Major Trials
Circulatory
Sections
Fluid Therapy
Vasoactive Therapy
Blood Pressure
Mechanical Support
Goal-Directed Therapy
Intra-Arrest Drug Therapy
Intra-Arrest Airway management
Chest Compression
Post-Arrest Temperature Management
Misellaneous Post-Arrest Management
Fluid Therapy
Crystalloid vs Colloid
General Critical Care
Sepsis
- Perner. Hydroxyethyl Starch 130/0.4 versus Ringer's Acetate in Severe Sepsis (6S). N Eng J Med 2012; 367:124-134
- Guidet. Assessment of hemodynamic efficacy and safety of 6% hydroxyethylstarch 130/0.4 versus 0.9% NaCl fluid replacement in patients with severe sepsis: the CRYSTMAS study. Crit Care 2012;16:R94
- Brunkhorst. Intensive insulin therapy and pentastarch resuscitation in severe sepsis (VISEP). N Eng J Med 2008;358:125-139
Crystalloid vs Albumin
General Critical Care
Crystalloid vs Crystalloid
0.9% Saline vs Buffered Crystalloid
Intensive Care Unit
- Finfer. Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults. N Engl J Med 2022;epublished January 18th
- Zampieri. Effect of Intravenous Fluid Treatment With a Balanced Solution vs 0.9% Saline Solution on Mortality in Critically Ill PatientsThe BaSICS Randomized Clinical Trial. JAMA 2021;epublished August 10th
- Semler. Balanced Crystalloids versus Saline in Critically Ill Adults (SMART). N Engl J Med 2018;epublished February 27th
- Young. Effect of a Buffered Crystalloid Solution vs Saline on Acute Kidney Injury Among Patients in the Intensive Care Unit (SPLIT Trial). JAMA 2015;314(16):1701-1710
Emergency Department
Hypertonic Saline
- Asfar. Hyperoxia and hypertonic saline in patients with septic shock (HYPERS2S): a two-by-two factorial, multicentre, randomised, clinical trial. Lancet Respir Med 2017;5(3):180-190
- Roquilly. Effect of Continuous Infusion of Hypertonic Saline vs Standard Care on 6-Month Neurological Outcomes in Patients With Traumatic Brain InjuryThe COBI Randomized Clinical Trial. JAMA 2021;325(20):2056-2066
Volume of Fluid Resuscitation
No Fluid or Fluid Restriction
Sepsis
Trauma
Speed of Fluid Infusion
Rate of Resuscitation
General Critical Care
Vasoactive Therapy
Drug Comparisons
Individual Drugs
Noradrenaline
- De Backer. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl 2010;362:779-89
- Myburgh. A comparison of epinephrine and norepinephrine in critically ill patients. Intensive Care Med 2008;34(12):2226-2234
- Annane. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: A randomised trial. Lancet 2007; 370:676-684
- Seguin. Dopexamine and norepinephrine versus epinephrine on gastric perfusion in patients with septic shock: A randomized study. Crit Care 2006; 10:R32.
Adrenaline
- Ramaswamy. Double-Blind Randomized Clinical Trial Comparing Dopamine and Epinephrine in Pediatric Fluid-Refractory Hypotensive Septic Shock. Pediatr Crit Care Med 2016;epublished September 23rd
- Myburgh. A comparison of epinephrine and norepinephrine in critically ill patients. Intensive Care Med 2008;34(12):2226-2234 (abstract)
- Annane. Norepinephrine plus dobutamine versus epinephrine alone for management of septic shock: A randomised trial. Lancet 2007; 370:676-684
- Seguin. Dopexamine and norepinephrine versus epinephrine on gastric perfusion in patients with septic shock: A randomized study. Crit Care 2006; 10:R32.
