Articles: adult.
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Randomized Controlled Trial Clinical Trial
Prehospital use of plasma in traumatic hemorrhage (The PUPTH Trial): study protocol for a randomised controlled trial.
Severe traumatic injury and haemorrhagic shock are frequently associated with disruptions of coagulation function (such as trauma-induced coagulopathy TIC) and activation of inflammatory cascades. These pathologies may be exacerbated by current standard of care resuscitation protocols. Observational studies suggest early administration of plasma to severely-injured haemorrhaging patients may correct TIC, minimise inflammation, and improve survival. The proposed randomised clinical trial will evaluate the clinical effectiveness of pre-hospital plasma administration compared with standard- of-care crystalloid resuscitation in severely-injured patients with major traumatic haemorrhage. ⋯ This study is part of a US Department of Defense (DoD)-funded multi-institutional investigation, conducted independently of, but in parallel with, the University of Pittsburgh and University of Denver. Demonstration of significant reductions in mortality and coagulopathic/inflammatory-related morbidities as a result of pre-hospital plasma administration would be of considerable clinical importance for the management of haemorrhagic shock in both civilian and military populations.
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Randomized Controlled Trial Comparative Study
Dexmedetomidine for tracheal extubation in deeply anesthetized adult patients after otologic surgery: a comparison with remifentanil.
Remifentanil and dexmedetomidine are well known to suppress airway reflexes during airway procedures. Smooth tracheal extubation is important after otologic surgery. The purpose of this study is to compare the effectiveness of dexmedetomidine or remifentanil infusion for producing smooth tracheal extubation in deeply anesthetized patients after otologic surgery. ⋯ Combined with 1 MAC sevoflurane, dexmedetomidine 0.7 ug/kg and remifentanil provided similar rates for smooth tracheal extubation in spontaneously breathing, anesthetized adults. Dexmedetomidine exhibited opioid-sparing effects postoperatively and was associated with less PONV than remifentanil.
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Randomized Controlled Trial Comparative Study
Comparison of Dexmedetomidine versus Propofol for Sedation after Uvulopalatopharyngoplasty.
Adequate sedation is important in the post-anesthesia care unit (PACU) following uvulopalatopharyngoplasty (UPPP) to ensure patient comfort and decrease the duration of mechanical ventilation (MV), PACU stay, and bleeding. This study aimed to compare dexmedetomidine and propofol as sedatives after UPPP in the PACU. ⋯ Dexmedetomidine provides safe and effective sedation for post-UPPP surgical patients and significantly reduces the use of analgesics, with minimal adverse effects.
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Health Technol Assess · Jul 2015
Randomized Controlled TrialA feasibility randomised controlled trial of a motivational interviewing-based intervention for weight loss maintenance in adults.
Obesity has significant health and NHS cost implications. Relatively small reductions in weight have clinically important benefits, but long-term weight loss maintenance (WLM) is challenging. Behaviour change interventions have been identified as key for WLM. Motivation is crucial to supporting behaviour change, and motivational interviewing (MI) has been identified as a successful approach to changing health behaviours. The study was designed as an adequately powered, pragmatic randomised controlled trial (RCT); however, owing to recruitment issues, the study became a feasibility trial. ⋯ This is the first trial of an intervention for WLM in the UK, the intervention is feasible and acceptable, and retention and adherence were high. The main effectiveness outcome showed a promising mean difference in the intensive arm. Owing to the small sample size, we are limited in the conclusions we can draw. However, findings suggest that the intensive intervention may facilitate long-term weight maintenance and, therefore, further testing in an effectiveness trial may be indicated. Research examining WLM is in its infancy, further research is needed to develop our understanding of WLM and to expand theory to inform the development of interventions to be tested in rigorously designed RCTs with cost-effectiveness assessed.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of ivacaftor in patients with cystic fibrosis who have an Arg117His-CFTR mutation: a double-blind, randomised controlled trial.
Ivacaftor has been previously assessed in patients with cystic fibrosis with Gly551Asp-CFTR or other gating mutations. We assessed ivacaftor in patients with Arg117His-CFTR, a residual function mutation. ⋯ Vertex Pharmaceuticals Incorporated.