ClinCalc.com is proud to announce that ICU Trials by ClinCalc, a mobile application that summarizes landmark critical care trials, has surpassed 100 studies in the app database!
With our most recent update on April 18th, the following recent and historic landmark trials were added:
- MIDEX (2012): Dexmedetomidine vs. midazolam for mechanical ventilation
- PAC-Man (2005): Efficacy of PA catheters in ICU patients
- FEAST (2011): Fluid boluses in African children with severe infection
- VSE (2013): Vasopressin, steroids, and epinephrine during cardiac arrest
- MOPETT (2012): Alteplase for moderate PE
- Brochard (1994): T-piece, SIMV, or PSV for ventilator weaning
Summary of the Kumar 2006 Trial
Among patients with septic shock, every hour of delay in appropriate antibiotic administration was associated with a significant increase in mortality.
Summary of the CORTICUS Trial (Sprung 2008)
Hydrocortisone therapy did not improve outcomes among patients with septic shock (onset within 72 hours), although it did shorten the duration of vasopressor dependence.
Summary of the Annane 2002 Trial
Among patients with very early septic shock who were non-responders to a cosyntropin stim test, hydrocortisone/fludrocortisone therapy improved 28-day survival. Furthermore, steroid therapy reduced duration of vasopressor therapy in all patients (regardless of stim test response).
Summary of the NICE-SUGAR Trial
Among critically ill patients, intensive glucose control increased 90-day mortality and the incidence of severe hypoglycemia compared to conventional therapy.
Summary of the Leuven I (van den Berghe 2002) Trial
In surgical ICU patients (primarily cardiac), intensive insulin therapy reduced ICU mortality, renal impairment, and bloodstream infections. The rate of severe hypoglycemia was higher with intensive insulin.
Summary of the NINDS Trial
In patients presenting within 3 hours of ischemic stroke, alteplase improved 3-month neurological function (NNT=9) but did not impact 24-hour symptoms or mortality. In patients receiving alteplase, approximately one-quarter had minor bleeding, and 6.4% had symptomatic ICH (NNH=17).
Summary of the Kress 2000 Trial
Medical ICU patients receiving continuous infusion sedation with daily interruption were liberated from mechanical ventilation and left the ICU quicker, but this effect did not translate to a shorter hospital course or a mortality benefit.
Summary of the EPaNIC (Casaer 2011) Trial
Early initiation of TPN increased ICU and hospital stay, the incidence of infection, and total healthcare costs. Delaying parenteral nutrition up to 7 days had no effect on mortality.
Summary of the Rivers 2001 Trial
Protocolized early goal-directed therapy initiated in the ED in severe sepsis and septic shock patients improved resuscitation parameters and reduced mortality.