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Decision-Making in the Democracy Medicine Era: The Consensus Conference Process

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Reducing Mortality in Critically Ill Patients

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Abstract

Randomized controlled trials (RCTs) are the gold standard of evidence-based medicine.

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References

  1. Vincent JL. We should abandon randomized controlled trials in the intensive care unit. In: Critical care medicine, vol. 38. Baltimore: Lippincott Williams and Wilkins; 2010. https://doi.org/10.1097/CCM.0b013e3181f208ac.

    Chapter  Google Scholar 

  2. Ospina-Tascón GA, Büchele GL, Vincent J-L. Multicenter, randomized, controlled trials evaluating mortality in intensive care: doomed to fail? Crit Care Med. 2008;36(4):1311–22. https://doi.org/10.1097/CCM.0b013e318168ea3e.

    Article  PubMed  Google Scholar 

  3. Bellomo R. The risks and benefits of the consensus process. In: Reducing mortality in the perioperative period. Cham: Springer; 2014. p. 1–7. https://doi.org/10.1007/978-3-319-02186-7_1.

    Chapter  Google Scholar 

  4. Rotondi AJ, Kvetan V, Carlet J, Sibbald WJ. Consensus conferences in critical care medicine. Crit Care Clin. 1997;13(2):417–40. https://doi.org/10.1016/S0749-0704(05)70319-5.

    Article  CAS  PubMed  Google Scholar 

  5. Greco M, Zangrillo A, Mucchetti M, et al. Democracy-based consensus in medicine. J Cardiothorac Vasc Anesth. 2015;29(2):506–9. https://doi.org/10.1053/j.jvca.2014.11.005.

    Article  PubMed  Google Scholar 

  6. Plant PK, Owen JL, Elliott MW. Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet. 2000;355(9219):1931–5. https://doi.org/10.1016/S0140-6736(00)02323-0.

    Article  CAS  PubMed  Google Scholar 

  7. Frat JP, Thille AW, Mercat A, et al. High-flow oxygen through nasal cannula in acute hypoxemic respiratory failure. N Engl J Med. 2015;372(23):2185–96. https://doi.org/10.1056/NEJMoa1503326.

    Article  CAS  PubMed  Google Scholar 

  8. Likhvantsev VV, Landoni G, Levikov DI, Grebenchikov OA, Skripkin YV, Cherpakov RA. Sevoflurane versus Total intravenous anesthesia for isolated coronary artery bypass surgery with cardiopulmonary bypass: a randomized trial. J Cardiothorac Vasc Anesth. 2016;30(5):1221–7. https://doi.org/10.1053/j.jvca.2016.02.030.

    Article  CAS  PubMed  Google Scholar 

  9. Guérin C, Reignier J, Richard J-C, et al. Prone positioning in severe acute respiratory distress syndrome. N Engl J Med. 2013;368(23):2159–68. https://doi.org/10.1056/NEJMoa1214103.

    Article  CAS  PubMed  Google Scholar 

  10. Brower RG, Matthay MA, Morris A, et al. Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med. 2000;342(18):1301–8. https://doi.org/10.1056/NEJM200005043421801.

    Article  PubMed  Google Scholar 

  11. De Jonge E, Schultz MJ, Spanjaard L, et al. Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial. Lancet. 2003;362(9389):1011–6. https://doi.org/10.1016/S0140-6736(03)14409-1.

    Article  CAS  PubMed  Google Scholar 

  12. Mancebo J, Fernández R, Blanch L, et al. A multicenter trial of prolonged prone ventilation in severe acute respiratory distress syndrome. Am J Respir Crit Care Med. 2006;173(11):1233–9. https://doi.org/10.1164/rccm.200503-353OC.

    Article  PubMed  Google Scholar 

  13. Lindner KH, Dirks B, Strohmenger HU, Prengel AW, Lindner IM, Lurie KG. Randomised comparison of epinephrine and vasopressin in patients with out-of-hospital ventricular fibrillation. Lancet. 1997;349(9051):535–7. https://doi.org/10.1016/S0140-6736(97)80087-6.

