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Angriman, Federico, Muttalib, Fiona, Lamontagne, François, Adhikari, Neill K. J., Chassé, Michaël, Aslanian, Pierre, Bélisle, Sylvain, Cailhier, Jean-François, Martin Carrier, François, Charbonney, Emmanuel, Denault, André, Girard, Martin, Guimond, Jean-Gilles, Halwagi, Antoine, Hébert, Paul, Kolan, Christophe, Ouellet, Caroline, Robillard, Nicholas, Benettaib, Fatna, Boumahni, Dounia, Lebrasseur, Martine, Salamé, Maya, Cantin, Marie-Ève, Archambault, Patrick, Drouin, Christine, Duquet-Deblois, Estel, Noël-Hunter, Monia, Dubé, Jean-Nicolas, Bériault, Marie-Josée, Chacon, Marco, Claveau, David, Naud, Jean-François, Rodrigue, Élise, Tapss, Danielle, Toupin, Guylaine, Ting Wang, Han, Brosseau, Marc, Laufer, Brian, Marquis, François, Toupin, Francis, Tassy, Danaë, Cheung, Vincent, Toun, Sam-Ang, Lamontagne, François, D’Aragon, Frédérick, Bérard, Dominique, Grondin-Beaudoin, Brian, Leclair, Marc-André, Lesur, Olivier, Mayette, Michaël, Poulin, Yannick, Quiroz Martinez, Hector, St-Arnaud, Charles, Carbonneau, Elaine, Bélisle, Julie, Bouchard, Marie-Pier, Côté, Line, Ladouceur, Marylène, Marchand, Joannie, Naisby, Alexandra, Robert-Petit, Louise, Thibault, Marie-Ève, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Williams, Virginie, Lainer Palacios, Julia, Lauzier, François, Francoeur, Charles, Leblanc, Guillaume, St-Onge, Maude, Turgeon, Alexis, Bellemare, David, Boulanger, Marie-Claude, Cloutier, Eve, Guilbault, Gabrielle, Thibeault, Frédérique, Belley-Côté, Emilie, Fox-Robichaud, Alison, Meade, Maureen, Whitlock, Richard, Hand, Lori, Hayward, Leah, Mullen, Courtney, Savija, Nevena, Lellouche, François, Simon, Mathieu, Tung Sia, Ying, Lizotte, Patricia, Rochwerg, Bram, Millen, Tina, Maslove, David, Gordon Boyd, J., Drover, John, Muscedere, John, Sibley, Stephanie, Boyd, Tracy, Hunt, Miranda, Mele, Tina, Bentall, Tracey, ElKhatib, Chadia, Shahin, Jason, Khwaja, Kosar, Campisi, Josie, Alam, Norine, Rahgoshai, Raham, Mehta, Sangeeta, Detsky, Michael, Shah, Sumesh, Kohli, Sonny, Cui, Fulan, Khera, Vikas, McConachie, David, Rehsia, Sachdeep, Bharti, Dalisha, Perez, Adic, James Kutsogiannis, Demetrios, Chowdhury, Raiyan, Davidow, Jon, Johnston, Curtis, Kim, Michael, Macala, Kimberley, Marcushamer, Sam, Markland, Darren, Matheson, Doug, Parker, Arabesque, Paton-Gay, Damian, Hewer, Tayne, Thompson, Patrica, Cook, Deborah, Al-Hazzani, Waleed, Duan, Erick, Ligori, Tania, Soth, Mark, Clarke, France, Copland, Mary, Matic, Karlo, Adhikari, Neill KJ, Amaral, Andre, Cuthbertson, Brian H, Fowler, Robert A, Piquette, Dominique, Scales, Damon C, Tillmann, Bourke, Wunsch, Hannah, Marinoff, Nicole, Kamra, Maneesha, Kaur, Navjot, Murali, Deeptha, Sabananthan, Thivya, Sugumaran, Thuva, Seely, Andrew, English, Shane, Meggison, Hilary, Microys, Sherissa, Millington, Scott, Sarti, Aimee, Haines, Jessica, Miezitis, Sydney, Porteous, Rebecca, Watpool, Irene, Del Sorbo, Lorenzo, Fan, Eddy, Granton, John, Abdelhady, Hesham, Romagnuolo, Tina, Rewa, Oleksa, Bagshaw, Sean, Meier, Michael, Sligl, Wendy, Baig, Nadia, Wood, Gordon, Ovakim, Daniel, Auld, Fiona, Carney, Gayle, Parfett, Deborah, Leblanc, Rémi, Poirier, Matthieu, Theriault, Theophile, Williston, Maryse, Caissie Collette, Jackie, Carriere, Melanie, Daigle, Melissa, Gaudet, Bernise, Morin, Karine, Ouellette-Bernier, Lola, Poitras, Julie, Robichaud, Melanie, Rockburn, Joanne, Mekontso Dessap, Armand, Arrestier, Romain, Bagate, François, Bendib, Ines, Benelli, Brice, Berti, Enora, Bertier, Astrid, Cavaleiro, Pedro, de Prost, Nicolas, Gendreau, Segolene, Hartman, Otto, Haudebourg, Anne-Fleur, Lopinto, Julien, Masi, Paul, Michaud, Gaël, Razazi, Keyvan, Tuffet, Samuel, Alves, Aline, Nait Chabane, Luiza, Ouali, Fariza, Ouedraogo, Rachida, Annane, Djillali, Abdeladim, Lilia, Bounab, Rania, Heming, Nicholas, Maxime, Virginie, Moine, Pierre, Bossard, Isabelle, Jourdier, Segolene, Mahiou, Siline, Tessa, Hayette, McGuinness, Shay, Ball, Jonathan, Hennessy, Immanuel, Hogan, Maurice, Butler, Magdalena, Cowdrey, Keri-Anne, Gilder, Eileen, Parke, Rachael, Ryan, Samantha, Woollett, Melissa, Van Der Poll, Andrew, Benson-Cooper, Kerry, Chen, Jonathan, Freeman, Kirk, Harley, David, Harvey, Dave, Hourigan, Craig, Julian, Kylie, Lo, Stephen, McArthur, Colin, Miller, Stuart, Pointer, Chris, Anthony Smith, Rex, Tincknell, Laura, McConnochie, Rachael, Simmonds, Catherine, Shaw, Geoffrey, Betteridge, Toby, Burke, Brandon, Closey, David, Crombie, Rosalind, Davidson, Neil, Henderson, Louise, Henderson, Seton, Hitchings, Louise, Knight, David, Quigley, Christine, Ritzema Carter, Jay, Roberts, Jessica, Townend, Katherine, Doyle, Tara, Mehrtens, Jan, Morgan, Stacey, Morris, Anna, Van Der Heyden, Kymbalee, Twardowski, Pawel, Dvoracek, Martin, Renner, Markus, Silverman, David, Smith, Myles, Monica Stephens, Katherine, Albert Waibel, Hansjörg, Wiebe, Stefan, Woolley, Mark, Eden, Amie, France, Dawn, Buehner, Ulrike, Erin Williams, Katallah Kramer, Browne, Troy, Callender, Owen, Chen, Jonathan, Farrell, Susanne, Higson, Vicky, Jackson, David, Keet, Owen, Goodson, Jennifer, Martynoga, Robert, Byrne, Kelly, Butler, Amelia, Trask, Kara, Mans, Gay, Termaat, Jonathan, Young, Paul, Barnes, Colin, Barry, Ben, Grayson, Kim, Moore, James, Psirides, Alex, Sturland, Shawn, Tietjens, Kate, Ure, Bob, Walker, Laurence, Wright, Jason, Aguilar-Dano, April, Delaney, Kirsha, Lawrence, Cassie, Lesona, Mildred, Millington, Alexandra, Navarra, Leanlove, Olatunji, Shaanti, Sol Cruz, Raulle, Sol Cruz, Rhoze, Young, Chelsea, Day, Andrew, Cook, Deborah J, Guyatt, Gordon H, Sprague, Sheila, Cohen, Dian, Heyland, Daren K, Lamontagne, François, Masse, Marie-Hélène, Ménard, Julie, Adhikari, Neill KJ, Pinto, Ruxandra, Kanji, Salmaan, Battista, Marie-Claude, Annane, Djillali, Tirupakuzhi Vijayaraghavan, Bharath Kumar, McGuinness, Shay, Parke, Rachael, and Arabi, Yaseen

