Article
Critical Care Medicine
Maya Dewan, Blaise Soberano, Tina Sosa, Matthew Zackoff, Philip Hagedorn, Patrick W. Brady, Ranjit S. Chima, Erika L. Stalets, Lindsey Moore, Maria Britto, Robert M. Sutton, Vinay Nadkarni, Ken Tegtmeyer, Heather Wolfe
Summary: The study aimed to decrease cardiopulmonary resuscitation events by applying improved situation awareness and demonstrate the sustainability of the process and outcomes. The structured quality improvement initiative included interventions targeting situation awareness such as safety huddles, mitigation signs, smaller pod-based huddles, and a clinical decision support tool.
PEDIATRIC CRITICAL CARE MEDICINE
(2022)
Article
Cardiac & Cardiovascular Systems
Rasmus Meyer Lyngby, Tom Quinn, Roselil Maria Oelrich, Dimitra Nikoletou, Mads Christian Tofte Gregers, Julie Samsoe Kjolbye, Annette Kjaer Ersboll, Fredrik Folke
Summary: This study investigated the association between real-time CPR feedback and CPR quality for out-of-hospital cardiac arrest. The results showed that real-time feedback improved adherence to guideline recommendations for chest compression depth, rate, and fraction. However, it did not significantly improve return of spontaneous circulation or survival to hospital discharge.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2023)
Article
Critical Care Medicine
Timmy Li, Kyle Essex, David Ebert, Brian Levinsky, Charles Gilley, Dee Luo, Eric Alper, Paul Barbara, Daniel M. Rolston, Jonathan Berkowitz, Priam Chakraborty
Summary: The objective of this study was to assess the impact of the Resuscitation Quality Improvement (RQI) HeartCode Complete (R) program on the quality of CPR performed on out-of-hospital cardiac arrest patients. It was found that paramedics trained with the RQI program showed significant improvement in chest compression rate, but no significant improvement in chest compression depth or fraction.
Article
Critical Care Medicine
Deborah Wagner, S. L. Kronick, H. Nawer, J. A. Cranford, S. M. Bradley, R. W. Neumar
Summary: This retrospective cohort study compared the use of amiodarone and lidocaine in adult patients with in-hospital cardiac arrest from VT/VF. The study found that compared to amiodarone, lidocaine therapy was associated with significantly higher rates of ROSC, 24 h survival, survival to hospital discharge, and favorable neurologic outcome.
Article
Public, Environmental & Occupational Health
Theo Walter Jensen, Stig Nikolaj Blomberg, Fredrik Folke, Soren Mikkelsen, Martin Rostgaard-Knudsen, Palle Juelsgaard, Erika Frishknecht Christensen, Christian Torp-Pedersen, Freddy Lippert, Helle Collatz Christensen
Summary: The Danish Cardiac Arrest Registry aims to monitor and evaluate the quality of prehospital cardiac arrest treatment and facilitate research. It records descriptive and qualitative variables related to out-of-hospital cardiac arrest and provides important data for assessing treatment protocols and patient outcomes. The registry is one of the oldest and most comprehensive national clinical registries in Denmark, playing a crucial role in improving the care for patients suffering from out-of-hospital cardiac arrest.
CLINICAL EPIDEMIOLOGY
(2022)
Article
Critical Care Medicine
Stephanie R. Brown, Maria Frazier, Joan Roberts, Heather Wolfe, Ken Tegtmeyer, Robert Sutton, Maya Dewan, PediRES Q Collaborative Investigators
Summary: The aim of this study was to determine the outcomes of pediatric patients who received extracorporeal cardiopulmonary resuscitation (ECPR) after in-hospital cardiac arrest. The study found a high rate of survival to ICU discharge with good neurologic outcome among the patients. No demographic or clinical variables were associated with survival after ECPR.
Article
Critical Care Medicine
Ziad Nehme, Jocasta Ball, Michael Stephenson, Tony Walker, Dion Stub, Karen Smith
Summary: The study revealed that implementing a high-performance CPR resuscitation quality improvement program significantly increased survival rates following OHCA, with a 33% increase in risk-adjusted odds of survival over the 12-month intervention period. The average marginal effect of the intervention resulted in 8.7 additional survivors per million population.