    Article  CAS  PubMed  Google Scholar 

  14. Sort P, Navasa M, Arroyo V, et al. Effect of intravenous albumin on renal impairment and mortality in patients with cirrhosis and spontaneous bacterial peritonitis. N Engl J Med. 1999;341(6):403–9. https://doi.org/10.1056/nejm199908053410603.

    Article  CAS  PubMed  Google Scholar 

  15. Dorian P, Cass D, Schwartz B, Cooper R, Gelaznikas R, Barr A. Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation. N Engl J Med. 2002;346(12):884–90. https://doi.org/10.1056/nejmoa013029.

    Article  CAS  PubMed  Google Scholar 

  16. Kudenchuk PJ, Cobb LA, Copass MK, et al. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med. 1999;341(12):871–8. https://doi.org/10.1056/nejm199909163411203.

    Article  CAS  PubMed  Google Scholar 

  17. Baudo F, Caimi TM, de Cataldo F, et al. Antithrombin III (ATILL) replacement therapy in patients with sepsis and/or postsurgical complications: a controlled double-blind, randomized, multicenter study. Intensive Care Med. 1998;24(4):336–42. https://doi.org/10.1007/s001340050576.

    Article  CAS  PubMed  Google Scholar 

  18. Ferrer M, Valencia M, Nicolas JM, Bernadich O, Badia JR, Torres A. Early noninvasive ventilation averts extubation failure in patients at risk: a randomized trial. Am J Respir Crit Care Med. 2006;173(2):164–70. https://doi.org/10.1164/rccm.200505-718OC.

    Article  PubMed  Google Scholar 

  19. Lavrentieva A, Bitzani M, Parlapani A, et al. The efficacy of antithrombin administration in the acute phase of burn injury. Thromb Haemost. 2008;100(08):286–90. https://doi.org/10.1160/th07-11-0684.

    Article  CAS  PubMed  Google Scholar 

  20. Warren BL, Eid A, Singer P, et al. High-dose Antithrombin III in severe Sepsis. JAMA. 2001;286(15):1869. https://doi.org/10.1001/jama.286.15.1869.

    Article  CAS  PubMed  Google Scholar 

  21. Chen ZM, et al. Addition of clopidogrel to aspirin in 45 852 patients with acute myocardial infarction: randomised placebo-controlled trial. Lancet. 2005;366(9497):1607–21. https://doi.org/10.1016/s0140-6736(05)67660-x.

    Article  CAS  PubMed  Google Scholar 

  22. de La Cal MA, Cerdá E, García-Hierro P, et al. Survival benefit in critically ill burned patients receiving selective decontamination of the digestive tract. Ann Surg. 2005;241(3):424–30. https://doi.org/10.1097/01.sla.0000154148.58154.d5.

    Article  Google Scholar 

  23. Krueger WA, Lenhart F-P, Neeser G, et al. Influence of combined intravenous and topical antibiotic prophylaxis on the incidence of infections, organ dysfunctions, and mortality in critically ill surgical patients. Am J Respir Crit Care Med. 2002;166(8):1029–37. https://doi.org/10.1164/rccm.2105141.

    Article  PubMed  Google Scholar 

  24. Rocha LA, Martín MJ, Pita S, et al. Prevention of nosocomial infection in critically ill patients by selective decontamination of the digestive tract. Intensive Care Med. 1992;18(7):398–404. https://doi.org/10.1007/bf01694341.

    Article  CAS  PubMed  Google Scholar 

  25. Ulrich C, Harinck-de Weerd JE, Bakker NC, Jacz K, Doornbos L, de Ridder VA. Selective decontamination of the digestive tract with norfloxacin in the prevention of ICU-acquired infections: a prospective randomized study. Intensive Care Med. 1989;15(7):424–31. https://doi.org/10.1007/bf00255597.