Dopamine
- Ramaswamy. Double-Blind Randomized Clinical Trial Comparing Dopamine and Epinephrine in Pediatric Fluid-Refractory Hypotensive Septic Shock. Pediatr Crit Care Med 2016;epublished September 23rd
- De Backer. Comparison of dopamine and norepinephrine in the treatment of shock. N Engl 2010;362:779-89
- Bellomo. Low-dose dopamine in patients with early renal dysfunction: a placebo-controlled randomised trial. Australian and New Zealand Intensive Care Society (ANZICS) Clinical Trials Group. Lancet 2000; 356: 2139-43
Vasopressin
Levosimendan
- Follath. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet 2002;360:196-202
- Nieminen. Randomized study on safety and effectiveness of levosimendan in patients with left ventricular failure after an acute myocardial infarction (RUSSLAN). European Heart Journal 2002;23:1422-32
Angiotensin II
Blood Pressure Targets
General
- Lamontagne. Effect of Reduced Exposure to Vasopressors on 90-Day Mortality in Older Critically Ill Patients With Vasodilatory Hypotension. A Randomized Clinical Trial. (65). JAMA 2020;323(10):938-949
- Lamontagne. Higher versus lower blood pressure targets for vasopressor therapy in shock: a multicentre pilot randomized controlled trial. (OVATION). Intensive Care Med 2016;42:542-550
Mechanical Support
Intra-Aortic Balloon Pump
ECMO
Left Ventricular Assist Device
Total Artificial Heart
Mechanical Chest Compression Devices
- Perkins. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Lancet 2014;epublished November 16th
- Wik. Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation 2014;epublished March 15th
- Rubertsson. Mechanical Chest Compressions and Simultaneous Defibrillation vs Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest. The LINC Randomized Trial. JAMA 2013;311(1):53-61
Goal-Directed Therapy
Pulmonary Artery Catheter
Intensive Care Unit
- Harvey. Assessment of the clinical effectiveness of pulmonary artery catheters in management of patients in intensive care (PAC-Man): a randomised controlled trial. Lancet 2006;366:472 - 477
- Rhodes. A randomised, controlled trial of the pulmonary artery catheter in critically ill patients. Intensive Care Med 2002;28:256–264
Acute Respiratory Distress Syndrome
- The National Heart, Lung, and Blood Institute Acute Respiratory Distress Syndrome (ARDS) Clinical Trials Network. Pulmonary-Artery versus Central Venous Catheter to Guide Treatment of Acute Lung Injury. N Engl J Med 2006;354:2213-24
- Richard. Early use of the pulmonary artery catheter and outcomes in patients with shock and acute respiratory distress syndrome: A randomized controlled trial. JAMA 2003; 290: 2713–2720
SvO2
Intensive Care Unit
Sepsis
- Mouncey. Trial of Early, Goal-Directed Resuscitation for Septic Shock. (ProMISe Trial). N Engl J Med 2015;epublished March 17th
- The ARISE Investigators. Goal-Directed Resuscitation for Patients with Early Septic Shock. New Engl J Med 2014;epublished October 1st
- The ProCESS Investigators. A Randomized Trial of Protocol-Based Care for Early Septic Shock (ProCESS study). New Engl J Med 2014;epublished March 18th
- Rivers. Early goal directed therapy in the treatment of severe sepsis and septic shock. N Eng J Med 2001;345:1368-77
Miscellaneous Goal Directed Approaches
Lactate
- Hernández. Effect of a Resuscitation Strategy Targeting Peripheral Perfusion Status vs Serum Lactate Levels on 28-Day Mortality Among Patients With Septic Shock: The ANDROMEDA-SHOCK Randomized Clinical Trial. JAMA 2019;321(7):654-664
- Jones. Lactate Clearance vs Central Venous Oxygen Saturation as Goals of Early Sepsis Therapy. JAMA. 2010;303(8):739-746.
- Jansen. Early Lactate-Guided Therapy in ICU Patients: A Multicenter, Open-Label, Randomized, Controlled Trial. Am. J. Respir. Crit. Care Med. 2010;182: 752-761
Percutaneous Coronary Intervention
Timing of Angiography
Cardiac Arrest
Intra-Arrest Management
Intra-Arrest Drug Therapy
Combination Therapy
- Andersen. Effect of Vasopressin and Methylprednisolone vs Placebo on Return of Spontaneous Circulation in Patients With In-Hospital Cardiac Arrest. A Randomized Clinical Trial. JAMA 2021;epublished September 29th
- Mentzelopoulos. Vasopressin, Steroids, and Epinephrine and Neurologically Favorable Survival After In-Hospital Cardiac Arrest: A Randomized Clinical Trial. JAMA 2013;310(3):270
- Mentzelopoulos. Vasopressin, epinephrine, and corticosteroids for in-hospital cardiac arrest. Arch Intern Med. 2009;169:15–24
- Olasveengen. Intravenous Drug Administration During Out-of-Hospital Cardiac Arrest: A Randomized Trial. JAMA 2009;302(20):2222-2229
Adrenaline
- Perkins. A Randomized Trial of Epinephrine in Out-of-Hospital Cardiac Arrest (PARAMEDIC2). N Engl J Med 2018;epublished July 18th
- Jacobs. Effect of adrenaline on survival in out-of-hospital cardiac arrest: A randomised double-blind placebo-controlled trial (PACA Trial). Resuscitation 2011;82(9):1138-43
- Gueugniaud. A comparison of repeated high doses and repeated standard doses of epinephrine for cardiac arrest outside the hospital. European epinephrine study group. N Engl J Med 1998;339(22):1595–601
