Critical care : the official journal of the Critical Care Forum
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Randomized Controlled Trial Multicenter Study
Seven versus 14 days of antimicrobial therapy for severe multidrug-resistant Gram-negative bacterial infections in intensive care unit patients (OPTIMISE): a randomised, open-label, non-inferiority clinical trial.
Shorter courses of antimicrobial therapy have been shown to be non-inferior to longer durations for the management of several infections. However, data on critically ill patients with severe infections by multidrug-resistant Gram-negative bacteria (MDR-GNB) are scarce. In the duratiOn of theraPy in severe infecTIons by MultIdrug-reSistant gram-nEgative bacteria (OPTIMISE) trial, we assessed the non-inferiority of 7-day versus 14-day antimicrobial therapy for patients with intensive care unit (ICU)-acquired severe infections by MDR-GNB. ⋯ The OPTIMISE trial could not determine the non-inferiority of 7-day compared to 14-day therapy for severe infections caused by MDR-GNB due to early termination related to the low recruitment rate.
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Guidelines for diabetic ketoacidosis (DKA) management are limited, resulting in varied practices. This study assessed Intensive Care Unit (ICU) admission criteria, fluid resuscitation, insulin therapy, and metabolic management in adult patients with DKA. ⋯ The management of patients with DKA remains heterogeneous worldwide. Future randomized trials are needed, especially regarding fluid resuscitation and insulin therapy. Trial registrationNot applicable.
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Delirium is a frequent complication in critically ill patients and is associated with adverse outcomes such as long-term cognitive impairment and increased mortality. It is unknown whether there are sex-related differences in intensive care unit (ICU) delirium and associated outcomes. We aimed to assess sex-specific differences in short-term mortality following ICU-delirium. ⋯ Our study suggests that women with ICU-delirium have a significantly higher risk of short-term mortality than men. Acknowledging the limitations inherent to observational studies with potential for residual confounding, further research is needed to understand the biological and clinical factors driving this disparity and to inform sex-specific interventions for ICU-delirium.