    Article  CAS  PubMed  Google Scholar 

  26. Eisenberg MS. Treatment of ventricular fibrillation. JAMA. 1984;251(13):1723. https://doi.org/10.1001/jama.1984.03340370055030.

    Article  CAS  PubMed  Google Scholar 

  27. Hallstrom AP, et al. Public-access defibrillation and survival after out-of-hospital cardiac arrest. N Engl J Med. 2004;351(7):637–46. https://doi.org/10.1056/nejmoa040566.

    Article  CAS  PubMed  Google Scholar 

  28. Lin S-MM, Da Huang C-D, Lin H-CC, Liu C-YY, Wang C-HH, Kuo H-PP. A modified goal-directed protocol improves clinical outcomes in intensive care unit patients with septic shock. Shock. 2006;26(6):551–7. https://doi.org/10.1097/01.shk.0000232271.09440.8f.

    Article  PubMed  Google Scholar 

  29. Ferrer M, Sellarés J, Valencia M, et al. Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial. Lancet. 2009;374(9695):1082–8. https://doi.org/10.1016/S0140-6736(09)61038-2.

    Article  PubMed  Google Scholar 

  30. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe Sepsis and septic shock. N Engl J Med. 2001;345(19):1368–77. https://doi.org/10.1056/nejmoa010307.

    Article  CAS  PubMed  Google Scholar 

  31. Annane D. Effect of treatment with low doses of hydrocortisone and fludrocortisone on mortality in patients with septic shock. JAMA. 2002;288(7):862. https://doi.org/10.1001/jama.288.7.862.

    Article  CAS  PubMed  Google Scholar 

  32. Bilgin YM, van de Watering LMG, Eijsman L, et al. Double-blind, randomized controlled trial on the effect of leukocyte-depleted erythrocyte transfusions in cardiac valve surgery. Circulation. 2004;109(22):2755–60. https://doi.org/10.1161/01.cir.0000130162.11925.21.

    Article  CAS  PubMed  Google Scholar 

  33. van de Watering LMG, Hermans J, Houbiers JGA, et al. Beneficial effects of leukocyte depletion of transfused blood on postoperative complications in patients undergoing cardiac surgery. Circulation. 1998;97(6):562–8. https://doi.org/10.1161/01.cir.97.6.562.

    Article  PubMed  Google Scholar 

  34. Fuhrmann JT, Schmeisser A, Schulze MR, et al. Levosimendan is superior to enoximone in refractory cardiogenic shock complicating acute myocardial infarction*. Crit Care Med. 2008;36(8):2257–66. https://doi.org/10.1097/ccm.0b013e3181809846.

    Article  CAS  PubMed  Google Scholar 

  35. Levin RL, Degrange MA, Porcile R, et al. The calcium sensitizer levosimendan gives superior results to dobutamine in postoperative low cardiac output syndrome. Rev Española Cardiol. 2008;61(5):471–9. https://doi.org/10.1016/s1885-5857(08)60160-7.

    Article  Google Scholar 

  36. Cohen TJ, Goldner BG, Maccaro PC, et al. A comparison of active compression-decompression cardiopulmonary resuscitation with standard cardiopulmonary resuscitation for cardiac arrests occurring in the hospital. N Engl J Med. 1993;329(26):1918–21. https://doi.org/10.1056/nejm199312233292603.

    Article  CAS  PubMed  Google Scholar 

  37. Gao C, Chen YY, Peng H, Chen YY, Zhuang Y, Zhou S. Clinical evaluation of the AutoPulse automated chest compression device for out-of-hospital cardiac arrest in the northern district of Shanghai, China. Arch Med Sci. 2016;3(3):563–70. https://doi.org/10.5114/aoms.2016.59930.

