Crit Care Resusc
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Intensivists frequently prescribe proton pump inhibitors (PPIs) or histamine-2 receptor blockers (H2RBs) to intensive care unit patients for stress ulcer prophylaxis (SUP). Despite the common use of SUP medicines, there is limited high-level evidence to support the choice between them. ⋯ Most survey respondents felt that current evidence is insufficient to justify the preferential use of PPIs or H2RBs for SUP and would enroll patients in a comparative SUP RCT.
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Donation after circulatory death (DCD) livers are at markedly increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to transplant DCD livers and may allow their use for artificial extracorporeal liver support of patients with fulminant liver failure. ⋯ Our experiments justify further investigations of the feasibility and efficacy of extended DCD liver preservation by ex-vivo perfusion.
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Randomized Controlled Trial Multicenter Study
A multicentre, randomised, double-blind, placebo-controlled trial of aminophylline for bronchiolitis in infants admitted to intensive care.
To determine whether aminophylline reduced the duration of respiratory support in children admitted to intensive care with bronchiolitis. ⋯ Not enough children were recruited for the study to test the hypothesis that aminophylline reduces the need for respiratory support in severe bronchiolitis. Consequently, the role of aminophylline in the management of severe bronchiolitis remains unknown.
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Randomized Controlled Trial Comparative Study
Individual patient data comparative analysis of hydroxyethyl starch 130/0.4 v 4% albumin for fluid resuscitation in critically ill patients: statistical analysis plan.
Recent randomised controlled trials have compared the effects of albumin and hydroxyethyl starch (HES) v crystalloids on patient-centred outcomes in critically ill patients. The Saline v Albumin Fluid Evaluation (SAFE) trial reported patient-centred outcomes at 28 days in 6933 patients assigned to fluid resuscitation with either 4% albumin or 0.9% saline; the Crystalloid v Hydroxyethyl Starch Trial (CHEST) reported patient-centred outcomes at 28 days in 6644 patients assigned to fluid resuscitation with either 6% HES (130/0.4) or 0.9% saline. As the two trials used a common reference fluid (0.9% saline) and had most trial methods and data collection points harmonised, a comparison of 4% albumin and 6% HES (130/0.4) on patient-centred outcomes at 28 days in critically ill patients using the individual patient data from the two trials is feasible. ⋯ We have developed a SAP for the SAFE/ CHEST individual patient data comparative analysis to increase the internal validity of the study and minimise bias.