Crit Care Resusc
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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.
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Multicenter Study Observational Study
Intravenous fluid use after cardiac surgery: a multicentre, prospective, observational study.
The optimal strategy for fluid replacement after major surgery remains unclear and there is considerable interest in the investigation of more restrictive fluid regimens. ⋯ We showed that fluid boluses are responsible for a large proportion of the positive fluid balance seen in patients after cardiac surgery. These data justify further study to evaluate whether modification of fluid bolus administration can improve patient outcomes.
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Multicenter Study
A multicentre feasibility study evaluating stress ulcer prophylaxis using hospital-based registry data.
It is unclear whether histamine-2 receptor blockers (H2RBs) or proton pump inhibitors (PPIs) are preferred for stress ulcer prophylaxis (SUP) in intensive care unit patients. Suitably powered comparative effectiveness trials are warranted. ⋯ It is feasible to use existing data sources to measure process-of-care and outcome data necessary for a registry-based interventional trial of SUP.
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Observational Study
Assessing the bowel function of critically ill children: a pilot study.
To describe the bowel function of critically ill children. ⋯ Critically unwell children needing more than 24 hours of intensive care have a state of non-defecation for most of the time, with formed stools being rare. Further observational studies will better define bowel function in critically unwell children.