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Critical Care Reviews Book 2017 Summarising, Critiquing and Putting in Context the Best Critical Care Trials of 2016

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Critical Care Reviews Book 2017 Summarising, Critiquing and Putting in Context the Best Critical Care Trials of 2016 CriticalCritical CareCare ReviewsReviews BookBook 20172017 The Biggest Trials of 2016 1 2 This book has been generously sponsored by Revive, the charity for the Regional Intensive Care Unit at the Royal Victoria Hospital, Belfast. 3 About The 2017 Critical Care Reviews Book seeks to summarise, critique and put in context the best critical care trials of 2016. Five intensivsts working in Northern Ireland have spent the past year writing this edition. Our choices are largely subjective and clearly some major studies may have been excluded, but we feel we have captured the essence of the critical care research output from the past 12 months. We hope you enjoy this work and find it useful in your daily practice. Please read the disclaimer at the bottom of this page. The print version of the book has been very generously sponsored by the REVIVE charity of the Regional Intensive Care at the Royal Victoria Hospital in Belfast, where two of the authors work. Every registered delegate at the annual Critical Care Reviews Meeting receives a complimentary copy. The pdf is available as a free download at the Critical Care Reviews website, www.criticalcarereviews.com We would love to hear any feedback you may have on this book. All correspondence will be gratefully received at [email protected] Peter McGuigan, Causeway Hospital, Coleraine Chris Nutt, Antrim Area Hospital, Antrim Chris Gowers, Ulster Hospital Dundonald, Belfast Dominic Trainor, Royal Victoria Hospital, Belfast Rob Mac Sweeney, Royal Victoria Hospital, Belfast Belfast, January 2017 Disclaimer: This book aims to summarise the major critical care trials of 2016. Although care has been taken to ensure information is correct, this is not guaranteed and no responsibility is accepted for clinical decisions based on material within this book. Clinicians are advised to check the primary literature at all times. The opinions stated within this book do not constitute clinical advice. They are opinions, not fact, and others may take a different view of our interpretations of these trials. Please refer to the appropriate clinical guideline issued by the relevant society or scientific body for the management of any specific condition. 4 Foreword There are at least 50,000 randomised controlled trials (RCTs) published each year and the doubling time for the number of RCTs is estimated to be between 7 and 10 years. Although only a small proportion of the trials and research papers published relate to critical care, the volume of new knowledge and data (at least 100 papers per week) far exceeds that which any individual could speed read, far less critically review, assimilate or truly understand. For busy clinicians the challenge of how to remain up to date and how to decide which new studies or trials should change their clinical practice is very real. It is not just the challenge provided by the sheer volume of data but also being honest with one self about whether you have the methodological skills to know whether a particular piece of work, no matter how attractive the results may seem and how strongly they support your pre-existing bias, is robust enough to consider changing your clinical practice. This book, which provides a reference work for the Critical Care Reviews meeting, and which summarizes and critiques the biggest critical care trials of 2016, is an invaluable resource to help with that challenge. Reading this book can’t fail to assist you in treating your patients. Even better is if you are reading this book as one of the attendees at the Critical Care Reviews Meeting held in Belfast in January 2017. The meeting will have given you the opportunity to hear and question the researchers who conducted the studies described in this book. No-one has better insight into the true meaning of a piece of research than those who conducted it and that insight can often illuminate the dry and often unnecessarily complex publication and presentation of research data. Researchers are often accused of overstating the importance and significance of their work and at times this accusation is justified, but an honest researcher will also be able to articulate their study’s weaknesses and the strength or otherwise of the inferences drawn from the results. The Critical Care Reviews Meeting and this book provides a unique opportunity to share in those insights. I commend both the meeting and the book to you. Simon Finfer Professor Simon Finfer MB BS, FRCA, FRCP, FCICM, FAHMS, DrMed Senior Staff Specialist in Intensive Care, Royal North Shore Hospital of Sydney Director of ICU, Sydney Adventist Hospital Professorial Fellow, The George Institute for Global Health Professor, Sydney Medical School, University of Sydney @icuresearch 5 Table of Contents The Best Critical Care Trials of 2016..............................................................................................1 Neuro Trials................................................................................................................................... 2 RESCUEicp................................................................................................................................. 3 HYBERNATUS........................................................................................................................... 9 Dexmedetomidine for Delirium in Non-Cardiac Surgery...............................................16 Light Therapy for Delirium..................................................................................................23 Circulatory Trials........................................................................................................................ 29 ALPS......................................................................................................................................... 30 RINSE....................................................................................................................................... 37 CYRUS...................................................................................................................................... 46 CCC........................................................................................................................................... 54 Respiratory Trials....................................................................................................................... 62 High-Flow Nasal Oxygen vs Facemask Oxygen post-extubation..................................63 High-Flow Nasal Oxygen vs NIV post-extubation............................................................73 OPERA..................................................................................................................................... 82 NIVAS....................................................................................................................................... 91 HELMET NIV......................................................................................................................... 100 LIPS-A.................................................................................................................................... 107 Oxygen-ICU.......................................................................................................................... 115 CLOSE.................................................................................................................................... 122 DIABOLO............................................................................................................................... 130 Rehabilitation in Acute Respiratory Failure....................................................................136 IPHIVAP................................................................................................................................. 145 LUNG SAFE........................................................................................................................... 154 GI & Nutrition Trials.................................................................................................................162 PEPaNIC................................................................................................................................ 163 POP-UP.................................................................................................................................. 171 Renal Trials................................................................................................................................ 177 AKIKI...................................................................................................................................... 178 ELAIN..................................................................................................................................... 186 Haematology Trials..................................................................................................................196 IRONMAN............................................................................................................................. 197 Sepsis Trials............................................................................................................................... 203 SEPSIS 3................................................................................................................................. 204 LeoPARDS............................................................................................................................. 212 VANISH.................................................................................................................................
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