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AVERT-Shock: Does Low Dose Vasopressin Reduce Need for Blood Products in Trauma

Study Design Summary: Double-blind, placebo controlled single center trial of 100 hemorrhagic shock patients comparing vasopressin vs placebo with a primary outcome of blood product transfusion requirements. Notes: Significant amounts of vasopressin are released during acute hemorrhage and stores diminish with time. Low levels are associated with catecholamine resistant hypotension and increased venous capacitance. TraumaContinue reading “AVERT-Shock: Does Low Dose Vasopressin Reduce Need for Blood Products in Trauma”

RELAx: Is Lower or Higher PEEP Better in Patients Without ARDS

Study Design Summary: Multicenter, randomized, open label, noninferiority trial of 980 patients without ARDS comparing low vs high PEEP with a primary outcome being number of ventilator free days at day 28. Notes: Patients included were those who did not have ARDS, were intubated less than 12 hours prior to randomization and not expected toContinue reading “RELAx: Is Lower or Higher PEEP Better in Patients Without ARDS”

Syncope vs Near Syncope 30 Day Serious Adverse Events

Study Design Summary: Multicenter, observational study of 3,500 adults ≥60 years old presenting to ED with syncope or presyncope. Primary outcome was rate of serious adverse events at 30 days compared between the syncope vs near syncope group. Notes: The goal of the study was to determine if patients presenting with near syncope had similarContinue reading “Syncope vs Near Syncope 30 Day Serious Adverse Events”

Is There Benefit to Hospitalization of Older Adults with Unexplained Syncope/Presyncope

Study Design Summary: Multicenter, observational study of hospitalization versus discharge on 3,000 adults ≥60 years old with no serious diagnosis found during index ED visit. Primary outcome was rate of post-ED serious adverse events. Notes: Patients were included if ≥60 years old, presenting with either syncope or presyncope. Patients were excluded if symptoms caused byContinue reading “Is There Benefit to Hospitalization of Older Adults with Unexplained Syncope/Presyncope”

NoPAC: Does Topical TXA Reduce Need for Anterior Nasal Packing in Spontaneous Epistaxis

Study Design Summary: Double-blind, placebo controlled, multicenter randomized control trial of 496 patients with spontaneous epistaxis that was persistent despite external pressure and topical vasoconstrictors, then randomized to either topical TXA or placebo. The primary outcome was the need for anterior nasal packing. Notes: The study included patients who presented with spontaneous, non traumatic epistaxis.Continue reading “NoPAC: Does Topical TXA Reduce Need for Anterior Nasal Packing in Spontaneous Epistaxis”

COVID-19 Vaccine Pfizer

Study Design Summary: Multinational, placebo controlled trial of 43,448 patient’s who received either a 2 dose COVID-19 vaccine 21 days apart or placebo, with primary outcomes being safety and efficacy against lab confirmed COVID-19 infections. Notes: The placebo and intervention arm were well balanced in their patient demographics, however, 83% of participants were white andContinue reading “COVID-19 Vaccine Pfizer”

SMART: Does Balanced Crystalloid Reduce Major Adverse Kidney Event Rate

Study Design Summary: Single center study of 15,802 ICU patients treated with either saline or balanced crystalloid, with a primary outcome of major adverse kidney event at 30 days or hospital discharge, whichever came first. Notes: The intervention group (balanced crystalloid) vs saline group were very well balanced in their baseline characteristics. The primary outcomeContinue reading “SMART: Does Balanced Crystalloid Reduce Major Adverse Kidney Event Rate”

ICU-ROX: Does Conservative Oxygen Therapy in the ICU Increase Ventilator Free Days

Study Design Summary: Randomized trial of 1,000 patients of patients with less than 2 hours of invasive or noninvasive mechanical ventilation. Separated into 2 groups of conservative vs usual oxygen therapy groups. Primary outcome was ventilator free days, secondary outcomes included death at 90 and 180 days as well as others. Notes: There were manyContinue reading “ICU-ROX: Does Conservative Oxygen Therapy in the ICU Increase Ventilator Free Days”

MOPETT: Does Low Dose tPA for Pulmonary Embolism Reduce Pulmonary Hypertension

Study Design Summary: Prospective, single center, unblinded study of 121 patients with a predefined “moderate” pulmonary embolism were given either half dose tPA with anticoagulation or only anticoagulation. Primary outcome was pulmonary hypertension at 28 months and a composite of pulmonary hypertension and recurrent PE at 28 months. Notes: The study predefined a “moderate” PEContinue reading “MOPETT: Does Low Dose tPA for Pulmonary Embolism Reduce Pulmonary Hypertension”

SALT-ED: Does Balanced Crystalloid Reduce Time to Hospital Discharge Compared to Saline

Study Design Summary: Single center study of 13,347 non-critically ill patients treated with either balanced crystalloid or saline in the emergency department, with a primary outcome of hospital free days. Notes: The two groups of saline vs balanced crystalloid (lactated ringers or plasma-lyte A) were balanced in their baseline characteristics including baseline serum Cr andContinue reading “SALT-ED: Does Balanced Crystalloid Reduce Time to Hospital Discharge Compared to Saline”

ADRENAL: Does Hydrocortisone Reduce Mortality in Septic Shock

Study Design Summary: Multicenter, double-blind trial of 2658 patients with septic shock randomized to either hydrocortisone or placebo for 7 days, with primary outcome all cause mortality at 90 days. Notes: Patients were fairly similar in their baseline characteristics, there was slightly more epinephrine used in the hydrocortisone group, more patients in the control groupContinue reading “ADRENAL: Does Hydrocortisone Reduce Mortality in Septic Shock”

SAFE: Does Resuscitation with Albumin Confer a Mortality Benefit Over Saline

Study Design Summary: Multicenter, double-blind trial of 6,997 ICU patients to receive 4% albumin or saline as choice of resuscitation fluid while in the ICU, with primary outcome as all cause mortality at 28 days. Notes: The study intervention was specifically resuscitation fluid, patients were placed on the physicians’ choice of maintenance fluids. The authorsContinue reading “SAFE: Does Resuscitation with Albumin Confer a Mortality Benefit Over Saline”