    Article  Google Scholar 

  38. Tucker KJ, Galli F, Savitt MA, Kahsai D, Bresnahan L, Redberg RF. Active compression-decompression resuscitation: effect on resuscitation success after in-hospital cardiac arrest. J Am Coll Cardiol. 1994;24(1):201–9. https://doi.org/10.1016/0735-1097(94)90564-9.

    Article  CAS  PubMed  Google Scholar 

  39. Wolcke BB, Mauer DK, Schoefmann MF, et al. Comparison of standard cardiopulmonary resuscitation versus the combination of active compression-decompression cardiopulmonary resuscitation and an inspiratory impedance threshold device for out-of-hospital cardiac arrest. Circulation. 2003;108(18):2201–5. https://doi.org/10.1161/01.cir.0000095787.99180.b5.

    Article  PubMed  Google Scholar 

  40. Nava S, Ambrosino N, Clini E, et al. Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease: a randomized, controlled trial. Ann Intern Med. 1998;128(9):721–8. https://doi.org/10.7326/0003-4819-128-9-199805010-00004.

    Article  CAS  PubMed  Google Scholar 

  41. Ferrer M, Esquinas A, Leon M, Gonzalez G, Alarcon A, Torres A. Noninvasive ventilation in severe hypoxemic respiratory failure. Am J Respir Crit Care Med. 2003;168(12):1438–44. https://doi.org/10.1164/rccm.200301-072oc.

    Article  PubMed  Google Scholar 

  42. L’Her E, Duquesne F, Girou E, et al. Noninvasive continuous positive airway pressure in elderly cardiogenic pulmonary edema patients. Intensive Care Med. 2004;30(5):882–8. https://doi.org/10.1007/s00134-004-2183-y.

    Article  PubMed  Google Scholar 

  43. Nava S, Grassi M, Fanfulla F, et al. Non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure: a randomised controlled trial. Age Ageing. 2011;40(4):444–50. https://doi.org/10.1093/ageing/afr003.

    Article  PubMed  Google Scholar 

  44. Park M, Sangean MC, Volpe MS, et al. Randomized, prospective trial of oxygen, continuous positive airway pressure, and bilevel positive airway pressure by face mask in acute cardiogenic pulmonary edema. Crit Care Med. 2004;32(12):2407–15. https://doi.org/10.1097/01.ccm.0000147770.20400.10.

    Article  PubMed  Google Scholar 

  45. Thompson J, Petrie DA, Ackroyd-Stolarz S, Bardua DJ. Out-of-hospital continuous positive airway pressure ventilation versus usual care in acute respiratory failure: a randomized controlled trial. Ann Emerg Med. 2008;52(3):232–241.e1. https://doi.org/10.1016/j.annemergmed.2008.01.006.

    Article  PubMed  Google Scholar 

  46. Brochard L, Mancebo J, Wysocki M, et al. Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med. 1995;333(13):817–22. https://doi.org/10.1056/nejm199509283331301.

    Article  CAS  PubMed  Google Scholar 

  47. Ferrer M, Esquinas A, Arancibia F, et al. Noninvasive ventilation during persistent weaning failure. Am J Respir Crit Care Med. 2003;168(1):70–6. https://doi.org/10.1164/rccm.200209-1074oc.

    Article  PubMed  Google Scholar 

  48. Ornico SR, Lobo SM, Sanches HS, et al. Noninvasive ventilation immediately after extubation improves weaning outcome after acute respiratory failure: a randomized controlled trial. Crit Care. 2013;17(2):R39. https://doi.org/10.1186/cc12549.

    Article  PubMed  PubMed Central  Google Scholar 

  49. Amato MBP, Barbas CSV, Medeiros DM, et al. Effect of a protective-ventilation strategy on mortality in the acute respiratory distress syndrome. N Engl J Med. 1998;338(6):347–54. https://doi.org/10.1056/nejm199802053380602.