Published
2023
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7. Effects of remdesivir in patients hospitalised with COVID-19: a systematic review and individual patient data meta-analysis of randomised controlled trials

Author

Amstutz, Alain, Speich, Benjamin, Mentré, France, Rueegg, Corina Silvia, Belhadi, Drifa, Assoumou, Lambert, Burdet, Charles, Murthy, Srinivas, Dodd, Lori Elizabeth, Wang, Yeming, Tikkinen, Kari A O, Ader, Florence, Hites, Maya, Bouscambert, Maude, Trabaud, Mary Anne, Fralick, Mike, Lee, Todd C, Pinto, Ruxandra, Barratt-Due, Andreas, Lund-Johansen, Fridtjof, Müller, Fredrik, Nevalainen, Olli P O, Cao, Bin, Bonnett, Tyler, Griessbach, Alexandra, Taji Heravi, Ala, Schönenberger, Christof, Janiaud, Perrine, Werlen, Laura, Aghlmandi, Soheila, Schandelmaier, Stefan, Yazdanpanah, Yazdan, Costagliola, Dominique, Olsen, Inge Christoffer, and Briel, Matthias

Published
2023
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8. IV Vitamin C in Adults With Sepsis: A Bayesian Reanalysis of a Randomized Controlled Trial*

Author

Angriman, Federico, Muttalib, Fiona, Lamontagne, François, Adhikari, Neill K. J., Chassé, Michaël, Aslanian, Pierre, Bélisle, Sylvain, Cailhier, Jean-François, Carrier, François Martin, Charbonney, Emmanuel, Denault, André, Girard, Martin, Guimond, Jean-Gilles, Halwagi, Antoine, Hébert, Paul, Kolan, Christophe, Ouellet, Caroline, Robillard, Nicholas, Benettaib, Fatna, Boumahni, Dounia, Lebrasseur, Martine, Salamé, Maya, Cantin, Marie-Ève, Archambault, Patrick, Drouin, Christine, Dubé, Jean-Nicolas, Bériault, Marie-Josée, Chacon, Marco, Claveau, David, Naud, Jean-François, Rodrigue, Élise, Ting Wang, Han, Brosseau, Marc, Laufer, Brian, Marquis, François, Toupin, Francis, Lamontagne, François, D’Aragon, Frédérick, Bérard, Dominique, Grondin-Beaudoin, Brian, Leclair, Marc-André, Lesur, Olivier, Mayette, Michaël, Poulin, Yannick, Quiroz Martinez, Hector, St-Arnaud, Charles, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Duquet-Deblois, Estel, Noël-Hunter, Monia, Tapss, Danielle, Toupin, Guylaine, Tassy, Danaë, Cheung, Vincent, Toun, Sam-Ang, Carbonneau, Elaine, Bélisle, Julie, Bouchard, Marie-Pier, Côté, Line, Ladouceur, Marylène, Marchand, Joannie, Naisby, Alexandra, Robert-Petit, Louise, Thibault, Marie-Ève, Williams, Virginie, Lainer Palacios, Julia, Charbonney, Emmanuel, Albert, Martin, Bernard, Francis, Cavayas, Alexandros, Serri, Karim, Williamson, David, Lauzier, François, Francoeur, Charles, Leblanc, Guillaume, St-Onge, Maude, Turgeon, Alexis, Belley-Côté, Emilie, Fox-Robichaud, Alison, Meade, Maureen, Whitlock, Richard, Lellouche, François, Simon, Mathieu, Tung Sia, Ying, Rochwerg, Bram, Maslove, David, Gordon Boyd, J., Drover, John, Muscedere, John, Sibley, Stephanie, Mele, Tina, Shahin, Jason, Khwaja, Kosar, Mehta, Sangeeta, Detsky, Michael, Kohli, Sonny, Cui, Fulan, Khera, Vikas, McConachie, David, Rehsia, Sachdeep, James Kutsogiannis, Demetrios, Chowdhury, Raiyan, Davidow, Jon, Johnston, Curtis, Kim, Michael, Macala, Kimberley, Marcushamer, Sam, Markland, Darren, Matheson, Doug, Parker, Arabesque, Paton-Gay, Damian, Cook, Deborah, Al-Hazzani, Waleed, Duan, Erick, Ligori, Tania, Soth, Mark, Adhikari, Neill KJ, Amaral, Andre, Cuthbertson, Brian H, Fowler, Robert A, Piquette, Dominique, Scales, Damon C, Tillmann, Bourke, Wunsch, Hannah, Seely, Andrew, English, Shane, Meggison, Hilary, Microys, Sherissa, Millington, Scott, Sarti, Aimee, Del