Canadian Journal of Anesthesia: Special Issue on Equity in Anesthesiology and Critical Care in Canada

The Panel on Research Ethics and Secretariat for Responsible Conduct of Research recently proposed new guidance for multi-jurisdictional review by Research Ethics Boards. We are pleased by the proposed requirement for a single REB of record for low risk studies, and encourage moving toward a single ethics approval for all multi-jurisdictional studies. Read CCCTG's formal submission to the public consultation.

New findings published in Journal of Journal of the American Medical Assocation (JAMA) show that among critically ill adults with confirmed COVID-19, treatment with 2 units of high-titer, ABO-compatible convalescent plasma had a low likelihood of providing improvement in the number of organ support–free days.

Randomized Clinical Trial results published September 2021 show that among critically ill patients requiring mechanical ventilation, administration of the probiotic L rhamnosus GG compared with placebo resulted in no significant difference in the development of ventilator-associated pneumonia.

The paper proposes three solutions to create a “learning healthcare system” (1) create a process to easily add new fields to data that is collected on hospital discharges when needed (2) enable the national coordination of data and research and (3) create and support durable national research and quality improvement networks.

ATTACC, ACTIV-4a and REMAP-CAP teams publish results in the New England Journal of Medicine from two RCTs addressing therapeutic anticoagulation in hospitalized COVID-19 patients.

We are encouraged by the proposed direction in Health Canada's Clinical Trials Regulatory Modernization initiative. Click Learn More to read CCCTG's formal submission to the public consultation.

This year’s recipient of the Deborah J. Cook Mentorship Award is Ellen McDonald. Ellen has spent more than 25 years as a Research Coordinator for McMaster University, based at St. Joseph’s Healthcare Hamilton and Hamilton Health Sciences and has played a pivotal role in CCCTG. We congratulate Ellen on this significant achievement and thank her for her tremendous contribution to critical care research!

Canada and other G7 Health Ministers endorse the G7 Therapeutics and Vaccines Clinical Trials Charter in their Oxford Declaration June 4, 2021. Includes commitment to “work with G7 regulators, ethics institutions and committees to achieve greater harmonisation and to streamline regulatory process to act more proportionately to risk.”

The CCCTG Board is delighted to introduce Brenda Lucas as the next CCCTG Executive Director. Brenda has most recently been seconded to the University of Waterloo to help with resuming research activities during COVID, and prior to this as the executive director for the Ontario water consortium. Previously, she was senior policy advisor to two Ministers of Environment for Ontario.

Recently completed IOS observational study describe practice variation in IMV discontinuation internationally, associations between initial discontinuation events and outcomes, and factors associated with the use of select discontinuation strategies and failed initial spontaneous breathing trials (SBTs). The IOS study was published in JAMA.

Recently completed DePPaRT study provides information about the process of death after withdrawal of life sustaining therapy in the ICU. The DePPaRT study was published in The New England Journal of Medicine.

Equity, diversity, and inclusion are core values of the CCCTG. Diversity in life experiences and backgrounds provide diversity of thought. Diversity of thought leads to the best science. It is important to represent the gender, cultural, and ethnic diversity of the critical care community to ensure representativeness, provide role models, and foster a critical care community based on inclusivity.  Click Learn More to read CCCTG's policy.

The Health Research Foundation (HRF) of Innovative Medicines Canada (IMC) announces that Dr. Srinivas Murthy has been awarded the Health Research Foundation of Innovative Medicines Canada Chair in Pandemic Preparedness Research.
 

REMAP-CAP uses a novel and innovative trial design able to adapt in the event of pandemics, and increases the likelihood that patients will receive the treatment that is most likely to be effective for them. REMAP-CAP is currently enrollling COVID-19 patients. Click on Learn More to get to the trial website.

In conjunction with the World Health Organization, Canada is participating in the SOLIDARITY trial, a global platform of research that is in various stages of approval in over 90 countries. 

