View clinical trials related to Critical Illness.
Filter by:The purpose of this pilot study is to improve inpatient monitoring of severely-ill children admitted to the hospital in low resource settings at Kenyatta National Hospital in Nairobi, Kenya. Given the high ratio of patients to medical staff in these settings, the lack of reliable patient monitoring tools, and the high rate of early inpatient mortality, we will prospectively train parents as monitoring aids of their hospitalized children. Early recognition and intervention in critical illness is important to avoid (further) organ failure. Parents will be taught how to assess their child's mental status, work of breathing and capillary refill time which will inform a 3-point severity of illness scale. The severity of illness will be conveyed by the parents to the medical staff via color-coded flag system. The goal is to increase the healthcare provider patient reassessment rate according to patients' level of severity to assist in early recognition and treatment of patients' deterioration.
RADAR-2 will be a randomised, open-label, allocation concealed, pilot trial of conservative fluid administration and deresuscitation compared with usual care in patients who are critically ill.
An open label, non-randomized, monocentric, interventional investigation in a cohort of adult critically ill patients
Hemophagocytic lymphohistiocytosis in adults (HLH) is at 68% mortality whereas 78% of all cases remain undiagnosed though therapies are available which clearly reduce mortality. The investigators aim to systematically investigate this life-threatening hyperinflammatory syndrome in intensive care units (ICU) in order to detect biomarkers that are highly sensitive and highly specific for HLH in ICU compared to patients with sepsis.
The quality of palliative care is highly variable for many patients treated in intensive care units (ICUs) and their family members. To address these challenges, the investigators will test the impact of a mobile app designed to help families navigate ICU-based palliative care vs. usual care. The investigators hypothesize that the intervention will reduce patient/family member unmet palliative care needs and improve the quality of clinical-family communication in racially/ethnically diverse populations.
Procalcitonin is a promising marker of sepsis in critically ill patients. Procalcitonin have better diagnostic accuracy compared to White blood cell count and C - reactive protein. Investigators propose that adding Procalcitonin to the list of standard laboratory work up of critically ill patients with suspected sepsis could increase diagnostic accuracy leading to better patient care.
Stress induced by pain and anxiety is common in pediatric intensive care unit (PICU) patients and can impede the delivery of care as well as their recovery. Sedation/analgesia in PICU is usually achieved using narcotics and benzodiazepines. Excessive use of these drugs can put patients at risk for hemodynamic and respiratory instability, prolonged mechanical ventilation, withdrawal symptoms, and delirium. Non-pharmacologic measures for analgesia and anxiolysis may reduce the total medication requirement and their side effects. The use of non-pharmacologic interventions, including music, has been recommended by sedation guidelines for critically ill patients; however, it is not clear how these interventions should be provided. We plan to conduct a pilot 3-arm RCT to determine the feasibility of a music intervention and assess its effects on sedation/analgesia requirements in children admitted to PICU. Children will be randomly assigned to receive music, noise cancellation or control. Music will be delivered by headphones and an iPod. Music will consist on classical music selected by the study's pediatric music therapist. The noise cancellation group will receive the same headphones but without music. Clinical care of the participants, including use of sedation and analgesia drugs, will not be protocolized. Primary outcomes of this pilot trial is feasibility. Secondary outcomes are drug requirements for sedation and analgesia, and incidence of delirium. These requirements will be captured as a daily intensity score and intermittent dose (PRN) frequency. Mixed-effects models will be used to analyze the effect of the music on sedation/analgesia requirements.
Sedation is one of the most common practices applied in intensive care units (ICU) and the management of sedation, analgesia and delirium is a quality measure in ICUs. Several intensive care societies published guidelines regarding the use of sedatives and analgesics recently. In literature there are many survey studies investigating practices of sedation in ICUs of different countries, but knowledge of the sedation practices of intensive care physicians in Turkey is lacking. The aim of this study was to provide a baseline knowledge on this matter and to establish some points to be improved. An electronic survey form, consisting of 34 questions was generated with google forms, posted to 1700 email addresses and 429 returned (25%). The survey included questions about demographics and choices and routines of sedation, analgesia, neuromuscular blockers and delirium administration. Ninety-six percent of the respondents indicated that they practiced sedation in their ICUs and mechanical ventilation was checked as the primary indication (94%). On the question regarding drug choices for sedation, midazolam was the most preferred agent (90%). About pain questions, the most used evaluation tool was visual analogue scale (69.0%) and 83% of the respondents preferred to use tramadol for pain, followed by paracetamol (81.6%). Of the participants, 50.5% indicated that they routinely evaluated delirium and 56% of them used confussion assessment method for ICU. The awareness of 2013 American College of Critical Care Medicine (ACCM) guideline for the management of pain, agitation, and delirium was only 38%. The results of this survey have indicated some areas to be improved, such as low incidence of written sedation protocols, frequent use of benzodiazepines, and delirium screening. A national guideline should be prepared taking pain, agitation, and delirium in focus.
In this study, we will explore the feasibility of a randomized controlled trial that will compare high protein dose from ICU day 6 to 14 with moderate protein intake.
Objective: Test the ability of vibration to produce physiologic, biochemical, and anatomic changes consistent with exercise that would help prevent the development of muscle weakness that occurs when patients are immobile for long periods of time.