategies for the Prevention of Airway Complications
Despite being infrequent, complications of airway management remain an important contributor to morbidity and mortality during anesthesia and care of the critically ill. Developments in the last three decades have made anesthesia... read more
A supplemental intravenous amino acid infusion sustains a positive protein balance for 24 hours in critically ill patients
Providing supplemental amino acids to ICU patients during a 3-h period results in improved whole-body net protein balance, without an increase in amino acid oxidation. The primary objective was to investigate if a 24-h intravenous... read more
Prehospital Antibiotics in the Ambulance for Sepsis
Emergency medical services (EMS) personnel have already made substantial contributions to improving care for patients with time-dependent illnesses, such as trauma and myocardial infarction. Patients with sepsis could also... read more
Effect of Procalcitonin-guided Antibiotic Treatment on Mortality in Acute Respiratory Infections
Use of procalcitonin to guide antibiotic treatment in patients with acute respiratory infections reduces antibiotic exposure and side-effects, and improves survival. Widespread implementation of procalcitonin protocols in... read more
Critical Care Cycling Study (CYCLIST) Trial Protocol
Critical Care Cycling Study (CYCLIST) trial protocol: a randomised controlled trial of usual care plus additional in-bed cycling sessions versus usual care in the critically ill. In-bed cycling with patients with critical... read more
Lowering systolic blood pressure would save more than 100,000 lives per year, study finds
Intensive treatment to lower systolic (top number) blood pressure to below 120 would save more than 100,000 lives per year in the United States, say scientists. Two thirds of the lives saved would be men and two thirds would... read more
Early Exercise in Critically Ill Youth and Children, a Preliminary Evaluation
Early mobilization is safe and feasible in the PICU. In-bed cycling may facilitate greater duration and intensity of mobilization, in critically ill children. A full-scale randomized controlled trial is warranted to evaluate... read more
The Septic Shock 3.0 Definition and Trials
Ranjit Deshpande, MD, speaks with James A. Russell, MD, about the article, "The Septic Shock 3.0 Definition and Trials: A Vasopressin and Septic Shock Trial Experience," published in the June 2017 issue of Critical Care Medicine.... read more
Does a 1-h Rest After a Successful SBT Really Improve Extubation Outcome?
Discussion on whether reconnection to mechanical ventilation for 1h after a successful spontaneous breathing trial (SBT) reduces reintubation in critically ill patients: a multicenter randomized controlled trial.... read more
Can we stop worrying about the age of blood?
Blood transfusions are common in critically ill patients; two in five adults admitted to an ICU receive at least one transfusion during their hospitalization. Recently, there has been growing concern about the potential dangers... read more
Enteral vs. Parenteral Early Nutrition in Ventilated Adults with Shock
In critically ill adults with shock, early isocaloric enteral nutrition did not reduce mortality or the risk of secondary infections but was associated with a greater risk of digestive complications compared with early isocaloric... read more
Effect of treatment delay on the effectiveness and safety of antifibrinolytics in acute severe hemorrhage
Antifibrinolytics reduce death from bleeding in trauma and post-partum haemorrhage. We examined the effect of treatment delay on the effectiveness of antifibrinolytics. We obtained data for 40,138 patients from two randomised... read more