Recent preliminary evidence suggests that intravenous vitamin C may be the first therapy to mitigate the dysregulated cascade of events transforming an infection into sepsis. However, definitive practice changing evidence requires a large trial powered to detect a plausible, modest, and clinically important difference in mortality. Click on Learn More to learn more about LOVIT.

The CIHR supports Drs. Jeanna Parsons Leigh and Srinivas Murthy through the Canadian 2019 Novel Coronavirus (COVID-19) Rapid Research Funding Opportunity.

Study reveals gender disparity exists in grant and personnel award success rates, especially for grants directed to selected research communities. This information is important to address potential sources of bias in the review process. Click Learn More to read the full article.

Dr. Brian Rowe acknowledges the role of research in critical care medicine and recognize the excellent work of health care professionals who provide intensive care. He also mentions contribution and impact of the CCCTG.

InFACT members include three dozen investigator-led research consortia from around the world. These groups have conducted many of the most impactful clinical trials in critical care. This year marks the 10th Anniversary of InFACT.

The CCCTG Patient and Family Engagement Committee has just launched the new website for patients and families who are experiencing, or have experienced, critical care. The purpose of the website is to support and engage patients and families in research.

The CCCTG is thrilled to support Drs. Nadia Roumeliotis and Oleksa Rewa so they can add to their experience by engaging in critical care research.  We are thankful to our partners, Fonds de recherche santé Québec and Alberta Health Services through the Critical Care Strategic Clinical Network for their contributions to the CCCTG Fellowship Program.

The RECOVER Program, lead by Dr. Margaret Herridge aims to elucidate the impact of critical illness and the caregiving situation on patients' and caregivers' long-term physical function and mental health.

The CCCTG contributes to the development of the report from the Canadian Institute of Health Information (CIHI) about the care in Canadian intensive care units. Click Learn More to access CIHI's report.

The TBI-Prognosis study aims at developing a prediction model to help provide objective information to patients and families on long-term prognosis in critically ill patients with severe traumatic brain injury. This multicenter prospective study is conducted by Dr Alexis Turgeon and a team of colleagues in 17 centers across Canada. Enrolment in the study has just been completed and 12-month follow-up outcome measures are ongoing.

François Lamontagne and the OVATION team have published the results from the pilot sutdy.  Click Learn More to view a video from Dr. Lamontagne and colleagues explaining the trial and the use of vasopressors in critically ill patients.

Acute kidney injury (AKI) is a common and increasingly encountered complication of critical illness. The STARRT-AKI research program aims to investigate strategies to starting acute renal replacement therapy in critically ill patients with severe AKI.

Researchers from the CCCTG investigated factors influencing the impact of clinical trials.  Authors found that investigator-lead clinical trials increasingly shape the knowledge base of critical care, in particular trials led by investigators within structured critical care research consortia.  Click Learn More to read the full article.

Dr. Dayre McNally, physician in CHEO’s pediatric intensive care unit, investigates how optimizing Vitamin D levels can help treat critically ill children. Click Learn More to view Dr. McNally's video.

All critically ill, mechanically ventilated patients in the Intensive Care Unit receive medications to relieve pain and anxiety. However, accumulation of these medications can be associated with serious complications. Researchers from the CCCTG compared sedation strategies in critically ill mechanically ventilated patients.

The OPTICS research program lead by Drs. John Muscedere and François Lamontagne aims to understand differences in priorities between patients, citizens, decision-makers and researchers about research priorities and outcomes assessment in critical care clinical research.  Click on Learn More for a short video (in French only) presenting the OPTICS study.

Blood used for transfusions is perishable. But contrary to general belief, results from a new study from CCCTG researchers published today in the New England Journal of Medicine shows that blood stored for three weeks is just as good as fresh blood.

The results of the PROTECT Trial and the recent corresponding cost-effectiveness study showed better health outcomes and overall, lower health care costs when using low molecular weight heparin dalteparin for the prevention of venous thromboembolism in the ICU.