Sorbo, Lorenzo, Fan, Eddy, Granton, John, Rewa, Oleksa, Bagshaw, Sean, Meier, Michael, Sligl, Wendy, Wood, Gordon, Ovakim, Daniel, Leblanc, Rémi, Poirier, Matthieu, Theriault, Theophile, Williston, Maryse, Bellemare, David, Boulanger, Marie-Claude, Cloutier, Eve, Guilbault, Gabrielle, Thibeault, Frédérique, Hand, Lori, Hayward, Leah, Mullen, Courtney, Savija, Nevena, Lizotte, Patricia, Millen, Tina, Boyd, Tracy, Hunt, Miranda, Bentall, Tracey, ElKhatib, Chadia, Campisi, Josie, Alam, Norine, Rahgoshai, Raham, Shah, Sumesh, Bharti, Dalisha, Perez, Adic, Hewer, Tayne, Thompson, Patrica, Clarke, France, Copland, Mary, Matic, Karlo, Marinoff, Nicole, Kamra, Maneesha, Kaur, Navjot, Murali, Deeptha, Sabananthan, Thivya, Sugumaran, Thuva, Haines, Jessica, Miezitis, Sydney, Porteous, Rebecca, Watpool, Irene, Abdelhady, Hesham, Romagnuolo, Tina, Baig, Nadia, Auld, Fiona, Carney, Gayle, Parfett, Deborah, Caissie Collette, Jackie, Carriere, Melanie, Daigle, Melissa, Gaudet, Bernise, Morin, Karine, Ouellette-Bernier, Lola, Poitras, Julie, Robichaud, Melanie, Rockburn, Joanne, Mekontso Dessap, Armand, Arrestier, Romain, Bagate, François, Bendib, Ines, Benelli, Brice, Berti, Enora, Bertier, Astrid, Cavaleiro, Pedro, de Prost, Nicolas, Gendreau, Segolene, Hartman, Otto, Haudebourg, Anne-Fleur, Lopinto, Julien, Masi, Paul, Michaud, Gaël, Razazi, Keyvan, Tuffet, Samuel, Annane, Djillali, Abdeladim, Lilia, Bounab, Rania, Heming, Nicholas, Maxime, Virginie, Moine, Pierre, Alves, Aline, Nait Chabane, Luiza, Ouali, Fariza, Ouedraogo, Rachida, Bossard, Isabelle, Jourdier, Segolene, Mahiou, Siline, Tessa, Hayette, McGuinness, Shay, Ball, Jonathan, Hennessy, Immanuel, Hogan, Maurice, Van Der Poll, Andrew, Benson-Cooper, Kerry, Chen, Jonathan, Freeman, Kirk, Harley, David, Harvey, Dave, Hourigan, Craig, Julian, Kylie, Lo, Stephen, McArthur, Colin, Miller, Stuart, Pointer, Chris, Anthony Smith, Rex, Tincknell, Laura, Shaw, Geoffrey, Betteridge, Toby, Burke, Brandon, Closey, David, Crombie, Rosalind, Davidson, Neil, Henderson, Louise, Henderson, Seton, Hitchings, Louise, Knight, David, Quigley, Christine, Ritzema Carter, Jay, Roberts, Jessica, Townend, Katherine, Twardowski, Pawel, Dvoracek, Martin, Renner, Markus, Silverman, David, Smith, Myles, Monica Stephens, Katherine, Albert Waibel, Hansjörg, Wiebe, Stefan, Woolley, Mark, Buehner, Ulrike, Kramer, Katallah, Browne, Troy, Callender, Owen, Chen, Jonathan, Farrell, Susanne, Higson, Vicky, Jackson, David, Keet, Owen, Martynoga, Robert, Byrne, Kelly, Young, Paul, Barnes, Colin, Barry, Ben, Grayson, Kim, Moore, James, Psirides, Alex, Sturland, Shawn, Tietjens, Kate, Ure, Bob, Walker, Laurence, Wright, Jason, Butler, Magdalena, Cowdrey, Keri-Anne, Gilder, Eileen, Parke, Rachael, Ryan, Samantha, Woollett, Melissa, McConnochie, Rachael, Simmonds, Catherine, Doyle, Tara, Mehrtens, Jan, Morgan, Stacey, Morris, Anna, Van Der Heyden, Kymbalee, Eden, Amie, France, Dawn, Williams, Erin, Goodson, Jennifer, Butler, Amelia, Trask, Kara, Mans, Gay, Termaat, Jonathan, Aguilar-Dano, April, Delaney, Kirsha, Lawrence, Cassie, Lesona, Mildred, Millington, Alexandra, Navarra, Leanlove, Olatunji, Shaanti, Cruz, Raulle Sol, Cruz, Rhoze Sol, Young, Chelsea, Day, Andrew, Cook, Deborah J, Guyatt, Gordon H, Sprague, Sheila, Cohen, Dian, Heyland, Daren K, Lamontagne, François, Masse, Marie-Hélène, Ménard, Julie, Adhikari, Neill KJ, Pinto, Ruxandra, Kanji, Salmaan, Battista, Marie-Claude, Annane, Djillali, Vijayaraghavan, Bharath Kumar Tirupakuzhi, McGuinness, Shay, Parke, Rachael, and Arabi, Yaseen

