Clinical Q, Bottom Line, Primary Outcome 1)ARDS

Question 1

ACURASYS Clinical Questions

Answer 1

Does administration of cisatracurium improve survival when compared to placebo in ICU patients undergoing mechanical ventilation for early severe ARDS?

Question 2

ACURASYS Bottom Line

Answer 2

Paralysis with cisatracurium for 48 hours in patients with early severe ARDS improves 90 day survival and increases ventilator-free days.

Question 3

ACURASYS Primary Outcome

Answer 3

Mortality before discharge or 90 days

Question 4

ARDSNet Clinical Q

Answer 4

In patients with ALI/ARDS receiving mechanical ventilation, how does a lung protective strategy using lower tidal volumes compare with traditional ventilation protocols in decreasing mortality and ventilator-free days?

Question 5

ARDSNet Bottomline

Answer 5

In patients with ARDS, low tidal volume ventilation (initial TV 6ml/kg PBW) had lower mortality and more ventilator-free days.

Question 6

ARDSNet Primary Outcome

Answer 6

ventilator free days, mortality at 120 days

Question 7

FACTT Clinical Q

Answer 7

In patients with ALI/ARDS that are intubated and receiving positive pressure ventilation, how does the conservative compare to the liberal fluid management strategy in reducing mortality?

Question 8

FACTT Bottom Line

Answer 8

Among patients with ALI/ARDS, a conservative fluid management strategy targeting a CVP <4 mmHg improves lung function, decreases ventilator days, and reduces ICU days compared to a liberal strategy.

Question 9

FACTT primary outcome

Answer 9

All cause mortality at 60 days

Dialysis at 60 days

Question 10

Clinical Question OSCILLATE

Answer 10

In patients is moderate to severe early ARDS, does high-frequency oscillatory ventilation reduce in-hospital mortality?

Question 11

OSCILLATE Bottom Line

Answer 11

In patients with moderate to severe early ARDS, early high-frequency oscillatory ventilation might increase in-hospital mortality

Question 12

OSCILLATE Primary outcome

Answer 12

In-hospital mortality

Question 13

PROSEVA Clinical Question

Answer 13

Among patients with severe ARDS, does prone positioning reduce all-cause mortality at 28 days when compared to supine-only positioning?

Question 14

PROSEVA Bottom Line

Answer 14

Among patients with severe ARDS (P:F ratio <150 mmHg), prone positioning reduces 28-day mortality.

Question 15

PROSEVA Primary Outcome

Answer 15

All-cause mortality at 28 days

Question 16

ROSE Clinical Q

Answer 16

In patients with moderate to severe ARDS, does the early use of continuous neuromuscular blockade with cisatracurium improve mortality when used with current light sedation protocols?

Question 17

ROSE Bottom Line

Answer 17

Not only does early neuromuscular blockade not reduce mortality when using modern light sedation protocols, it was associated with an increase in ICU-acquired weakness and serious adverse cardiovascular events. Contradicts ACURASYS

Question 18

ROSE Primary Outcome

Answer 18

90-day in-hospital death from any cause

Question 19

What study does ROSE contradict

Answer 19

ACURASYS