Title: Interventions Shown to Reduce Mortality in RCTs<br/>Author: Mike Winters<br/><a href='http://umem.org/profiles/faculty/141/'>[Click to email author]</a><hr/><p> <u><strong>Interventions Shown to Reduce Mortality in RCTs</strong></u></p> <ul> <li> Santacruz and colleagues recently performed a systematic review to determine which multicenter RCTs in critically ill patients have shown that an intervention was associated with a reduction in mortality.</li> <li> Approximately 13% of the 212 trials included in this review reported a statistically significant reduction in mortality. Unfortunately, many of the interventions were not associated with reduced mortality in subsequent studies.</li> <li> Interventions consistently shown to reduce mortality in multicenter RCTs in critically ill patients were <strong>limited tidal volume in patients with ARDS, noninvasive ventilation in acute hypercapnic respiratory failure, </strong>and<strong> noninvasive ventilation following extubation in complex cases.</strong></li> <li> Corticosteroids in septic shock, selective digestive decontamination, and prone positioning in ARDS remain controversial.</li> </ul> <fieldset><legend>References</legend>
<p> Santacruz CA, et al. Which multicenter randomized controlled trials in critical care medicine have shown reduced mortality? A systematic review. <em>Crit Care Med</em>. 2019; 47:1680-1691.</p> </fieldset>