Trauma Landmarks

Question 1

TRICC

Answer 1

Multicenter RCT of Transfusion requirements in critical care 1999

Question 2

TRICC endpoints

Answer 2

primary: 30 day mortality rate
secondary: 60 day, in-hospital mortality, severity of organ dysfunction, LOS

Question 3

TRICC RCT arms

Answer 3

initial <9.
transfuse >7 (restrictive)
and >10 (liberal)

Question 4

TRICC findings

Answer 4

1. in-hospital mortality rate trend to lower in RESTRICTIVE (7 g/dL)
2. 30 day mortality the same overall
3. 30 day mortality lower in RESTRICTIVE if:
   LESS acutely ill (APACHE < 20), <55, and no cardiac disease

“possibly superior restrictive in ICU pts except in clinically significant cardiac disease”

Question 5

STOP-IT

Answer 5

Trial of short-course antimicrobial therapy for intraabdominal infection = Study to Optimize Peritoneal Infection Therapy trial 2015

Mutlicenter RCT

Question 6

STOP-IT endpoints

Answer 6

primary: surgical site infection, 30 day mortality, recurrent intraabdominal infection
secondary: duration of therapy, rates of subsequent infections 30 days

Question 7

STOP-IT findings

Answer 7

1. no difference between groups SSI + intraabd recurrence + 30 day mortality
2. but overall still 22 (control) vs 21 (experimental) % in composite incidence (high)… which is high