Vasopressin vs Adrenaline
- Ong. A randomised, double-blind, multi-Centre trial comparing vasopressin and adrenaline in patients with cardiac arrest presenting to or in the emergency department. Resuscitation 2012;83:953–60
- Wenzel. A comparison of vasopressin and epinephrine for out-of-hospital cardiopulmonary resuscitation. N Engl J Med 2004;350:105–13
- Lindner. Randomized comparison of epinephrine and vasopressin in patients with out-of-hospital ventricular fibrillation. Lancet 1997;349:535–7
Amidarone vs Lidocaine
- Kudenchuk. Amiodarone, Lidocaine, or Placebo in Out-of-Hospital Cardiac Arrest. N Engl J Med 2016;epublished April 4th
- Dorian. Amiodarone as compared with lidocaine for shock- resistant ventricular fibrillation. N Engl J Med 2002;346(12):884–90
- Somberg. Intravenous lidocaine versus intravenous amiodarone (in a new aqueous formulation) for incessant ventricular tachycardia. Am J Cardiol. 2002;90(8):853–9
Magnesium
- Hassan. A randomised trial to investigate the efficacy of magnesium sulphate for refractory ventricular fibrillation. Emerg Med J. 2002;19:57–62
- Allegra. Magnesium sulfate in the treatment of refractory ventricular fibrillation in the prehospital setting. Resuscitation. 2001;49:245–9
- Thel. Randomised trial of magnesium in in-hospital cardiac arrest. Duke internal medicine housestaff. Lancet 1997;350:1272–6
- Fatovich. Magnesium in cardiac arrest (the magic trial). Resuscitation. 1997;35:237–41
- Miller. Pilot study of intravenous magnesium sulfate in refractory cardiac arrest: safety data and recommendations for future studies. Resuscitation. 1995;30:3–14
Buffer Therapy
Bretylium
- Olson. A randomized comparison study of bretylium tosylate and lidocaine in resuscitation of patients from out-of-hospital ventricular fibrillation in a paramedic system. Ann Emerg Med 1984;13:807–10
- Haynes. Comparison of bretylium tosylate and lidocaine in management of out of hospital ventricular fibrillation: a randomized clinical trial. Am J Cardiol. 1981;48(2):353–6
- Nowak. Bretylium tosylate as initial treatment for cardiopulmonary arrest: randomized comparison with placebo. Ann Emerg Med. 1981;10(8):404–7
Intra-Arrest Airway Management
Cricoid Pressure
SGA vs ETT
- Wang. Effect of a Strategy of Initial Laryngeal Tube Insertion vs Endotracheal Intubation on 72-Hour Survival in Adults With Out-of-Hospital Cardiac Arrest. A Randomized Clinical Trial. JAMA 2018;320(8):769-778
- Benger. Effect of a Strategy of a Supraglottic Airway Device vs Tracheal Intubation During Out-of-Hospital Cardiac Arrest on Functional Outcome. The AIRWAYS-2 Randomized Clinical Trial. JAMA 2018;320(8):779-791
Chest Compression
Devices
- Perkins. Mechanical versus manual chest compression for out-of-hospital cardiac arrest (PARAMEDIC): a pragmatic, cluster randomised controlled trial. Lancet 2014;epublished November 16th
- Wik. Manual vs. integrated automatic load-distributing band CPR with equal survival after out of hospital cardiac arrest. The randomized CIRC trial. Resuscitation 2014;epublished March 15th
- Rubertsson. Mechanical Chest Compressions and Simultaneous Defibrillation vs Conventional Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest. The LINC Randomized Trial. JAMA 2013;311(1):53-61
Compression Rates
Post Arrest Management
Temperature Management
Temperature Comparisons
- Le May. Effect of Moderate vs Mild Therapeutic Hypothermia on Mortality and Neurologic Outcomes in Comatose Survivors of Out-of-Hospital Cardiac Arrest: The CAPITAL CHILL Randomized Clinical Trial. JAMA 2021;326(15):1494-1503
- Dankiewicz. Hypothermia versus Normothermia after Out-of-Hospital Cardiac Arrest. N Engl J Med 2021;384:2283-2294
- Lascarrou. Targeted Temperature Management for Cardiac Arrest with Nonshockable Rhythm. N Engl J Med N Engl J Med 2019;381:2327-2337
- Nielsen. Targeted Temperature Management at 33°C versus 36°C after Cardiac Arrest (TTM study). N Engl J Med 2013;369:2197-2206
- Kim. Effect of Prehospital Induction of Mild Hypothermia on Survival and Neurological Status Among Adults With Cardiac Arrest: A Randomized Clinical Trial. JAMA 2014;311(1):45-52
- Bernard. Treatment of Comatose Survivors of Out-of-Hospital Cardiac Arrest with Induced Hypothermia. N Engl J Med 2002; 346:557-563
- The Hypothermia after Cardiac Arrest Study Group. Mild Therapeutic Hypothermia to Improve the Neurologic Outcome after Cardiac Arrest. N Engl J Med 2002; 346:549-556
Intra-Arrest Cooling
- Nordberg. Effect of trans-nasal evaporative intra-arrest cooling on functional neurologic outcome in out-of-hospital cardiac arrest: the PRINCESS randomized clinical trial. JAMA 2019;321(17):1677–85
- Bernard. Induction of Therapeutic Hypothermia During Out-of-Hospital Cardiac Arrest Using a Rapid Infusion of Cold Saline: The RINSE Trial (Rapid Infusion of Cold Normal Saline). Circulation 2016;134(11):797-805
Cooling Method
Duration of Cooling
Paediatrics
Miscellaneous Post Arrest Management
Blood Pressure
Oxygenation
Percutaneous Coronary Intervention
Coronary Angiography Post Cardiac Arrest
Cardiogenic Shock
Last updated August 27th, 2022