Journal of critical care
-
Journal of critical care · Jun 2022
Randomized Controlled TrialThe effect of prostacyclin infusion on markers of endothelial activation and damage in mechanically ventilated patients with SARS-CoV-2 infection.
In a pilot study, we found a significant reduction in mean daily sequential organ failure assessment score in mechanically ventilated patients with COVID-19 who received prostacyclin, compared to placebo. We here investigate the effect on biomarkers of endothelial activation and damage. ⋯ Prostacyclin infusion, compared to placebo, resulted in a measurable decrease in endothelial glycocalyx shedding (syndecan-1) at 24 h, suggesting a protective effect on the endothelium, which may be related to the observed reduction in organ failure.
-
Journal of critical care · Apr 2022
Randomized Controlled TrialEffectiveness of combined non-pharmacological interventions in the prevention of delirium in critically ill patients: A randomized clinical trial.
Delirium is a common dysfunction in the intensive care unit (ICU) and it is associated with negative short- and long-term outcomes. This study evaluated the effectiveness of combined non-pharmacological interventions in preventing delirium in critically ill patients. ⋯ Combined non-pharmacological interventions reduced delirium in critically ill patients, compared to standard care.
-
Journal of critical care · Apr 2022
Randomized Controlled TrialFailure of non-sedation strategy in critically ill, mechanically ventilated patients - a retrospective, post-hoc analysis of the NONSEDA trial.
There is a growing awareness on minimizing sedation in ICUs. In the NONSEDA trial 700 critically ill patients were randomized to light sedation or non-sedation during mechanical ventilation. Approximately 40% of patients randomized to non-sedation needed sedation. The aim of this study is to obtain knowledge on patients, who experienced failure of non-sedation. ⋯ Patients with non-sedation success had better in-hospital outcomes, but mortality and long-term outcomes were not affected by success or failure of non-sedation.
-
Journal of critical care · Feb 2022
Randomized Controlled TrialA pilot, feasibility, randomised controlled trial of midodrine as adjunctive vasopressor for low-dose vasopressor-dependent hypotension in intensive care patients: The MAVERIC study.
To assess the feasibility and physiological efficacy of adjunctive midodrine in patients with vasopressor-dependent hypotension. ⋯ Adjunctive midodrine therapy was feasible with acceptable compliance, duration of therapy, and safety profile. However, at the chosen dose, there was no evidence of physiological or clinical efficacy.
-
Journal of critical care · Dec 2021
Randomized Controlled TrialUtilization and effect of neuromuscular blockade in a randomized trial of high-frequency oscillation.
We evaluated characteristics associated with neuromuscular blockade (NMB) use, center-level variation, and whether NMB mediated excess mortality among patients assigned to high-frequency oscillatory ventilation (HFOV) in the OSCILLATE trial. ⋯ In OSCILLATE, receipt of post-randomization NMB was associated with worse outcomes, but NMB use did not mediate HFOV-associated higher mortality.