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.
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.
Interventions consistently shown to reduce mortality in multicenter RCTs in critically ill patients were limited tidal volume in patients with ARDS, noninvasive ventilation in acute hypercapnic respiratory failure, and noninvasive ventilation following extubation in complex cases.
Corticosteroids in septic shock, selective digestive decontamination, and prone positioning in ARDS remain controversial.
References
Santacruz CA, et al. Which multicenter randomized controlled trials in critical care medicine have shown reduced mortality? A systematic review. Crit Care Med. 2019; 47:1680-1691.