Published
2023
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12. The evolution of mean arterial pressure in critically ill patients on vasopressors before and during a trial comparing a specific mean arterial pressure target to usual care

Author

Masse, Marie-Hélène, Adhikari, Neill K. J., Théroux, Xavier, Battista, Marie-Claude, D’Aragon, Frédérick, Pinto, Ruxandra, Cohen, Alan, Mayette, Michaël, St-Arnaud, Charles, Kho, Michelle, Chassé, Michaël, Lebrasseur, Martine, Watpool, Irene, Porteous, Rebecca, Wilcox, M. Elizabeth, and Lamontagne, François

Published
2022
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14. Effect of oral chlorhexidine de-adoption and implementation of an oral care bundle on mortality for mechanically ventilated patients in the intensive care unit (CHORAL): a multi-center stepped wedge cluster-randomized controlled trial

Author

Dale, Craig M., Rose, Louise, Carbone, Sarah, Pinto, Ruxandra, Smith, Orla M., Burry, Lisa, and Fan, Eddy

Subjects
Bacterial pneumonia -- Research -- Patient outcomes, Mortality -- Ontario -- Canada, Pneumonia -- Research -- Patient outcomes, Hospital patients -- Patient outcomes, Evidence-based medicine -- Analysis -- Usage -- Research, Health care industry
Abstract

