Agitation is a frequent complication following traumatic braing injury in patients admitted to the intensive care unit. This agitation frequently results in the liberal use of rescue drugs such as antipsychotics, sedatives and opiates, which in turn may delay rehabilitation, liberation from mechanical ventilation and emergence from posttraumatic amnesia. Dexmedetomidine may be a better agent given it's light sedative properties. The main objective is to assess the feasibility of conducting a multicenter randomized controlled trial of dexmedetomidine following TBI in the ICU.

开始日期2024-10-01

申办/合作机构

Centre integre universitaire de sante & de services sociaux

[+1]

NCT05969275 / Recruiting临床2期IIT

Umbilical Mesenchymal Stromal Cells as Cellular Immunotherapy for Septic Shock: A Multi-Center, Double Blind, Phase II Randomized Controlled Trial

Septic shock is associated with substantial burden in terms of both mortality and morbidity for survivors of this illness. Pre-clinical sepsis studies suggest that mesenchymal stem (stromal) cells (MSCs) modulate inflammation, enhance pathogen clearance and tissue repair and reduce death. Our team has completed a Phase I dose escalation and safety clinical trial that evaluated MSCs in patients with septic shock. The Cellular Immunotherapy for Septic Shock Phase I (CISS) trial established that MSCs appear safe and that a randomized controlled trial (RCT) is feasible. Based on these data, the investigators have planned a phase II RCT (UC-CISS II) at several Canadian academic centres which will evaluate intermediate measures of clinical efficacy (primary outcome), as well as biomarkers, safety, clinical outcome measures, and a health economic analysis (secondary outcomes).

开始日期2024-02-14

申办/合作机构

Ottawa Hospital Research Institute

[+4]

NCT05848713 / Recruiting临床3期IIT

AntiThrombotic Therapy to Ameliorate Clinical Complications in Community Acquired Pneumonia

This is an international, open-label, stratified randomized controlled trial with Bayesian adaptive stopping rules to compare the effects of therapeutic-dose heparin vs. usual care pharmacological thromboprophylaxis on outcomes in patients admitted to hospital with community acquired pneumonia (CAP).

开始日期2023-10-10

申办/合作机构

University of Manitoba

[+5]

100 项与 Canadian Critical Care Trials Group 相关的临床结果

登录后查看更多信息

0 项与 Canadian Critical Care Trials Group 相关的专利（医药）

登录后查看更多信息

项与 Canadian Critical Care Trials Group 相关的文献（医药）

2024-06-01·Journal of Critical Care

Patient-important upper gastrointestinal bleeding in the ICU: A mixed-methods study of patient and family perspectives

Article

作者: Debigare, Sylvie ; Rochwerg, Bram ; Ball, Ian ; Taneja, Shipra ; Burns, Karen E A ; Verhovsek, Madeleine ; Myburgh, John A ; Cook, Deborah J ; Mele, Tina ; Guyatt, Gordon ; Vanstone, Meredith G ; English, Shane W ; Gouskos, Audrey ; Swinton, Marilyn ; Deane, Adam M ; Finfer, Simon ; Krewulak, Karla ; Niven, Daniel J ; Dionne, Joanna C ; Marshall, John C ; Muscedere, John G ; Fiest, Kirsten

INTRODUCTIONThe objective of this study was to create a definition of patient-important upper gastrointestinal bleeding during critical illness as an outcome for a randomized trial.DESIGNThis was a sequential mixed-methods qualitative-dominant multi-center study with an instrument-building aim. In semi-structured individual interviews or focus groups we elicited views from survivors of critical illness and family members of patients in the intensive care unit (ICU) regarding which features indicate important gastrointestinal bleeding. Quantitative demographic characteristics were collected. We analyzed qualitative data using inductive content analysis to develop a definition for patient-important upper gastrointestinal bleeding.SETTINGCanada and the United States.PARTICIPANTS51 ICU survivors and family members of ICU patients.RESULTSParticipants considered gastrointestinal bleeding to be important if it resulted in death, disability, or prolonged hospitalization. The following also signaled patient-important upper gastrointestinal bleeding: blood transfusion, vasopressors, endoscopy, CT-angiography, or surgery. Whether an intervention evinced concern depended on its effectiveness, side-effects, invasiveness and accessibility; contextual influences included participant familiarity and knowledge of interventions and trust in the clinical team.CONCLUSIONSSurvivors of critical illness and family members described patient-important upper gastrointestinal bleeding differently than current definitions of clinically-important upper gastrointestinal bleeding.

2023-05-19·BMJ open

What counts as patient-important upper gastrointestinal bleeding in the ICU? A mixed-methods study protocol of patient and family perspectives.

