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. 2021 Sep 28;50:683–692. doi: 10.1016/j.ajem.2021.09.056

Table 1.

Summary of articles and key findings.

Article Clinical Topic Study Type Key Findings
The RECOVERY Collaborative Group. Dexamethasone in hospitalized patients with COVID-19 – Preliminary Report. N Engl J Med. 2020. Published online July 17, 2020 COVID-19 Multicenter, randomized, controlled, open-label trial
  • Decreased 28-day all-cause mortality in patients who required respiratory support or supplemental oxygen and received dexamethasone.

HALT-IT Trial Collaborators. Effects of a high dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomized, double-blind, placebo-controlled trial. Lancet. 2020; 395:1927–1936. Acute Gastrointestinal Bleeding Multicenter, randomized, double-blind, placebo-controlled trial
  • No difference in death due to bleeding in patients randomized to receive TXA for acute gastrointestinal bleeding.

Lau JYW, Yu Y, Yang RS, et al. Timing of endoscopy for acute gastrointestinal bleeding. N Engl J Med. 2020; 382:1299–1308. Acute Gastrointestinal Bleeding Single-center, randomized trial
  • No difference in 30-0 day all-cause mortality between patients randomized to receive urgent endoscopy (within 6 h) compared to those randomized to receive early endoscopy (within 24 h).

Writing Group and Steering Committee for the RELAx Collaborative Group. Effect of a lower vs higher positive end-expiratory pressure strategy on ventilator-free days in ICU patients without ARDS. JAMA. 2020; 324:2509–2520. Mechanical Ventilation Prospective, randomized, controlled study
  • The use of a low PEEP strategy was non-inferior to a high PEEP strategy in ventilated patients without ARDS.

Barrot L, Asfar P, Mauny F, et al. Liberal or conservative oxygen therapy for acute respiratory distress syndrome. N Engl J Med. 2020; 382:999–1008. Mechanical Ventilation Prospective, multicenter, randomized trial
  • No difference in 28-day all-cause mortality between patients with ARDS randomized to a conservative oxygen therapy group and those randomized to a liberal oxygen therapy group.

Lamontagne F, Richards-Belle A, Thomas K, et al. Effect of reduced exposure to vasopressors on 90-day mortality in older critically ill patients with vasodilatory hypotension: a randomized clinical trial. JAMA. 2020; 323:938–49. Vasopressors Pragmatic, randomized trial
  • No difference in 90-day all-cause mortality between patients randomized to permissive hypotension (MAP 60–65 mmHg) compared with those randomized to usual care for vasodilatory shock.

Panwar R, Tarvade S, Lanyon N, et al. Relative hypotension and adverse kidney-related outcomes among critically ill patients with shock. A multicenter, prospective cohort study. Am J Respir Crit Care Med. 2020; 202:1407–18. Vasopressors Investigator-initiated, multicenter, prospective, observational trial
  • Increased incidence of new acute kidney injury and major adverse kidney events in patients who experienced a deficit in mean perfusion pressure.

Fujii T, Luethi N, Young PJ, et al. Effect of vitamin C, hydrocortisone, and thiamine vs hydrocortisone alone on time alive and free of vasopressor support among patients with septic shock: the VITAMINS randomized clinical trial. JAMA. 2020; 323:423–431. Septic Shock Multicenter, open-label, parallel-group, randomized trial
  • No difference in time alive and vasopressor-free days at day 7 for patients randomized to receive vitamin C, hydrocortisone, and thiamine compared to patients randomized to receive hydrocortisone.

Moskowitz A, Huang DT, Hou PC, et al. Effect of ascorbic acid, corticosteroids, and thiamine on organ injury in septic shock: the ACTS randomized clinical trial. JAMA. 2020; 324:642–650. Septic Shock Multicenter, blinded, placebo-controlled, randomized, superiority trial
  • No difference in the change in SOFA scores at 72 h for patients randomized to receive vitamin C, hydrocortisone, and thiamine compared to patients randomized to receive placebo.

Yannopoulos D, Bartos JA, Reveendran G, et al. Advanced reperfusion strategies for patients with out-of-hospital cardiac arrest and refractory ventricular fibrillation (ARREST): a phase 2, single center, open-label, randomized controlled trial. Lancet. 2020; 396:1807–1816. Cardiac Arrest Phase 2, single-center, open-label, pragmatic, randomized trial
  • Improved survival to hospital discharge for OHCA patients randomized to ECMO-facilitated resuscitation compared to patients randomized to receive standard ED-based ACLS resuscitation.

Pareek N,Kordis P, Beckley-Hoelscher N, et al. A practical risk score for early prediction of neurological outcome after out-of-hospital cardiac arrest: MIRACLE 2. European Heart Journal. 2020; 41:4508–17. Post-Arrest Care Prospective investigation of a cardiac arrest registry
  • The MIRA2CLE2 score has a high specificity for predicting poor neurologic outcome in OHCA patients presumed due to a cardiac etiology.