Classic Trial
In adult patients in ICU with septic shock, does a restrictive approach to fluid therapy compared to a standard care result in fewer deaths at day 90?
Continue reading »Author: George Walker
SETPOINT2
In patients with severe stroke does early (≤5 days of intubation) tracheostomy when compared to standard timing (from day 10) of tracheostomy improve functional outcome at 6 months?
Continue reading »Endovascular Therapy for Large Ischemic Stroke
In patients with large cerebral infarction volumes does the use of endovascular therapy alongside medical care compared with medical care alone improve 90-day functional outcomes?
Continue reading »DECRA
In patients admitted to ICU with severe diffuse traumatic brain injury (TBI) and refractory raised intracranial pressure (ICP), does early decompressive craniectomy improve functional outcomes when compared with continued medical management?
Continue reading »Prague OHCA
In patients with a witnessed refractory out-of-hospital cardiac arrest (OHCA) does early intra-arrest transport, extracorporeal CPR (ECPR) and invasive assessment improve neurological outcome at 180 days?
Continue reading »PLUS Study
Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults Finfer S, NEJM, 2022; DOI: 10.1056/NEJMoa2114464 Clinical Question In critically ill adults does the use of a balanced multielectrolyte solution (BMES, Plasmalyte 148), as opposed to 0.9% Sodium Chloride, for fluid resuscitation and therapy result in reduced 90 day mortality? Background Fluid administration is a key component of critical care therapy […]
Continue reading »CONTROLING
Individualised versus conventional glucose control in critically-ill patients: the CONTROLING study—a randomized clinical trial Bohé. Intensive Care Medicine 2021. https://doi.org/10.1007/s00134-021-06526-8 Clinical Question In critically unwell adults does targeting individualised glycaemic control compared to glycaemia < 180 mg/dL improve 90 day mortality? Background Hyperglycaemia has been shown to result in worse outcomes in the critically ill, especially in non-diabetic patients In […]
Continue reading »VAM-IHCA
Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest: A Randomized Clinical Trial Anderson et al. JAMA 2021. doi:10.1001/jama.2021.16628 Clinical Question In adult patients suffering an in-hospital cardiac arrest (IHCA) does the use of vasopressin and methylprednisolone compared to a placebo result in increased rates of return of spontaneous circulation (ROSC)? […]
Continue reading »TOMAHAWK
Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation Desch S et al. NEJM 2021. DOI: 10.1056/NEJMoa2101909 Clinical Question In adults > 30 years old suffering out-of-hospital cardiac arrest (OOHCA) without ST elevation on their ECG does routine immediate coronary angiography compared to a delayed or selective approach to coronary angiography improve 30-day all-cause mortality? Background The DISCO pilot study showed […]
Continue reading »BaSICS
In adult intensive care patients does the use of a balanced crystalloid compared to 0.9% saline reduce 90-day all-cause mortality?
In adult intensive care patients needing administration of resuscitation fluids, does the slow infusion compared to a fast infusion of a fluid boluses reduce 90-day all-cause mortality?
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