Article
Multidisciplinary Sciences
Jun Nakajima, Yusuke Sawada, Yuta Isshiki, Yumi Ichikawa, Kazunori Fukushima, Yuto Aramaki, Kiyohiro Oshima
Summary: The prehospital administered dosage of epinephrine influences the plasma levels of Ep, but does not contribute to the plasma levels of norepinephrine (Nep), dopamine (DOA) and vasopressin (ADH) in patients with out-of-hospital cardiac arrest (OHCA).
Article
Pharmacology & Pharmacy
Yunke Tan, Kai Yu, Lian Liang, Yuanshan Liu, Fengqing Song, Qiulin Ge, Xiangshao Fang, Tao Yu, Zitong Huang, Longyuan Jiang, Peng Wang
Summary: Empagliflozin, a newly developed antidiabetic drug, positively affects cardiac function in non-diabetic rats with acute myocardial dysfunction after cardiac arrest by reducing glucose levels and promoting ketone body oxidation metabolism. The study found that Empagliflozin can improve cardiac function, reduce myocardial damage, and increase cardiac energy metabolism.
FRONTIERS IN PHARMACOLOGY
(2021)
Letter
Medicine, General & Internal
Olivier C. Manintveld, Stefan Roest, Yannick J. H. J. Taverne
Summary: In the study by Suverein et al., the use of extracorporeal cardiopulmonary resuscitation (CPR) in patients with refractory out-of-hospital cardiac arrest was examined. The results showed similar survival rates with a favorable neurologic outcome between extracorporeal CPR and conventional CPR. This raises questions about the role of extracorporeal CPR as an adjunct to conventional CPR.
NEW ENGLAND JOURNAL OF MEDICINE
(2023)
Article
Medicine, General & Internal
Tomoaki Hashida, Nanami Hata, Akiko Higashi, Yoshito Oka, Shunsuke Otani, Eizo Watanabe
Summary: REBOA is used to treat hemorrhagic shock, but its use in patients with gastrointestinal hemorrhage is relatively rare. Appropriate patient selection and early use may improve survival in patients with upper gastrointestinal hemorrhage.
FRONTIERS IN MEDICINE
(2021)
Article
Cardiac & Cardiovascular Systems
Sebastian Wolfrum, Kevin Roedl, Alexia Hanebutte, Rudiger Pfeifer, Volkhard Kurowski, Reimer Riessen, Anne Daubmann, Stephan Braune, Gerold Soffker, Eric Bibiza-Freiwald, Karl Wegscheider, Heribert Schunkert, Holger Thiele, Stefan Kluge
Summary: This study found that hypothermic temperature control after IHCA did not improve survival nor functional outcome. The study may have been underpowered to detect clinically important differences between hypothermic temperature control and normothermia.
Article
Medicine, General & Internal
Francesco Corazza, Marta Arpone, Giacomo Tardini, Valentina Stritoni, Giulia Mormando, Alessandro Graziano, Paolo Navalesi, Elena Fiorese, Sofia Portalone, Marco De Luca, Marco Binotti, Luca Tortorolo, Serena Salvadei, Alessia Nucci, Alice Monzani, Giulia Genoni, Marco Bazo, Adam Cheng, Anna Chiara Frigo, Liviana Da Dalt, Silvia Bressan
Summary: This study developed an interactive tablet application, PediAppRREST, to reduce deviations from international resuscitation guidelines in the management of pediatric cardiac arrest. The effectiveness of PediAppRREST in improving the management of simulated in-hospital pediatric cardiac arrest was assessed. The use of PediAppRREST resulted in fewer deviations from guidelines and improved team clinical performance.
Article
Cardiac & Cardiovascular Systems
Richard Chocron, Julia Jobe, Sally Guan, Madeleine Kim, Mia Shigemura, Carol Fahrenbruch, Thomas Rea
Summary: The study evaluated bystander CPR quality in non-traumatic out-of-hospital cardiac arrest cases in a large metropolitan emergency medical system. The compression fraction and rate approached guideline goals, but performance varied based on the type of CPR and the number of bystanders.