    Article  CAS  PubMed  Google Scholar 

  50. Gattinoni L, Tognoni G, Pesenti A, et al. Effect of prone positioning on the survival of patients with acute respiratory failure. N Engl J Med. 2001;345(8):568–73. https://doi.org/10.1056/nejmoa010043.

    Article  CAS  PubMed  Google Scholar 

  51. Mansouri P, Javadpour S, Zand F, et al. Implementation of a protocol for integrated management of pain, agitation, and delirium can improve clinical outcomes in the intensive care unit: a randomized clinical trial. J Crit Care. 2013;28(6):918–22. https://doi.org/10.1016/j.jcrc.2013.06.019.

    Article  PubMed  Google Scholar 

  52. Villar J, Kacmarek RM, Pérez-Méndez L, Aguirre-Jaime A. A high positive end-expiratory pressure, low tidal volume ventilatory strategy improves outcome in persistent acute respiratory distress syndrome: a randomized, controlled trial. Crit Care Med. 2006;34(5):1311–8. https://doi.org/10.1097/01.ccm.0000215598.84885.01.

    Article  PubMed  Google Scholar 

  53. Girardis M, Busani S, Damiani E, et al. Effect of conservative vs conventional oxygen therapy on mortality among patients in an intensive care unit. JAMA. 2016;316(15):1583. https://doi.org/10.1001/jama.2016.11993.

    Article  CAS  PubMed  Google Scholar 

  54. Meyhoff CS, Jorgensen LN, Wetterslev J, Christensen KB, Rasmussen LS. Increased long-term mortality after a high perioperative inspiratory oxygen fraction during abdominal surgery. Anesth Analg. 2012;115(4):849–54. https://doi.org/10.1213/ane.0b013e3182652a51.

    Article  PubMed  Google Scholar 

  55. Brown CH, Azman AS, Gottschalk A, Mears SC, Sieber FE. Sedation depth during spinal anesthesia and survival in elderly patients undergoing hip fracture repair. Anesth Analg. 2014;118(5):977–80. https://doi.org/10.1213/ane.0000000000000157.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. GREAT Group. Feasibility, safety, and efficacy of domiciliary thrombolysis by general practitioners: Grampian region early anistreplase trial. BMJ. 1992;305(6853):548–53. https://doi.org/10.1136/bmj.305.6853.548.

    Article  Google Scholar 

  57. Jerjes-Sanchez C, Ramírez-Rivera A, de Lourdes GM, et al. Streptokinase and heparin versus heparin alone in massive pulmonary embolism: a randomized controlled trial. J Thromb Thrombolysis. 1995;2(3):227–9. https://doi.org/10.1007/bf01062714.

    Article  CAS  PubMed  Google Scholar 

  58. Rawles JM. Quantification of the benefit of earlier thrombolytic therapy: five-year results of the Grampian region early anistreplase trial (GREAT). J Am Coll Cardiol. 1997;30(5):1181–6. https://doi.org/10.1016/s0735-1097(97)00299-4.

    Article  CAS  PubMed  Google Scholar 

  59. Bösel J, Schiller P, Hook Y, et al. Stroke-related early tracheostomy versus prolonged orotracheal intubation in neurocritical care trial (SETPOINT). Stroke. 2013;44(1):21–8. https://doi.org/10.1161/strokeaha.112.669895.

    Article  PubMed  Google Scholar 

  60. Rumbak MJ, Newton M, Truncale T, Schwartz SW, Adams JW, Hazard PB. A prospective, randomized, study comparing early percutaneous dilational tracheotomy to prolonged translaryngeal intubation (delayed tracheotomy) in critically ill medical patients*. Crit Care Med. 2004;32(8):1689–94. https://doi.org/10.1097/01.ccm.0000134835.05161.b6.

    Article  PubMed  Google Scholar 

  61. CRASH-2 Trial Collaborators. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial. Lancet. 2010;376(9734):23–32. https://doi.org/10.1016/s0140-6736(10)60835-5.

