Tag: trial
External Corroboration That Corticosteroids May Be Harmful to Septic Shock Endotype A Patients
This exploratory analysis provides further evidence that corticosteroid exposure may be associated with increased mortality among septic shock endotype A patients. We previously reported gene expression-based endotypes... read more
The hospital of the future – building intelligent environments to facilitate safe and effective acute care delivery
Both the integrity of the healing professions and the safety of our patients hinge on our ability to identify and overcome barriers to effective, error-free care delivery. These barriers are not due to the lack of a sophisticated... read more
Harmonizing Heterogeneous Endpoints in COVID-19 Trials Without Loss of Information
All ongoing clinical trials should include a stacked probability plot in their statistical analysis plan as descriptive analysis. While primary analysis should be on an early endpoint with appropriate capability to be... read more
NIH ACTIV trial of blood thinners pauses enrollment of critically ill COVID-19 patients
Three clinical trial platforms working together to test the effects of full doses of anticoagulants (blood thinners) in COVID-19 patients have paused enrollment for one group of patients. Among critically ill COVID-19... read more
Weaning the patient: between protocols and physiology
Ventilator weaning forms an integral part in critical care medicine and strategies to shorten duration are rapidly evolving alongside our knowledge of the relevant physiological processes. The purpose of the current review... read more
Oral Vitamin K Lowers the International Normalized Ratio More Rapidly
Oral vitamin K lowers INR more rapidly than subcutaneous vitamin K in asymptomatic patients who have supratherapeutic INR values while receiving warfarin. Warfarin therapy was withheld, and 1 mg of vitamin K was given... read more
Genetic Mechanisms of Critical Illness in COVID-19
Host-mediated lung inflammation is present, and drives mortality, in critical illness caused by COVID-19. Host genetic variants associated with critical illness may identify mechanistic targets for therapeutic development. Here... read more
Improved Oxygenation After Prone Positioning May Be a Predictor of Survival in Patients With ARDS
We found a significant difference in the Pao2:Fio2 ratio after the first prone positioning between ICU survivors and nonsurvivors. The improvement in oxygenation after the first prone positioning was a significant predictor... read more
Myorelaxants in ARDS patients
Neuromuscular blocking agents (NMBAs) inhibit patient-initiated active breath and the risk of high tidal volumes and consequent high transpulmonary pressure swings, and minimize patient/ ventilator asynchrony in acute respiratory... read more
Assessment of Cancer Therapy Evaluation Program Advocacy and Inclusion of People With HIV in Anti–PD1/PDL1 Trials
This study identified encouraging trends in the inclusion of PLWH in anti–PD1/PDL1 cancer trials that occurred in the period following the initiation of CTEP advocacy. Work is needed to examine what impact this will have... read more
Will COVID-19 Vaccines Save Lives? Current Trials Aren’t Designed To Tell Us
The world has bet the farm on vaccines as the solution to the pandemic, but the trials are not focused on answering the questions many might assume they are. As phase III trials of covid-19 vaccines reach their target... read more
Effect of Tocilizumab vs. Standard Care on Clinical Worsening in Patients Hospitalized With COVID-19 Pneumonia
The administration of tocilizumab in patients with COVID-19 pneumonia and a Pao2/Fio2 ratio between 200 and 300 mm Hg did not reduce the risk of clinical worsening. Further blinded, placebo-controlled randomized clinical... read more
Conservative or Liberal Oxygen Therapy in Adults After Cardiac Arrest
Conservative oxygen therapy was associated with a statistically significant reduction in mortality at last follow-up compared to liberal oxygen therapy but the certainty of available evidence was low or very low due to bias,... read more
Effect of Early Activity Combined with Early Nutrition on Acquired Weakness in ICU Patients
This trial has the potential to identify a novel strategy for preventing or managing ICU-AW. The findings may increase the clinical knowledge about nutrition and mobilization interventions for people with ICU-AW, and contribute... read more
Efficacy and Safety of a Paired Sedation and Ventilator Weaning
The purpose of this study is to determine the impact of a new RN/RRT (Registered Nurse/Registered Respiratory Therapist) directed 2-step protocol to wean patients off of a ventilator. This protocol involves daily attempts... read more
Mortality Outcomes with Hydroxychloroquine and Chloroquine in COVID-19
No benefit of hydroxychloroquine or chloroquine on the survival of COVID-19 patients found. For hydroxychloroquine, the confidence interval is compatible with increased mortality or negligibly reduced mortality. Findings... read more
Dual Therapy Using Sildenafil and Milrinone Superior to Monotherapy in Neonates with Severe PPHN
Dual therapy using sildenafil and milrinone was superior to monotherapy with either drug in neonates with severe persistent pulmonary hypertension (PPHN) and is recommended for use in resource-constrained settings. A double-blind... read more
Thrombotic and Hemorrhagic Complications in Critically Ill Patients with COVID-19
Critically ill patients with COVID-19 experience high rates of venous and arterial thrombotic complications. The rates of bleeding may be higher than previously reported and re-iterate the need for randomised trials to better... read more
ECMO During the Coronavirus Disease 2019 Pandemic
In the midst of the 2009 influenza A H1N1 pandemic, clinicians turned to extracorporeal membrane oxygenation (ECMO) as a strategy to save lives. Based on the H1N1 experience, and the ECMO to Rescue Lung Injury in Severe... read more
Quality of Life of Intensive Care Unit-Acquired Weakness Symptoms in Long-Term Intensive Care Survivors
Intensive care unit-acquired weakness (ICUAW) symptoms were disturbingly common in the majority of long-term survivors, indicating that symptoms persist up to 10y and frequently impair QoL. However, only a small number of... read more
From Russia with Love – “Sputnik V” COVID-19 Vaccine Generated an Immune Response
Between June 18 and Aug 3, 2020, Ministry of Health of the Russian Federation enrolled 76 participants to the two studies (38 in each study). In each study, 9 volunteers received rAd26-S in Phase 1, nine received rAd5-S in... read more
COVID-19: A Critical Analysis of Chloroquine and Hydroxychloroquine Clinical Pharmacology
Chloroquine and hydroxychloroquine have been used for over 60 years in the treatment of malaria, amoebic liver abscess, and several rheumatological conditions, but their clinical pharmacology is not well understood. COVID-19... read more