JOURNAL OF THE AMERICAN HEART ASSOCIATION
(2021)
Review
Medicine, General & Internal
Wachira Wongtanasarasin, Karan Srisurapanont, Daniel K. Nishijima
Summary: Current guidelines recommend administering 1 mg of epinephrine every 3-5 min for cardiac arrest treatment. This study aimed to investigate the impact of different epinephrine administration intervals on resuscitation outcomes in adult patients. Three high-quality studies were included in the systematic review. The results showed that the administration interval of epinephrine during CPR was not associated with better hospital outcomes.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Respiratory System
Mark Griffiths, Susanna Meade, Charlotte Summers, Daniel Francis McAuley, Alastair Proudfoot, Marta Montero Baladia, Paul M. Dark, Kate Diomede, Simon J. Finney, Lui G. Forni, Chris Meadows, Ian A. Naldrett, Brijesh Patel, Gavin D. Perkins, Mark A. Samaan, Laurence Sharifi, Ganesh Suntharalingam, Nicholas T. Tarmey, Harriet F. Young, Matt P. Wise, Peter M. Irving
Summary: COVID-19 has become a common cause of ARDS worldwide, with pathophysiological and clinical features that distinguish it from traditional ARDS. An expert panel recommended adherence to evidence-based supportive strategies for managing ARDS, regardless of the presence or absence of COVID-19. For patients with ARDS and COVID-19, routine corticosteroid treatment and a lower threshold for full anticoagulation are recommended based on suspicion for venous thromboembolic disease.
Article
Biology
Nigel Stallard
Summary: This article introduces a popular design for clinical trials, the two-stage adaptive enrichment design, and proposes two methods to control the statistical challenges in subgroup selection. The methods are illustrated using survival data from a breast cancer trial.
Article
Economics
Daniel Gallacher, Nigel Stallard, Peter Kimani, Elvan Gokalp, Juergen Branke
Summary: Advancements in medical technology have led to the development of targeted medicines, but also increased costs for pharmaceutical manufacturers. Healthcare providers prefer the development of stratified drugs, a preference shared by pharmaceutical manufacturers with some areas of disagreement. Aligning preferences through rewards or penalties depends on the true value of health to the healthcare provider among other factors.
Editorial Material
Biology
Nigel Stallard
Article
Medicine, General & Internal
Karin Eli, Claire Hawkes, Gavin D. Perkins, Anne-Marie Slowther, Frances Griffiths
Summary: This study aims to understand the reasons behind clinicians' deferral and avoidance of ECTP conversations, and how they rationalize these decisions. The findings suggest that barriers to ECTP conversations are driven by concerns over caring well, timing and time constraints, and the high-turnover ward environment. Overcoming these barriers requires promoting good conversational practices that consider the affordances of hospital time and space.
Article
Nursing
Jane Ball, Sydney Anstee, Keith Couper, Jill Maben, Holly Blake, Janet E. Anderson, Daniel Kelly, Ruth Harris, Anna Conolly
Summary: This study analyzed nurses' responses to a survey on what could have improved their working lives during the first wave of the COVID-19 pandemic in the UK. The results identified key areas for improvement, including the provision of personal protective equipment, support for the workforce, and better communication. The findings highlight the importance of addressing these issues to ensure the safety and well-being of nurses and to prevent negative long-term impacts on their retention.
JOURNAL OF ADVANCED NURSING
(2023)
Article
Pharmacology & Pharmacy
Stella Jinran Zhan, Cornelia Ursula Kunz, Nigel Stallard
Summary: This article discusses the standard requirement of two pivotal trials for drug approval and the limitations of the two-trial paradigm. It suggests alternative approaches and compares the two paradigms in terms of error protection and power. The results show that a single trial provides better error protection and power in the same population, but may not always prevent errors in different populations.
PHARMACEUTICAL STATISTICS
(2023)
Article
Medicine, Research & Experimental
Richard A. A. Parker, Christopher J. J. Weir, Tra My Pham, Ian R. R. White, Nigel Stallard, Mahesh K. B. Parmar, Robert J. J. Swingler, Rachel S. S. Dakin, Suvankar Pal, Siddharthan Chandran
Summary: MND-SMART is a multi-arm, multi-stage, multi-centre randomized controlled trial for motor neuron disease. It compares the efficacy of memantine and trazodone with placebo, and may introduce other investigational treatments later. The co-primary outcomes are ALS-FRS-R functional outcome and overall survival. The trial randomizes participants 1:1:1 to receive placebo or one of the investigational treatments, with a maximum of 531 participants. Comparisons will be conducted in four stages, with the opportunity to stop randomizations to poorly performing arms. The final analysis will be based on a statistical analysis plan finalized in May 2022.