    Article  Google Scholar 

  62. Kudenchuk PJ, Brown SP, Daya M, et al. Amiodarone, lidocaine, or placebo in out-of-hospital cardiac arrest. N Engl J Med. 2016;374(18):1711–22. https://doi.org/10.1056/NEJMoa1514204.

    Article  CAS  PubMed  Google Scholar 

  63. Mentzelopoulos SD, Zakynthinos SG, Tzoufi M, et al. Vasopressin, epinephrine, and corticosteroids for in-hospital cardiac arrest. Arch Intern Med. 2009;169(1):15. https://doi.org/10.1001/archinternmed.2008.509.

    Article  CAS  PubMed  Google Scholar 

  64. Mentzelopoulos SD, Malachias S, Chamos C, et al. Vasopressin, steroids, and epinephrine and neurologically favorable survival after in-hospital cardiac arrest. JAMA. 2013;310(3):270. https://doi.org/10.1001/jama.2013.7832.

    Article  CAS  PubMed  Google Scholar 

  65. De Hert S, Vlasselaers D, Barbé R, et al. A comparison of volatile and non volatile agents for cardioprotection during on-pump coronary surgery. Anaesthesia. 2009;64(9):953–60. https://doi.org/10.1111/j.1365-2044.2009.06008.x.

    Article  CAS  PubMed  Google Scholar 

  66. Sarullo M. Ospedale Buccheri la Ferla F. [The safety and efficacy of systemic salvage thrombolysis in acute myocardial infarct]; 2000. http://www.researchgate.net/publication/12486256. Accessed 20 Aug 2020.

  67. Girard TD, Kress JP, Fuchs BD, et al. Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (awakening and breathing controlled trial): a randomised controlled trial. Lancet. 2008;371(9607):126–34. https://doi.org/10.1016/S0140-6736(08)60105-1.

    Article  PubMed  Google Scholar 

  68. Zhu G, Wang D, Liu S, Jia M, Jia S. Efficacy and safety of noninvasive positive pressure ventilation in the treatment of acute respiratory failure after cardiac surgery. Chin Med J. 2013;126(23):4463–9.

    PubMed  Google Scholar 

  69. Doig GS, Simpson F, Heighes PT, et al. Restricted versus continued standard caloric intake during the management of refeeding syndrome in critically ill adults: a randomised, parallel-group, multicentre, single-blind controlled trial. Lancet Respir Med. 2015;3(12):943–52. https://doi.org/10.1016/S2213-2600(15)00418-X.

    Article  PubMed  Google Scholar 

  70. de Jong E, van Oers JA, Beishuizen A, et al. Efficacy and safety of procalcitonin guidance in reducing the duration of antibiotic treatment in critically ill patients: a randomised, controlled, open-label trial. Lancet Infect Dis. 2016;16(7):819–27. https://doi.org/10.1016/S1473-3099(16)00053-0.

    Article  CAS  PubMed  Google Scholar 

  71. Jacobs IG, Finn JC, Jelinek GA, Oxer HF, Thompson PL. Effect of adrenaline on survival in out-of-hospital cardiac arrest: a randomised double-blind placebo-controlled trial. Resuscitation. 2011;82(9):1138–43. https://doi.org/10.1016/j.resuscitation.2011.06.029.

    Article  CAS  PubMed  Google Scholar 

  72. Acker CG, Singh AR, Flick RP, Bernardini J, Greenberg A, Johnson JP. A trial of thyroxine in acute renal failure. Kidney Int. 2000;57(1):293–8. https://doi.org/10.1046/j.1523-1755.2000.00827.x.

    Article  CAS  PubMed  Google Scholar 

  73. López A, Lorente JA, Steingrub J, et al. Multiple-center, randomized, placebo-controlled, double-blind study of the nitric oxide synthase inhibitor 546C88: effect on survival in patients with septic shock. Crit Care Med. 2004;32(1):21–30. https://doi.org/10.1097/01.CCM.0000105581.01815.C6.

