Clinical Trials in Intensive Care

Long-term effects of remote ischaemic preconditioning in high-risk patients undergoing cardiac surgery (Zarbock)

No specific therapy to prevent AKI previously

In this trial, remote ischaemic preconditioning (RIPC) reduced incidence of AKI

Summary

  • RIPC reduces MAkE90 (biomarker) in high risk surery
  • RIPC enhances AKI recovery

Reference

Original work

Upper limb remote ischaemia preconditioning dos not sow a relevant benefit in elective cardiac surgery: RIPHEART study (Meybohm)

No benefit in RIPC either in primary or secondary end-points

Reference

Original work

The article

 

One year outcome after ICU discharge: FROG-ICU (Mebezaa)

Aim: To identify biomarkers in patients who were alive at 1 year after discharge from ICU

CVS biomarkers – BNP, troponin, adrenomedullin and soluble ST2 were higher in non-survivors compared to survivors

Post ICU period is associated

  • higher mortality rate
  • unrelated to initial severity or cause administration

Post ICU care needs to be promoted and better studied

 

References

The complexities of ICU discharge

 

HEAT Trial (Young)

Acetaminophen for fever in critically ill patients

700 randomised

Early administration of acetaminophen to treat fever due to probable infection did not affect the number of ICU-free days

Paracetamol had modest effect on fever reduction

In non-survivors, paracetamol inceased their LOS i.e. delayed death

References

HEAT Trial

 

DESIST Trial (Walsh)

Interventions to improve sedation-analgesia quality

Measured using a new tool – Sedation Quality Assessment Tool (SQAT)

Over 1600 enrolled

Education programme did not make a difference

Responsiveness technology showed trend towards improvement

BUT combination of education and responsiveness technology reduce adverse events and improve sedation quality

 

References

DESIST trial protocol

 

Inhaled NO for acute chest syndrome in patients with sickle disease (Maitre)

NO crucial mediator of pulmonary circulation

No difference in primary outcome

Reference

The paper