Purpose Oral chlorhexidine is used widely for mechanically ventilated patients to prevent pneumonia, but recent studies show an association with excess mortality. We examined whether de-adoption of chlorhexidine and parallel implementation of a standardized oral care bundle reduces intensive care unit (ICU) mortality in mechanically ventilated patients. Methods A stepped wedge cluster-randomized controlled trial with concurrent process evaluation in 6 ICUs in Toronto, Canada. Clusters were randomized to de-adopt chlorhexidine and implement a standardized oral care bundle at 2-month intervals. The primary outcome was ICU mortality. Secondary outcomes were time to infection-related ventilator-associated complications (IVACs), oral procedural pain and oral health dysfunction. An exploratory post hoc analysis examined time to extubation in survivors. Results A total of 3260 patients were enrolled; 1560 control, 1700 intervention. ICU mortality for the intervention and control periods were 399 (23.5%) and 330 (21.2%), respectively (adjusted odds ratio [aOR], 1.13; 95% confidence interval [CI] 0.82 to 1.54; P = 0.46). Time to IVACs (adjusted hazard ratio [aHR], 1.06; 95% CI 0.44 to 2.57; P = 0.90), time to extubation (aHR 1.03; 95% CI 0.85 to 1.23; P = 0.79) (survivors) and oral procedural pain (aOR, 0.62; 95% CI 0.34 to 1.10; P = 0.10) were similar between control and intervention periods. However, oral health dysfunction scores (- 0.96; 95% CI - 1.75 to - 0.17; P = 0.02) improved in the intervention period. Conclusion Among mechanically ventilated ICU patients, no benefit was observed for de-adoption of chlorhexidine and implementation of an oral care bundle on ICU mortality, IVACs, oral procedural pain, or time to extubation. The intervention may improve oral health., Author(s): Craig M. Dale [sup.1] [sup.2] [sup.3], Louise Rose [sup.4] [sup.5], Sarah Carbone [sup.1], Ruxandra Pinto [sup.6], Orla M. Smith [sup.1] [sup.7] [sup.8], Lisa Burry [sup.5] [sup.9] [sup.10], Eddy Fan [...]

Published
2021
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15. Evaluating the impact of a SIMPlified LaYered consent process on recruitment of potential participants to theStaphylococcus aureusNetwork Adaptive Platform trial: study protocol for a multicentre pragmatic nested randomised clinical trial (SIMPLY-SNAP trial)

Author

Ong, Sean W X, primary, Lee, Todd C, additional, Fowler, Robert A, additional, Mahar, Robert, additional, Pinto, Ruxandra L, additional, Rishu, Asgar, additional, Petrella, Lina, additional, Whiteway, Lyn, additional, Cheng, Matthew, additional, McDonald, Emily, additional, Johnstone, Jennie, additional, Mertz, Dominik, additional, Kandel, Christopher, additional, Somayaji, Ranjani, additional, Davis, Joshua S, additional, Tong, Steven Y C, additional, and Daneman, Nick, additional

Published
2024
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23. Impact of Centre of Admission on Receipt of ECMO among Patients with Hypoxemic Respiratory Failure: A Secondary Analysis of the LUNG SAFE and REVA Influenza A(H1N1) Studies

Author

Tillmann, Bourke W., primary, Pham, Tai, additional, Scales, Damon C., additional, Fan, Eddy, additional, Pinto, Ruxandra, additional, Rubenfeld, Gordon, additional, Rios, Fernando, additional, Van Haren, Frank, additional, T, Sottiaux, additional, P, Depuydt, additional, Lora, Fredy S., additional, Azevedo, Luciano Cesar, additional, Bugedo, Guillermo, additional, Qiu, Haibo, additional, Gonzalez, Marcos, additional, Silesky, Juan, additional, Cerny, Vladimir, additional, Nielsen, Jonas, additional, Jibaja, Manuel, additional, Pham, Tài, additional, Wrigge, Hermann, additional, Matamis, Dimitrios, additional, Ranero, Jorge Luis, additional, Amin, Pravin, additional, Hashemian, S.M., additional, Clarkson, Kevin, additional, Bellani, Giacomo, additional, Kurahashi, Kiyoyasu, additional, Villagomez, Asisclo, additional, Zeggwagh, Amine Ali, additional, Heunks, Leo M., additional, Laake, Jon Henrik, additional, Palo, Jose Emmanuel, additional, Fernandes, Antero do Vale, additional, Sandesc, Dorel, additional, Arabi, Yaasen, additional, Bumbasierevic, Vesna, additional, Nin, Nicolas, additional, Lorente, Jose A., additional, Larsson, Anders, additional, Piquilloud, Lise, additional, Abroug, Fekri, additional, McAuley, Daniel F., additional, McNamee, Lia, additional, Hurtado, Javier, additional, Bajwa, Ed, additional, Démpaire, Gabriel, additional, Zogheib, E., additional, Dupont, H., additional, Mercat, A., additional, Pierrot, M., additional, Capellier, G., additional, Verdiere, B., additional, Bastien, O., additional, Lehot, J.-J., additional, Tonnelier, J.M., additional, Guelon, D., additional, du Cheyron, D., additional, Thille, A., additional, Pham, T., additional, Brun-Buisson, C., additional, Quenot, J.-P., additional, Arasomoano, C., additional, Minet, C., additional, Timsit, J.-F., additional, Dessertaine, G., additional, Robriquet, L., additional, Jaillette, E., additional, Castanier, M., additional, Roch, A., additional, Papazian, L., additional, Eliet, J., additional, Gaudard, P., additional, Machado, S., additional, Kuteifan, K., additional, Kimmoun, A., additional, Levy, B., additional, Bizouarn, P., additional, Villiers, D., additional, Guitton, C., additional, Dellamonica, J., additional, Boulain, T., additional, Mourvillier, B., additional, Salin, J. Bailly, additional, Wolff, M., additional, Charpentier, J., additional, Chiche, J.-D., additional, Ricome, S., additional, Megarbane, B., additional, Combes, A., additional, Schmidt, M., additional, Bréchot, N., additional, Chastre, J., additional, Rozé, H., additional, Ouattara, A., additional, Robert, R., additional, Carise, E., additional, Reignier, J., additional, Beduneau, G., additional, Richard, J.-C.M., additional, Le Tulzo, Y., additional, Zeni, F., additional, Jospe, R., additional, Kummerlen, C., additional, Gouello, J.P., additional, Cerf, C., additional, Devaquet, J., additional, Riu-Poulenc, B., additional, Luzi, A., additional, Georges, B., additional, Mayeur, N., additional, Mercier, E., additional, Guillon, A., additional, and Eustache, M.L., additional

