Publications by authors named "Carly Au"

Background: Peripheral oxygen saturation (SpO) above 94% is typical in children in paediatric intensive critical care units (PICUs) who are receiving invasive ventilation and supplemental oxygen. In a previous report from the Oxy-PICU trial, we showed that lower (conservative) oxygenation targets (SpO 88-92%) are beneficial, showing small but statistically significant differences in duration of organ support and large but non-significant cost reductions at 30 days. In this pre-specified analysis of the Oxy-PICU trial, we compare longer-term outcomes and cost-effectiveness of conservative versus liberal (SpO >94%) oxygenation targets in children with emergency PICU admission.

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Article Synopsis
  • The study aimed to automate the filling of case report forms (CRFs) for a COVID-19 trial across multiple locations in the U.S.
  • It utilized data from 27 hospitals and electronic health records to efficiently populate trial forms, successfully processing 499 out of 526 variables for 417 enrolled patients.
  • The researchers concluded that the automated system was effective and suggested improvements for future clinical trials.
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Objectives: Management of hypotension is a fundamental part of pediatric critical care, with cardiovascular support in the form of fluids or vasoactive drugs offered to every hypotensive child. However, optimal blood pressure (BP) targets are unknown. The PRotocolised Evaluation of PermiSSive BP Targets Versus Usual CaRE (PRESSURE) trial aims to evaluate the clinical and cost-effectiveness of a permissive mean arterial pressure (MAP) target of greater than a fifth centile for age compared with usual care.

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Background: The optimal target for systemic oxygenation in critically ill children is unknown. Liberal oxygenation is widely practiced, but has been associated with harm in paediatric patients. We aimed to evaluate whether conservative oxygenation would reduce duration of organ support or incidence of death compared to standard care.

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  • The study aimed to evaluate the effectiveness of simvastatin in critically ill Covid-19 patients compared to a control group not receiving statins.
  • A total of 2684 patients were analyzed, showing a median of 11 organ support-free days in the simvastatin group versus 7 in the control group, with a high probability indicating simvastatin’s potential superiority.
  • However, the study was halted due to decreasing Covid-19 cases, and while simvastatin had some benefits, it also led to more reported serious adverse effects, such as elevated liver enzymes.
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Importance: The efficacy of vitamin C for hospitalized patients with COVID-19 is uncertain.

Objective: To determine whether vitamin C improves outcomes for patients with COVID-19.

Design, Setting, And Participants: Two prospectively harmonized randomized clinical trials enrolled critically ill patients receiving organ support in intensive care units (90 sites) and patients who were not critically ill (40 sites) between July 23, 2020, and July 15, 2022, on 4 continents.

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  • Overactivation of the renin-angiotensin system (RAS) could lead to worse outcomes for COVID-19 patients, prompting a study to see if ACE inhibitors or ARBs could help.
  • In a clinical trial with 721 patients, participants were randomly assigned to receive either an ACE inhibitor, an ARB, or no RAS inhibitor to evaluate their effects on patient recovery.
  • Results showed no significant improvement in organ support-free days among the treatment groups compared to the control, leading to the discontinuation of enrollment due to safety concerns.
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Background: STAMPEDE previously reported adding upfront docetaxel improved overall survival for prostate cancer patients starting long-term androgen deprivation therapy. We report long-term results for non-metastatic patients using, as primary outcome, metastatic progression-free survival (mPFS), an externally demonstrated surrogate for overall survival.

Methods: Standard of care (SOC) was androgen deprivation therapy with or without radical prostate radiotherapy.

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Objectives: Oxygen administration is a fundamental part of pediatric critical care, with supplemental oxygen offered to nearly every acutely unwell child. However, optimal targets for systemic oxygenation are unknown. Oxy-PICU aims to evaluate the clinical effectiveness and cost-effectiveness of a conservative peripheral oxygen saturation (Sp o2 ) target of 88-92% compared with a liberal target of more than 94%.

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