    Article  CAS  PubMed  Google Scholar 

  74. Morris PE, Papadakos P, Russell JA, et al. A double-blind placebo-controlled study to evaluate the safety and efficacy of L-2-oxothiazolidine-4-carboxylic acid in the treatment of patients with acute respiratory distress syndrome. Crit Care Med. 2008;36(3):782–8. https://doi.org/10.1097/CCM.0B013E318164E7E4.

    Article  CAS  PubMed  Google Scholar 

  75. Olldashi F, Muzha I, Filipi N, et al. Effect of intravenous corticosteroids on death within 14 days in 10008 adults with clinically significant head injury (MRC CRASH trial): randomised placebo-controlled trial. Lancet. 2004;364(9442):1321–8. https://doi.org/10.1016/S0140-6736(04)17188-2.

    Article  CAS  PubMed  Google Scholar 

  76. Braunschweig CA, Sheean PM, Peterson SJ, et al. Intensive nutrition in acute lung injury: a clinical trial (INTACT). J Parenter Enter Nutr. 2015;39(1):13–20. https://doi.org/10.1177/0148607114528541.

    Article  Google Scholar 

  77. Mourvillier B, Tubach F, Van De Beek D, et al. Induced hypothermia in severe bacterial meningitis: a randomized clinical trial. J Am Med Assoc. 2013;310(20):2174–83. https://doi.org/10.1001/jama.2013.280506.

    Article  CAS  Google Scholar 

  78. Takala J, Ruokonen E, Webster NR, et al. Increased mortality associated with growth hormone treatment in critically ill adults. N Engl J Med. 1999;341(11):785–92. https://doi.org/10.1056/NEJM199909093411102.

    Article  CAS  PubMed  Google Scholar 

  79. Fergusson DA, Hébert PC, Mazer CD, et al. A comparison of aprotinin and lysine analogues in high-risk cardiac surgery. N Engl J Med. 2008;358(22):2319–31. https://doi.org/10.1056/NEJMoa0802395.

    Article  CAS  PubMed  Google Scholar 

  80. Pappalardo F, Crivellari M, Di Prima AL, et al. Protein C zymogen in severe sepsis: a double-blinded, placebo-controlled, randomized study. Intensive Care Med. 2016;42(11):1706–14. https://doi.org/10.1007/s00134-016-4405-5.

    Article  CAS  PubMed  Google Scholar 

  81. Smith F, Perkins G, Gates S, Young D, Lancet DM-T. Effect of intravenous β-2 agonist treatment on clinical outcomes in acute respiratory distress syndrome (BALTI-2): a multicentre, randomised controlled trial. Lancet. 2012;379:229–35. https://doi.org/10.1016/S0140-6736(11)61623-1.

    Article  CAS  PubMed Central  Google Scholar 

  82. Sloan EP, Koenigsberg M, Gens D, et al. Diaspirin cross-linked hemoglobin (DCLHb) in the treatment of severe traumatic hemorrhagic shock: a randomized controlled efficacy trial. J Am Med Assoc. 1999;282(19):1857–64. https://doi.org/10.1001/jama.282.19.1857.

    Article  CAS  Google Scholar 

  83. Myburgh J, Cooper DJ, Finfer S, et al. Saline or albumin for fluid resuscitation in patients with traumatic brain injury. N Engl J Med. 2007;357(9):874–84. https://doi.org/10.1056/NEJMoa067514.

    Article  CAS  PubMed  Google Scholar 

  84. Sartini C, Lomivorotov V, Pieri M, et al. A systematic review and international web-based survey of randomized controlled trials in the perioperative and critical care setting: interventions reducing mortality. J Cardiothorac Vasc Anesth. 2019;33(5):1430–9. https://doi.org/10.1053/j.jvca.2018.11.026.