Published
2023
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24. A Pilot Feasibility Randomized Controlled Trial of Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit: The Lessening Organ Dysfunction with Vitamin C-India (LOVIT-India) Trial

Author

Venkataraman, Ramesh, primary, Sprague, Sheila, additional, Ramakrishnan, Nagarajan, additional, Ramachandran, Pratheema, additional, Jayakumar, Devachandran, additional, Vijayaraghavan, Bharath Kumar Tirupakuzhi, additional, Margabandhu, Saravanan, additional, Ramanathan, Yamunadevi, additional, Adhikari, Neill KJ, additional, Lamontagne, Francois, additional, Pinto, Ruxandra, additional, Masse, Marie-Hélène, additional, and Ménard, Julie, additional

Published
2023
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29. Mental illness after admission to an intensive care unit

Author

Sivanathan, Lavarnan, Wunsch, Hannah, Vigod, Simone, Hill, Andrea, Pinto, Ruxandra, and Scales, Damon C.

Subjects
Ontario. Ministry of Health and Long-Term Care -- Analysis, Hospital patients -- Analysis, Health care industry
Abstract

Purpose Survivors of critical illness may be at higher risk of developing subsequent mental illness. We sought to determine the risk of new mental illness diagnoses across a large population of intensive care unit (ICU) survivors compared with hospitalized patients. Methods Population-based study (2005-2015) conducted in adults hospitalized in Ontario, Canada. The primary exposure was ICU admission for [greater than or equal to] 48 h; secondary exposures were ICU procedures including mechanical ventilation and duration of ICU. The primary outcome was mental illness diagnosed during the year after hospital discharge. To account for case mix differences between ICU and other hospitalized patients, sensitivity analyses were conducted restricting to six pre-specified diagnoses that can lead to hospitalization with or without ICU. Results 1,847,462 patients survived hospitalization, of whom 121,101 were admitted to ICU for [greater than or equal to] 48 h. ICU patients had a higher rate of new mental illness diagnoses in the year after discharge compared to hospitalized patients (17 vs. 15%, adjusted hazard ratio (aHR) 1.08, 95% CI 1.07-1.10). In analyses restricted to pre-specified most responsible diagnoses, the increased risk associated with ICU was only significant for patients with pneumonia. Among ICU survivors, exposure to mechanical ventilation (aHR: 1.08; 95% CI 1.05-1.12) or longer ICU stays (aHR: 1.004 per day; 95% CI 1.003-1.005) increased the risk of new mental illness diagnosis. Conclusions ICU was associated with a marginally increased risk of mental illness diagnosis after hospitalization that was often no longer apparent when reason for admission was considered. Patients exposed to mechanical ventilation or longer ICU stays may be at higher risk of subsequent mental illnesses., Author(s): Lavarnan Sivanathan [sup.1] [sup.2], Hannah Wunsch [sup.1] [sup.2] [sup.3] [sup.4] [sup.5], Simone Vigod [sup.1] [sup.3] [sup.6] [sup.7], Andrea Hill [sup.5], Ruxandra Pinto [sup.5], Damon C. Scales [sup.1] [sup.3] [sup.4] [...]

Published
2019
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39. Prognostic Factors Associated With Extubation Failure in Acutely Brain-Injured Patients: A Systematic Review and Meta-Analysis*

Author

Taran, Shaurya, Angeloni, Natalia, Pinto, Ruxandra, Lee, Shawn, McCredie, Victoria A., Schultz, Marcus J., Robba, Chiara, Taccone, Fabio S., Adhikari, Neill K. J., Intensive Care Medicine, ACS - Pulmonary hypertension & thrombosis, and AII - Inflammatory diseases

Subjects
prognosis research, acute brain injury, extubation failure, mechanical ventilation, Critical Care and Intensive Care Medicine, ventilation liberation
Abstract

