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


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


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


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



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


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



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


The paper