Clinical Research Directory

Canadian Critical Care Comparative Effectiveness Platform

The Canadian Critical Care Comparative Effectiveness Platform(e) d'Évaluation Clinique Comparée en soins Critiques (CEPEC) is an international multi-centered randomized adaptive platform clinical trial. CEPEC will evaluate supportive care interventions that are used routinely in intensive care units throughout the world.

Virtual Reality Use for ICU Mobility

The purpose of this study is to explore if Virtual Reality (VR) helps patients in the Intensive Care Unit (ICU) move more and feel better.

Using a Hypotension Prediction Index to Prevent Low Blood Pressure During Dialysis in ICU Patients

This single-center, crossover randomized controlled trial (HyPIR-ICU) investigates whether a Hypotension Prediction Index (HPI)-guided management strategy can reduce intradialytic hypotension (IDH) during prolonged intermittent renal replacement therapy (PIRRT) in critically ill patients. All participants must have an indwelling arterial catheter for continuous hemodynamic monitoring.

Acute Kidney Injury - Epidemiology in Intensive Care Unit Patients 2: an International Multicenter Cohort Study

The goal of this observational study is to learn the epidemiology and outcomes of acute kidney injury in critically ill adult patients admited to the intensive care unit (ICU). The main questions it aims to answer are:To provide a contemporary update on the epidemiology (rates, severity, duration, and etiology) of acute kidney injury and associated outcomes in critically ill patients. The co-primary outcomes are: * occurrence rate of acute kidney injury within 7 days of ICU admission * maximum severity of acute kidney injury within 7 days of ICU admission. Secondary outcomes: * Proportion of acute kidney injury in patients with and without known baseline serum creatinine * Duration of acute kidney injury episodes (within first week of ICU admission) * Proportion of episodes with rapid reversal (duration \<48h) versus persistent acute kidney injury (duration ≥48h) * Incidence of acute kidney disease at ICU discharge and hospital discharge, truncated at 90-d * Use of Renal Replacement Therapy within 7 days of ICU admission * Type and specifics of applied Renal Replacement Therapy (indications, timing, modality, method duration, anticoagulation, discontinuation) * ICU lenght of stay (ICU LOS), Hospital lenght of stay (Hospital LOS) * ICU readmission up to day 90 * Hospital readmission up to day 90 * Serum creatinine level at ICU and hospital discharge (truncated at day 90) * RRT dependence at hospital discharge (any RRT applied within 72 hours of discharge) * Mortality at hospital discharge (truncated at 90-d) * Magnitude of acute kidney injury: area under the curve of acute kidney injury severity over time * Incidence of acute kidney injury and maximum acute kidney injury severity stage defined by serum creatinine and/or urine output criteria only, within 7 days of ICU admission. Additional endpoints for patients included in the "long term outcomes substudy": * Serum creatinine level at day 90, and 1 y * Renal Replacement Therapy dependence at day 90, and 1y * Mortality at hospital discharge at day 90, and 1y * Survival analysis up to day 90 and 1 y * Health-related quality of life at day 90 and 1y * Major Adverse Kidney Events (MAKE): a composite endpoint of death, use of Renal Replacement Therapy and decreased kidney function at day 90, and 1 year.

The Effects of Endotracheal Suctioning on Pain and Serum Markers

The goal of this experimental study is to understand if endotracheal tube (ETT) suctioning increases pain and causes stress on the body in intubated adult ICU patients. These patients are already on ventilators, which means they need suctioning to keep their airways clear, but this procedure may be uncomfortable and cause stress. The main questions this study aims to answer are: Does ETT suctioning raise pain levels as measured by the Critical-Care Pain Observation Tool (CPOT)? Does ETT suctioning increase certain chemicals in the blood (hypoxanthine, xanthine, and uric acid) that show stress and lack of oxygen in the body? Researchers will compare patients who have ETT suctioning (intervention group) with those who do not have suctioning during the study period (control group) to see if there are differences in pain and blood markers of stress. Participants will: Have pain measured before and after suctioning using the CPOT. Have blood samples taken from an existing line at three time points: 5 minutes before, 5 minutes after, and 30 minutes after suctioning. Provide demographic information (like age, gender, and diagnosis) from medical records. This research will help improve how pain is managed for ICU patients who cannot speak for themselves, potentially leading to better pain relief methods in the future.

Expectations and Experiences With Virtual Reality Training Among ICU Physicians and Nurses

The goal of this observational study is to describe the expectations and experiences with virtual reality in physicians and nurses working in the European ICUs. The main questions it aims to answer are: What emotions and worries does the expected training with virtual reality evoke? What are the potential factors causing negative emotions and fear from expected training? What is the institutional approach to the online training approach regarding participation in working hours and covering the costs? How does the experience of training using virtual reality spread among the population of ICU physicians and nurses? Participants will fill out an electronic survey.

Ventilatory Settings and Monitoring Variables Associated With Weaning Failure in Critically Ill Patients

Mechanical ventilation (MV) is essential in managing acute respiratory failure. Its duration is a crucial aspect since both, unnecessary prolongation and premature withdrawal have deleterious effects on patient outcomes in the ICU. The process of weaning refers to the set of procedures and evaluations carried out to discontinue MV. Regardless of the definition used, within the population undergoing weaning, there is a group of patients who successfully pass the daily screening but fail the spontaneous breathing trial (SBT) or the separate attempt (SA). In Argentina, this figure is 39.5%, and 31.4% in patients with COVID-19. On the other hand, another group of patients successfully passes the SA, is extubated, but fails in post-extubation. This failure rate varies in the literature, ranging from approximately 10 to 20%. In our country, this figure is 16% in the general population and rises to 29.7% in COVID-19 patients. Additionally, this population is divided into those who cannot tolerate ventilation without an artificial airway due to upper airway patency issues (such as laryngeal edema), i.e., "airway failure," and those who experience acute respiratory failure. In 2023, the WEAN SAFE study reported novel findings regarding variables associated with weaning failure. In multivariable analysis, it was found that the MV settings and monitoring variables at the time of the first SBT - respiratory rate, positive end-expiratory pressure (PEEP), dynamic airway pressure difference (peak pressure (Ppeak) minus PEEP) on the day of the SA - were associated with weaning failure. In this context, the investigators will conduct a retrospective cohort study, whose primary objective will be to assess which MV settings and monitoring variables are associated with weaning failure. \*\*Primary Objective\*\* To determine if there are any MV settings or monitoring variables that are associated with extubation failure. \*\*Secondary Objective\*\* To determine if there are any MV settings or monitoring variables that are associated with failure in the first SBT.