Article
Medicine, Research & Experimental
Ya Lv, Deming Chen, Xinyi Tian, Ji Xiao, Congcong Xu, Linan Du, Jiacong Li, Siyu Zhou, Yuxiang Chen, Rong Zhuang, Yuqiang Gong, Binyu Ying, Fang Gao-Smith, Shengwei Jin, Ye Gao
Summary: This study suggests that PCTR1 suppresses LPS-induced ferroptosis via the ALX/PKA/CREB signaling pathway, which may offer promising therapeutic prospects in sepsis-related ALI.
JOURNAL OF TRANSLATIONAL MEDICINE
(2023)
Article
Multidisciplinary Sciences
Vanisha Patel, Antje Lindenmeyer, Fang Gao, Joyce Yeung
Summary: This study explores the lived experiences of frail patients who have undergone hip fracture surgery and identifies important themes. The findings suggest that providing ongoing physical and psychological support, information and education, as well as a robust pathway for transition of care into the community, can improve the opportunities for frailer patients to find a new routine to their everyday lives.
Article
Health Care Sciences & Services
Benjamin Duputel, Nigel Stallard, Francois Montestruc, Sarah Zohar, Moreno Ursino
Summary: Master protocol designs allow for simultaneous comparison of multiple treatments or disease subgroups. They can be designed as seamless studies, either operationally or inferentially seamless. Bayesian operationally seamless Phase II/III designs using a binary endpoint for the first stage and a time-to-event endpoint for the second stage are proposed and compared. Simulation studies show that Bayesian operationally seamless designs approach the inferentially seamless counterpart and have increased simulated power compared to operationally frequentist designs.
STATISTICAL METHODS IN MEDICAL RESEARCH
(2023)
Article
Mathematical & Computational Biology
Silvia Calderazzo, Sergey Tarima, Carissa Reid, Nancy Flournoy, Tim Friede, Nancy Geller, James Rosenberger, Nigel Stallard, Moreno Ursino, Marc Vandemeulebroecke, Kelly Van Lancker, Sarah Zohar
Summary: Clinical trials disruption is a significant issue in ending interventional studies. The COVID-19 pandemic has not only led to a surge in clinical research, but also a substantial disruption in non-COVID-19 trials, with about 80% being stopped or interrupted. This paper presents methods to compensate for the loss of information caused by trial disruptions by incorporating additional information from auxiliary data sources. These methods include using auxiliary data from the trial itself and incorporating information from external data sources using frequentist and Bayesian approaches. The methods are demonstrated using artificial data based on a clinical trial affected by the COVID-19 pandemic.
STATISTICS IN BIOPHARMACEUTICAL RESEARCH
(2023)
Article
Health Care Sciences & Services
Yaqza Hussain, Ayman Bannaga, Neil Fisher, Ashwin Krishnamoorthy, Peter Kimani, Ahmad Malik, Maria Truslove, Shivam Joshi, Megan Hitchins, Abdullah Abbasi, Christopher Corbett, Matthew Brookes, Harpal Randeva, Nwe Ni Than, Ramesh P. Arasaradnam
Summary: The TENDENCY study aims to validate novel screening markers for HCC diagnosis and explore noninvasive biomarkers in liver disease. The use of more sensitive plasma and urinary biomarkers in clinical practice will improve early detection of HCC and overall outcomes.
JMIR RESEARCH PROTOCOLS
(2023)
Editorial Material
Critical Care Medicine
Keith Couper, Siobhan Masterson, Ziad Nehme
RESUSCITATION PLUS
(2023)
Article
Medicine, Research & Experimental
Ben Shelley, Andreas Goebel, Stephen Grant, Louise Jackson, Hugh Jarrett, Marcus Jepson, Amy Kerr, Nandor Marczin, Rajnikant Mehta, Teresa Melody, Lee Middleton, Babu Naidu, Lajos Szentgyorgyi, Sarah Tearne, Ben Watkins, Matthew Wilson, Andrew Worrall, Joyce Yeung, Fang Gao Smith
Summary: This trial compares the clinical and cost-effectiveness of two commonly used modes of acute analgesia provision during thoracotomy in preventing chronic post-surgical pain.