Objective: Extubation failure in brain-injured patients is associated with increased morbidity. Our objective was to systematically review prognostic factors associated with extubation failure in acutely brain-injured adult patients receiving invasive ventilation in an ICU. Data Sources: MEDLINE, Embase, and Cochrane Central were searched from inception to January 31, 2022. Study Selection: Two reviewers independently screened citations and selected English-language cohort studies and randomized trials examining the association of prognostic factors with extubation failure. Studies were considered if they included greater than or equal to 80% adult patients with acute brain injury admitted to the ICU and mechanically ventilated for greater than or equal to 24 hours. Data Extraction: Two reviewers extracted data on population, prognostic factors, extubation outcomes, and risk of bias (using the quality in prognostic factors tool). Data Synthesis: In the primary analysis, adjusted odds ratios (aOR) for each prognostic factor were pooled using random-effects models. Certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. The search identified 7,626 citations, of which 21 studies met selection criteria. Moderate-certainty evidence suggested increased risk of extubation failure with older age (aOR, 3.0 for upper vs lower tertile; 95% CI, 1.78-5.07) and longer duration of mechanical ventilation (aOR, 3.47 for upper vs lower tertile; 95% CI, 1.68-7.19). Presence of cough (aOR, 0.40; 95% CI, 0.28-0.57) and intact swallow (aOR, 0.34; 95% CI, 0.21-0.54) probably decreased risk of extubation failure (moderate certainty). Associations of other factors with extubation failure were informed by low or very low certainty evidence. Conclusions: Patient age, duration of mechanical ventilation, and airway reflexes were associated with extubation failure in brain-injured patients with moderate certainty. Future studies are needed to determine the optimal application of these variables in clinical practice.

Published
2022

40. Non-inferiority trial of a shorter (7 days) compared with a longer (14 days) duration of antimicrobial therapy for the treatment of bacteraemic urinary sepsis, measured by microbiological success after the completion of therapy: a substudy protocol for the Bacteraemia Antibiotic Length Actually Needed for Clinical Effectiveness (BALANCE) multicentre randomised controlled trial

Author

Rogers, Benjamin A, primary, Fowler, Robert, additional, Harris, Patrick N A, additional, Davis, Joshua S, additional, Pinto, Ruxandra L, additional, Bhatia Dwivedi, Dhiraj, additional, Rishu, Asgar, additional, Shehabi, Yahya, additional, and Daneman, Nick, additional

Published
2023
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43. Protocol for a multi-centered, stepped wedge, cluster randomized controlled trial of the de-adoption of oral chlorhexidine prophylaxis and implementation of an oral care bundle for mechanically ventilated critically ill patients: the CHORAL study

Author

Dale, Craig M., Rose, Louise, Carbone, Sarah, Smith, Orla M., Burry, Lisa, Fan, Eddy, Amaral, Andre Carlos Kajdacsy-Balla, McCredie, Victoria A., Pinto, Ruxandra, Quiñonez, Carlos R., Sutherland, Susan, Scales, Damon C., and Cuthbertson, Brian H.

Published
2019
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44. A Pilot Feasibility Randomized Controlled Trial of Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit: The Lessening Organ Dysfunction with Vitamin C-India (LOVIT-India) Trial.

Author

Vijayaraghavan, Bharath Kumar Tirupakuzhi, Venkataraman, Ramesh, Ramanathan, Yamunadevi, Margabandhu, Saravanan, Jayakumar, Devachandran, Ramachandran, Pratheema, Adhikari, Neill K. J., Lamontagne, Francois, Pinto, Ruxandra, Masse, Marie-Hélène, Ménard, Julie, Sprague, Sheila, and Ramakrishnan, Nagarajan

Subjects
INTENSIVE care units, PILOT projects, RELATIVE medical risk, INTRAVENOUS therapy, CONFIDENCE intervals, CRITICALLY ill, VITAMIN C, PATIENTS, SEPSIS, TREATMENT effectiveness, RANDOMIZED controlled trials, COMPARATIVE studies, DESCRIPTIVE statistics, RESEARCH funding, STATISTICAL sampling
Abstract

Background: The burden of sepsis is high in India and is associated with substantial morbidity and mortality. Vitamin C, an endogenous antioxidant, may improve patient outcomes. Methods: This was a parallel-group pilot feasibility randomized controlled trial conducted at 2 intensive care units in India. Adult patients (≥18 years) with proven or suspected infection as the main diagnosis and needing a continuous intravenous vasopressor infusion were randomized to intravenous vitamin C (50 mg/kg every 6 hours for a maximum of 16 doses) or matching placebo. Primary outcomes were related to protocol adherence and feasibility (enrollment per month). The key secondary outcome was the composite of mortality or persistent organ dysfunction (POD) at day 28 after randomization. Results: 60 patients were screened, 51 were eligible, 32 were randomized, and 30 were included in the analysis (randomized/eligible ratio: 0.63). The overall rate of enrollment was 1.5 patients per month. The median (IQR) age was 63.5 (51.0, 70.0) and 70.0% of the patients were male. In both arms, all patients received ≥90% of scheduled doses of the study drug. No patient received open-label vitamin C and there were no deviations from the glucose monitoring protocol. The composite outcome of mortality or POD at day 28 occurred in 56.3% (9/16) in the vitamin C arm as compared to 42.9% (6/14) in the placebo arm [RR: 1.31 (95% CI: 0.62, 2.76), p = 0.47]. Conclusion: In this pilot feasibility randomized controlled trial of vitamin C for adult patients with sepsis, protocol adherence was excellent and feasibility endpoints were met. Trial registration: CTRI/2020/03/024371. [ABSTRACT FROM AUTHOR]

