Comparing 3 approaches for intensive care unit ICU

Exclusion

• −Adult patients (age ≥18 years) admitted to the ICU;
• −Treating team does not have equipoise for at least two contiguous MAP target ranges in the CEPEC Vasopressor Domain;
• −Acute traumatic brain injury (within 7 days or ongoing active treatment for elevated intracranial pressure);
• −Acute subarachnoid hemorrhage (within 21 days);
• −Acute spinal cord injury (within 7 days of injury or ongoing vasopressor therapy for suspected spinal cord ischemia);
• −Lung, heart, liver, kidney transplant recipient (within 7 days);
• −Patient expected to become an organ donor (Donor Neurologic Death - DND or Donation After Circulatory Death - DCD);
• −More than 24 hours since meeting inclusion criteriaInclusion criteriaThe things you must have or be for a study to consider you.Read more → in the ICU;
• −Previously randomizedRandomisedWhich group you go into is decided by chance, not by you or your doctor.Read more → into the CEPEC Vasopressor Domain or a confounding trial.
• −PLATELET DOMAIN
• −Inclusion criteria:
• −Latest platelet count in this hospital admission \<50×109/L;
• −Planned to undergo a specified low-moderate bleeding risk invasive procedure.
• −Exclusion criteriaExclusion criteriaThe things that would prevent someone from taking part.Read more →:
• −Ongoing major hemorrhage requiring blood products and/or surgical/ radiological intervention;
• −Intracranial hemorrhage within prior 72 hours;
• −Contraindications to platelet transfusion (e.g. thrombotic microangiopathies, heparin-induced thrombocytopenia, recent history of immune thrombocytopaenia, congenital platelet function defects);
• −Known advance decision of refusing blood/blood component transfusions;
• −Acute promyelocytic leukemia (APML);
• −Death perceived as imminent or admission for palliation;
• −Previously randomized into the CEPEC Platelet Domain or the T4P Trial;
• −Fulfilled all the inclusion criteria and none of the exclusion criteria ≥72 hours.
• −NUTRITION DOMAIN
• −Inclusion criteria:
• −Critically ill patients ≥18 years of age;
• −Are invasively mechanically ventilated (including endotracheal tube or tracheostomy);
• −Orogastric/nasogastric tube in place; or have an in dwelling percutaneous gastric tube (with confirmed placement);
• −Treating team has started or has the intention of providing enteral nutrition.
• −Exclusion criteria:
• −Bowel obstruction or ischemia; active;
• −Has a post-pyloric small bowel feeding tube;
• −Active GI bleeding;
• −Patient who is chronically receiving enteral nutrition.
• −Patients who have had gastrointestinal (GI) surgery; in the last 3 months and deemed not ready to receive possible bolus nutrition;