Tag: trial
What’s New in Severe Pulmonary Embolism?
Severe pulmonary embolism (PE) remains a major cause of mortality. For intensivists managing the most "severe" forms of PE, we highlight the main recent advances in the care of such patients including risk stratification,... read more
Nine Reasons to Quit Using Normal Saline for Resuscitation
Saline vs. balanced solutions has been a topic of ongoing debate. Two fresh studies will illuminate this: the SMART and SALT-ED trials. This post summarizes current knowledge, beginning with physiology and working our way... read more
Intravenous Iron, Not Oral, Improves Functional Capacity in HF Patients
The oral iron supplement failed to be absorbed, while the successful IV formulation is not without significant logistical and cost issues. In one study testing a convenient and easy-to-use oral iron supplement, investigators... read more
Distinguishing Pneumonia From Pneumonitis to Safely Discontinue Antibiotics
Consequences of pulmonary aspiration can be biphasic with dissimilar sequelae. An early phase, coined pneumonitis, involves an inflammatory reaction to gastrointestinal contents with a pH typically less than 2.4 resulting... read more
Lighter Emergency Breathing Tubes Associated with Higher Survival After OHCA
In the LT group, 18.3% of patients survived 72 hours in the hospital, compared to 15.4% in the intubation group. From the LT group, 10.8% survived to hospital discharge, and only 8.1% in the intubation group. The proportion... read more
Management and Outcomes of ARDS Patients With and Without Comorbid Conditions
Half the patients with acute respiratory distress syndrome (ARDS) had major comorbidities, which were associated with severe ARDS, multiple organ dysfunction, and day‑28 mortality. These findings do not support the exclusion... read more
The Fluid Debate: Balanced or Unbalanced
Consider using balanced fluids in your ED unless you are treating a patient at risk for cerebral edema, or a patient with a chloride responsive metabolic alkalosis, e.g. from gastric losses. Although the superiority of balanced... read more
Very high intact-protein formula successfully provides protein intake according to nutritional recommendations in overweight critically ill patients
Enteral feeding with VHPF (8 g/100 kcal) resulted in higher protein intake and plasma amino acid concentrations than an isocaloric SHPF (5 g/100 kcal), without an increase in energy intake. This VHPF facilitates feeding according... read more
Trophic or Full Nutritional Support?
A two-phase approach for nutritional support may more appropriately account for the physiologic changes during critical illness than one-phase approach. Further evidence is awaited for the optimal protein amount during critical... read more
Effectiveness of targeted enhanced terminal room disinfection on hospital-wide acquisition and infection with multidrug-resistant organisms and Clostridium difficile
The hospital environment is a source of pathogen transmission. The effect of enhanced disinfection strategies on the hospital-wide incidence of infection has not been investigated in a multicentre, randomised controlled trial.... read more
Evaluating the Cost-Effectiveness of Proportional-Assist Ventilation Plus vs. Pressure Support Ventilation in the ICU in Two Countries
The published reductions in asynchrony and length of stay in the ICU with proportional assist ventilation (PAV ventilation by Medtronic) led to shorter time on ventilation, and reduced incidence of ventilator-associated pneumonia... read more
Clinical Trial Participants’ Views of the Risks and Benefits of Data Sharing
In a survey of participants in clinical trials, most believe the potential benefits of data sharing outweigh potential negative consequences and are willing to share their data. Less than 8% of respondents felt that the potential... read more
FIRST-line Support for Assistance in Breathing in Children (FIRST-ABC)
A multicentre pilot randomised controlled trial of high-flow nasal cannula therapy versus continuous positive airway pressure in pediatric critical care. Our pilot trial confirms that, following minor changes to consent procedures... read more
Central venous oxygen desaturation during early sepsis linked to higher mortality
n the ALBIOS trial, persistence of low (... read more
Abnormal Saline and the History of Intravenous Fluids
Two new clinical trials together involving nearly 30,000 patients support previous observational evidence that the most common solution used for intravenous fluid therapy in the world is associated with kidney damage. Both... read more
A Randomized Trial of a Family-Support Intervention in ICUs
Family-support intervention in ICUs increased patient comfort and reduced costs. Among critically ill patients and their surrogates, a family-support intervention delivered by the interprofessional ICU team did not significantly... read more
Do We Know Enough to Recommend Corticosteroids in ARDS?
We read with interest the evidence-based recommendations for the use of prolonged corticosteroids in early moderate to severe acute respiratory distress syndrome (ARDS) published in Critical Care Medicine by the Corticosteroid... read more
Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy
The 5-year TACTIC project is a multi-component study, a main focus of which is the development of European-wide clinical trial, entitled "Implementing Treatment Algorithms for the Correction of Trauma Induced Coagulopathy... read more
