The New England journal of medicine
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Effect of recombinant surfactant protein C-based surfactant on the acute respiratory distress syndrome.
Preclinical studies suggest that exogenous surfactant may be of value in the treatment of the acute respiratory distress syndrome (ARDS), and two phase 2 clinical trials have shown a trend toward benefit. We conducted two phase 3 studies of a protein-containing surfactant in adults with ARDS. ⋯ The use of exogenous surfactant in a heterogeneous population of patients with ARDS did not improve survival. Patients who received surfactant had a greater improvement in gas exchange during the 24-hour treatment period than patients who received standard therapy alone, suggesting the potential benefit of a longer treatment course.
-
Multicenter Study Clinical Trial
Circulating tumor cells, disease progression, and survival in metastatic breast cancer.
We tested the hypothesis that the level of circulating tumor cells can predict survival in metastatic breast cancer. ⋯ The number of circulating tumor cells before treatment is an independent predictor of progression-free survival and overall survival in patients with metastatic breast cancer.
-
Multicenter Study Clinical Trial Controlled Clinical Trial
Advanced cardiac life support in out-of-hospital cardiac arrest.
The Ontario Prehospital Advanced Life Support (OPALS) Study tested the incremental effect on the rate of survival after out-of-hospital cardiac arrest of adding a program of advanced life support to a program of rapid defibrillation. ⋯ The addition of advanced-life-support interventions did not improve the rate of survival after out-of-hospital cardiac arrest in a previously optimized emergency-medical-services system of rapid defibrillation. In order to save lives, health care planners should make cardiopulmonary resuscitation by citizens and rapid-defibrillation responses a priority for the resources of emergency-medical-services systems.
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Public-access defibrillation and survival after out-of-hospital cardiac arrest.
The rate of survival after out-of-hospital cardiac arrest is low. It is not known whether this rate will increase if laypersons are trained to attempt defibrillation with the use of automated external defibrillators (AEDs). ⋯ Training and equipping volunteers to attempt early defibrillation within a structured response system can increase the number of survivors to hospital discharge after out-of-hospital cardiac arrest in public locations. Trained laypersons can use AEDs safely and effectively.