Tag: trial
The Impact of Neonatal Simulations on Trainees Stress and Performance
Neonatal simulations cause significant anticipatory and participatory stress. Despite this, trainees' performance score in simulation was over 80%. Simulated death did not impact performance, magnitude of rise in salivary... read more
CDC and Prevention Guideline for the Prevention of Surgical Site Infection
This guideline is intended to provide new and updated evidence-based recommendations for the prevention of SSI and should be incorporated into comprehensive surgical quality improvement programs to improve patient safety.... read more
Albumin Administration in Sepsis: The Case for and Against
Serum albumin is an essential plasma protein, with a variety of homeostatic and predictive roles in health and disease. Hypoalbuminaemia is common in critical illness. Human albumin solution has been administered clinically... read more
Effect of Reminder Devices on Medication Adherence
In this randomized clinical trial of 53 480 enrollees of a pharmacy benefit manager, no statistically significant difference in adherence was found between those in the control group and those who received a reminder device... read more
Eltrombopag Added to Standard Immunosuppression for Aplastic Anemia
Acquired aplastic anemia results from immune-mediated destruction of bone marrow. Immunosuppressive therapies are effective, but reduced numbers of residual stem cells may limit their efficacy. In patients with aplastic anemia... read more
Single IRBs in Multisite Trials
On June 21, 2016, the US government announced changes that are arguably the most significant of the last quarter century concerning the protection of human research participants - a requirement for use of central or single... read more
NIH Consortium to Study Biomarkers for Dementia
A new National Institutes of Health (NIH) funded consortium will work to identify and validate trial-ready biomarkers for small vessel diseases in the brain that contribute to cognitive impairment and dementia. Seven participating... read more
Promoting Mobility and Preventing Falls in the Hospital
When older adults are hospitalized, there is an inherent tension between preventing falls and promoting mobility. In response to public and professional attention to medical errors, federal policy and, in turn, hospital culture... read more
The impact of oral care on oral health status and prevention of VAP in critically ill patients
Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections which increase mortality rate and length stay of hospitalization. Oral care would not only improve patient’s oral health and well-being,... read more
Manual vs. Integrated Automatic Load-distributing Band CPR with Equal Survival after out of Hospital Cardiac Arrest
Between March 5, 2009 and January 11, 2011 a randomized, unblinded, controlled group sequential trial of adult out-of-hospital cardiac arrests of presumed cardiac origin was conducted at three US and two European sites. After... read more
Effect of an automated notification system for deteriorating ward patients on clinical outcomes
We performed a prospective before-and-after study in all patients admitted to two clinical ward areas in a district general hospital in the UK. We examined the effect on clinical outcomes of deploying an electronic automated... read more
The Confusion Assessment Method for the ICU-7 Delirium Severity Scale
Delirium severity is independently associated with longer hospital stays, nursing home placement, and death in patients outside the ICU. Delirium severity in the ICU is not routinely measured because the available instruments... read more
Which position is safest for central line placement: subclavian, jugular, femoral?
Where to place a central venous catheter is a decision driven mainly by individual experience and preference. The limited evidence available has not established any site as superior; the subclavian position has been reported... read more
Comparison of Alveolar Recruitment Strategies for Preventing Postoperative Pulmonary Complications
This randomized clinical trial compares the effects of adding an intensive vs moderate alveolar recruitment strategy to protective ventilation on the number and severity of pulmonary complications following cardiac surgery.... read more
Family Responses to Prognostic Information in Chronic Critical Illness
Prognostic disclosure by skilled clinician communicators evokes a repertoire of responses from surrogates for the chronically critically ill. Recognition of these response patterns may help all clinicians better communicate... read more
Pre-hospital therapeutic hypothermia: The RINSE trial
Therapeutic hypothermia has had a bit of a rollercoaster ride over the last few years. It was all the rage following three small trials, which initially suggested a significant benefit from cooling patients to 33C following... read more
Meta-analysis confirms EGDT for sepsis is unhelpful and wasteful (PRISM)
Three large, well-conducted randomized trials around the world (ProCESS, ARISE, and ProMISe) all agreed: use of early goal-directed therapy (EGDT) for sepsis does not improve mortality or any other important clinical outcome.... read more
The Case for CRISPR-Cas9
Few techniques in the history of modern science have made as large an impact in as short a time as CRISPR-Cas9. Only a few years after the technique was first described, its inventors are predicted to be on the shortlist... read more
Mechanical Ventilation: Which Patients Benefit from High PEEP?
Among patients with hypoxaemia after cardiac surgery, the use of an intensive alveolar recruitment strategy compared with a moderate recruitment strategy resulted in less severe pulmonary complications during the hospital... read more
Vitamin C and the Ethics of Borrowing data
I was recently amazed to be engaged in a Twitter kerfuffle which generated more than 10,000 Impressions within 24 hours. Passions were running high, libellous comments were being broadcast, and old friendships seemed to be... read more
Clinical review: The ABC of weaning failure
About 20% to 30% of patients are difficult to wean from invasive mechanical ventilation. The pathophysiology of difficult weaning is complex. Accordingly, determining the reason for difficult weaning and subsequently developing... read more