Published
2023

45. Intravenous Vitamin C for Patients Hospitalized With COVID-19: Two Harmonized Randomized Clinical Trials.

Author

Adhikari, Neill K. J., Hashmi, Madiha, Tirupakuzhi Vijayaraghavan, Bharath Kumar, Haniffa, Rashan, Beane, Abi, Webb, Steve A., Angus, Derek C., Gordon, Anthony C., Cook, Deborah J., Guyatt, Gordon H., Berry, Lindsay R., Lorenzi, Elizabeth, Mouncey, Paul R., Au, Carly, Pinto, Ruxandra, Ménard, Julie, Sprague, Sheila, Masse, Marie-Hélène, Huang, David T., and Heyland, Daren K.

Subjects
COVID-19, VITAMIN C, CLINICAL trials, INTENSIVE care units, PATIENT experience
Abstract

Key Points: Question: Does vitamin C administered intravenously to patients hospitalized with COVID-19 improve organ support–free days (composite outcome of in-hospital mortality and days alive and free of intensive care unit–based respiratory and cardiovascular support) up to day 21? Findings: In 2 prospectively harmonized randomized clinical trials, the use of vitamin C vs control (placebo or no vitamin C) yielded posterior probabilities for efficacy of 8.6% among 1568 critically ill patients and 2.9% among 1022 patients who were not critically ill regarding the odds of improvement for organ support–free days. Meaning: Among hospitalized patients with COVID-19, there was a low probability that vitamin C improved organ support–free days. Importance: The efficacy of vitamin C for hospitalized patients with COVID-19 is uncertain. Objective: To determine whether vitamin C improves outcomes for patients with COVID-19. Design, Setting, and Participants: Two prospectively harmonized randomized clinical trials enrolled critically ill patients receiving organ support in intensive care units (90 sites) and patients who were not critically ill (40 sites) between July 23, 2020, and July 15, 2022, on 4 continents. Interventions: Patients were randomized to receive vitamin C administered intravenously or control (placebo or no vitamin C) every 6 hours for 96 hours (maximum of 16 doses). Main Outcomes and Measures: The primary outcome was a composite of organ support–free days defined as days alive and free of respiratory and cardiovascular organ support in the intensive care unit up to day 21 and survival to hospital discharge. Values ranged from –1 organ support–free days for patients experiencing in-hospital death to 22 organ support–free days for those who survived without needing organ support. The primary analysis used a bayesian cumulative logistic model. An odds ratio (OR) greater than 1 represented efficacy (improved survival, more organ support–free days, or both), an OR less than 1 represented harm, and an OR less than 1.2 represented futility. Results: Enrollment was terminated after statistical triggers for harm and futility were met. The trials had primary outcome data for 1568 critically ill patients (1037 in the vitamin C group and 531 in the control group; median age, 60 years [IQR, 50-70 years]; 35.9% were female) and 1022 patients who were not critically ill (456 in the vitamin C group and 566 in the control group; median age, 62 years [IQR, 51-72 years]; 39.6% were female). Among critically ill patients, the median number of organ support–free days was 7 (IQR, −1 to 17 days) for the vitamin C group vs 10 (IQR, −1 to 17 days) for the control group (adjusted proportional OR, 0.88 [95% credible interval {CrI}, 0.73 to 1.06]) and the posterior probabilities were 8.6% (efficacy), 91.4% (harm), and 99.9% (futility). Among patients who were not critically ill, the median number of organ support–free days was 22 (IQR, 18 to 22 days) for the vitamin C group vs 22 (IQR, 21 to 22 days) for the control group (adjusted proportional OR, 0.80 [95% CrI, 0.60 to 1.01]) and the posterior probabilities were 2.9% (efficacy), 97.1% (harm), and greater than 99.9% (futility). Among critically ill patients, survival to hospital discharge was 61.9% (642/1037) for the vitamin C group vs 64.6% (343/531) for the control group (adjusted OR, 0.92 [95% CrI, 0.73 to 1.17]) and the posterior probability was 24.0% for efficacy. Among patients who were not critically ill, survival to hospital discharge was 85.1% (388/456) for the vitamin C group vs 86.6% (490/566) for the control group (adjusted OR, 0.86 [95% CrI, 0.61 to 1.17]) and the posterior probability was 17.8% for efficacy. Conclusions and Relevance: In hospitalized patients with COVID-19, vitamin C had low probability of improving the primary composite outcome of organ support–free days and hospital survival. Trial Registration: ClinicalTrials.gov Identifiers: NCT04401150 (LOVIT-COVID) and NCT02735707 (REMAP-CAP) Two randomized clinical trials were harmonized to compare the effect of vitamin C vs control on outcomes in hospitalized patients with COVID-19 who were critically ill or who were not critically ill. [ABSTRACT FROM AUTHOR]

Published
2023
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