Article

作者: Deane, Adam M ; Guyatt, Gordon ; Myburgh, John ; Marshall, John C ; Fiest, Kirsten ; Verhovsek, Madeleine ; Vanstone, Meredith ; Taneja, Shipra ; Cook, Deborah J ; English, Shane ; Mele, Tina ; Debigare, Sylvie ; Burns, Karen E A ; Alhazzani, Waleed ; Dionne, Joanna ; Gouskos, Audrey ; Ball, Ian ; Niven, Daniel ; Krewulak, Karla D ; Muscedere, John ; Finfer, Simon ; Rochwerg, Bram ; Swinton, Marilyn

INTRODUCTIONClinically important upper gastrointestinal bleeding is conventionally defined as bleeding accompanied by haemodynamic changes, requiring red blood cell transfusions or other invasive interventions. However, it is unclear if this clinical definition reflects patient values and preferences. This protocol describes a study to elicit views from patients and families regarding features, tests, and treatments for upper gastrointestinal bleeding that are important to them.METHODS AND ANALYSISThis is a sequential mixed-methods qualitative-dominant multi-centre study with an instrument-building aim. We developed orientation tools and educational materials in partnership with patients and family members, including a slide deck and executive summary. We will invite intensive care unit (ICU) survivors and family members of former ICU patients to participate. Following a virtual interactive presentation, participants will share their perspectives in an interview or focus group. Qualitative data will be analysed using inductive qualitative content analysis, wherein codes will be derived directly from the data rather than using preconceived categories. Concurrent data collection and analysis will occur. Quantitative data will include self-reported demographic characteristics. This study will synthesise the values and perspectives of patients and family members to create a new trial outcome for a randomised trial of stress ulcer prophylaxis. This study is planned for May 2022 to August 2023. The pilot work was completed in Spring 2021.ETHICS AND DISSEMINATIONThis study has ethics approval from McMaster University and the University of Calgary. Findings will be disseminated via manuscript and through incorporation as a secondary trial outcome on stress ulcer prophylaxis.TRIAL REGISTRATION NUMBERNCT05506150.

2023-04-01·Canadian Journal of Anesthesia/Journal canadien d'anesthésie

A brain-based definition of death and criteria for its determination after arrest of circulation or neurologic function in Canada: a 2023 clinical practice guideline

Article

作者: Pope, Thaddeus M ; Hartwick, Michael ; Sutherland, Stephanie ; Dhanani, Sonny ; Doig, Christopher J ; Brewster, Heather ; Matheson, Shauna ; Lee, Laurie A ; Mooney, Owen T ; Shemie, Sam D ; Elliott-Pohl, Kennedy ; Dawe, Kirk J ; Healey, Andrew ; Briard, Joel Neves ; Dawson, Rosanne ; Boyd, J Gordon ; Shanker, Jai Jai S ; Lee-Ameduri, Katarina ; Carignan, Robert ; Zorko, David J ; Manara, Alex ; Singh, Gurmeet ; Basmaji, John ; Isac, George ; Weiss, Matthew J ; Lewis, Ariane ; Chassé, Michaël ; Klowak, Jennifer A ; Honarmand, Kimia ; Simpson, Christy ; Leeies, Murdoch ; Sarti, Aimee J ; Sekhon, Mypinder S ; Chandler, Jennifer A ; Murphy, Nicholas ; Zuckier, Lionel S ; Singh, Jeffrey ; Torrance, Sylvia ; Baker, Andrew J ; Kanji, Aly ; LeBlanc, Allana E ; McKinnon, Nicole K A ; Brennan, Joanne ; Rochwerg, Bram ; Shaul, Randi Zlotnik ; Kawchuk, Joann ; Soliman, Karim ; Kromm, Julie ; Teitelbaum, Jeanne ; Bensimon, Cécile M ; Gofton, Teneille E ; Kramer, Andreas H ; Slessarev, Marat ; Wilson, Lindsay C ; Hornby, Laura ; Hornby, Karen

This 2023 Clinical Practice Guideline provides the biomedical definition of death based on permanent cessation of brain function that applies to all persons, as well as recommendations for death determination by circulatory criteria for potential organ donors and death determination by neurologic criteria for all mechanically ventilated patients regardless of organ donation potential. This Guideline is endorsed by the Canadian Critical Care Society, the Canadian Medical Association, the Canadian Association of Critical Care Nurses, Canadian Anesthesiologists' Society, the Canadian Neurological Sciences Federation (representing the Canadian Neurological Society, Canadian Neurosurgical Society, Canadian Society of Clinical Neurophysiologists, Canadian Association of Child Neurology, Canadian Society of Neuroradiology, and Canadian Stroke Consortium), Canadian Blood Services, the Canadian Donation and Transplantation Research Program, the Canadian Association of Emergency Physicians, the Nurse Practitioners Association of Canada, and the Canadian Cardiovascular Critical Care Society.

100 项与 Canadian Critical Care Trials Group 相关的药物交易

登录后查看更多信息

100 项与 Canadian Critical Care Trials Group 相关的转化医学

登录后查看更多信息