    Article  PubMed  Google Scholar 

  85. Sartini C, Lomivorotov V, Pisano A, et al. A systematic review and international web-based survey of randomized controlled trials in the perioperative and critical care setting: interventions increasing mortality. J Cardiothorac Vasc Anesth. 2019;33(10):2685–94. https://doi.org/10.1053/j.jvca.2019.03.022.

    Article  PubMed  Google Scholar 

  86. Landoni G, Rodseth RN, Santini F, et al. Randomized evidence for reduction of perioperative mortality. J Cardiothorac Vasc Anesth. 2012;26(5):764–72. https://doi.org/10.1053/j.jvca.2012.04.018.

    Article  PubMed  Google Scholar 

  87. Landoni G, Pisano A, Lomivorotov V, et al. Randomized evidence for reduction of perioperative mortality: an updated consensus process. J Cardiothorac Vasc Anesth. 2017;31(2):719–30. https://doi.org/10.1053/j.jvca.2016.07.017.

    Article  PubMed  Google Scholar 

  88. Landoni G, Lomivorotov V, Silvietti S, et al. Nonsurgical strategies to reduce mortality in patients undergoing cardiac surgery: an updated consensus process. J Cardiothorac Vasc Anesth. 2018;32(1):225–35. https://doi.org/10.1053/j.jvca.2017.06.017.

    Article  PubMed  Google Scholar 

  89. Landoni G, Bove T, Székely A, et al. Reducing mortality in acute kidney injury patients: systematic review and international web-based surveY. J Cardiothorac Vasc Anesth. 2013;27(6):1384–98. https://doi.org/10.1053/j.jvca.2013.06.028.

    Article  PubMed  Google Scholar 

  90. Pisano A, Landoni G, Lomivorotov V, et al. Worldwide opinion on multicenter randomized interventions showing mortality reduction in critically ill patients: a democracy-based medicine approach. J Cardiothorac Vasc Anesth. 2016;30(5):1386–95. https://doi.org/10.1053/j.jvca.2016.05.005.

    Article  PubMed  Google Scholar 

  91. Landoni G, Comis M, Conte M, et al. Mortality in multicenter critical care trials: an analysis of interventions with a significant effect. Crit Care Med. 2015;43(8):1559–68. https://doi.org/10.1097/CCM.0000000000000974.

    Article  PubMed  Google Scholar 

  92. Landoni G, Augoustides JG, Guarracino F, et al. Mortality reduction in cardiac anesthesia and intensive care: results of the first international consensus conference. Acta Anaesthesiol Scand. 2011;55(3):259–66. https://doi.org/10.1111/j.1399-6576.2010.02381.x.

    Article  CAS  PubMed  Google Scholar 

  93. Warren BL, Eid A, Singer P, et al. High-dose antithrombin III in severe sepsis: a randomized controlled trial. J Am Med Assoc. 2001;286(15):1869–78. https://doi.org/10.1001/jama.286.15.1869.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Anesthesiology and Intensive Care, IRCCS Humanitas Research Hospital, Rozzano, MI, Italy

    Massimiliano Greco

  2. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, MI, Italy

    Massimiliano Greco

  3. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Maria Luisa Azzolini & Giacomo Monti

Authors
  1. Massimiliano Greco
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  2. Maria Luisa Azzolini
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  3. Giacomo Monti
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Correspondence to Massimiliano Greco .

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Editors and Affiliations

  1. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy

    Giovanni Landoni

  2. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Martina Baiardo Redaelli

  3. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Chiara Sartini

  4. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy

    Alberto Zangrillo

  5. Department of Intensive Care, Austin Hospital, Heidelberg, VIC, Australia

    Rinaldo Bellomo

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Greco, M., Azzolini, M.L., Monti, G. (2021). Decision-Making in the Democracy Medicine Era: The Consensus Conference Process. In: Landoni, G., Baiardo Redaelli, M., Sartini, C., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Critically Ill Patients. Springer, Cham. https://doi.org/10.1007/978-3-030-71917-3_1

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