NHKI - Care strategies & supportive care

Ongoing Studies

• Fluid resuscitation and deresuscitation

  ALTER-AKI

  • ALTER-AKI: Albumin To Enhance Recovery after severe Acute Kidney Injury
  • To maintain blood pressure during dialysis treatments, ICU patients receive extra fluid. The objective of this study is to determine whether a protein-based fluid (albumin) or salt-based fluid (normal saline) provides better outcomes for patients.

  RADAR-Canada

  • Among critically ill patients, the body’s ability to successfully regulate fluid and electrolyte balance can be impaired. When patients are given intravenous fluids, a fluid overload can sometimes occur. The RADAR pilot trial aims to evaluate if fluid removal, using diuretics or renal replacement therapy, compared to usual care can reduce positive fluid balance among mechanically ventilated patients.
• Treatment optimization

  CRC.10 (CIRCULATE – NORTH AMERICA)

  • CIRCULATE-NORTH AMERICA: Colon Adjuvant Chemotherapy Based on Evaluation of Residual Disease
  • This study aims to identify optimal chemotherapy recommendations to patients based on the presence or absence of circulating tumor DNA following colon cancer surgery.

  CANPOINT

  • CANPoint: Point Prevalence Study
  • This study collects information on ICU capacity, disease burden and interventions that patients receive in Canadian ICUs with the goal of advancing the development a learning health system for critical care in Canada.
• Transfusion strategies

  PATH III

  • PATH III: Platelet Transfusions in Hematopoietic Stem Cell Transplantation
  • Patients undergoing autologous hematopoietic stem cell transplants (ASCT) typically receive platelet transfusions to prevent bleeding. However, this routine practice may be unnecessary and could pose risks to patients. An alternative strategy to prevent bleeding and reduce the need for platelet transfusions is Tranexamic Acid. This study evaluates the safety and effectiveness of preventive Tranexamic Acid, (with therapeutic platelet transfusions provided in the event of active bleeding), compared to preventive platelet transfusions in ASCT patients.
• Prevention strategies

  ATOMIC

  • ATOMIC: Magnesium Prophylaxis for the Prevention of New-Onset Atrial Fibrillation in Critically Ill Patients
  • This trial investigates the use of parenteral magnesium sulfate compared to placebo for the prevention of new onset atrial fibrillation of critically ill patients.

  AIM to Prevent Delirium

  • This trial evaluates how artificial intelligence (AI) can help predict and prevent delirium in hospitalized patients.
• Ventilation and sedation strategies

  PRACTICAL: IMV Domain

  • PRACTICAL: Platform of Randomized Adaptive Clinical Trials in Critical Illness
  • This platform trial evaluates novel interventions for patients with acute hypoxemic respiratory failure (AHRF).
  • Invasive Mechanical Ventilation (IMV) Strategies: will compare the use of the current recommended ventilation method to two new approaches: one that focuses on controlling lung-inflating pressure and another that aims to keep breathing effort at an optimal level to prevent injury to the diaphragm.

  REMAP-CAP

  • REMAP-CAP: Randomized, Embedded, Multifactorial, Adaptive Platform Trial for Patients with Community Acquired Pneumonia
  • Community acquired pneumonia that is severe enough to require admission to an ICU will often receive many different treatments as many as 20 or 30. These treatments act together to treat both the infection and its effect on the body. This study aims to help doctors understand which treatment options are best.
  • Mechanical Ventilation Strategy Domain: will compare protocolized mechanical ventilation strategy to clinician-preferred mechanical ventilation strategy.

Studies Closed for Recruitment, Patients in Follow-Up

• Treatment optimization

  IMPACT Implementation-Effectiveness Trial

  • The IMPACT Implementation-Effectiveness Trial
  • This trial assesses the effectiveness of a combined exercise and education program among individuals with cancer.

  LUMINA

  • LUMINA: A Prospective Cohort Study Evaluating Risk of Local Recurrence Following Breast Conserving Surgery and Endocrine Therapy in Low-Risk Luminal A Breast Cancer
  • 15 participants enrolled
• Rehabilitation, recovery and physical activity

  MAC.20 (BWEL)

  • BWEL: Randomized Phase III Trial Evaluation the Role of Weight Loss in Adjuvant Treatment of Overweight and Obese Women with Early Breast Cancer
  • 12 participants enrolled

Completed Studies

• Fluid resuscitation and deresuscitation

  FISSH

  • FISSH: Fluids in Septic Shock
  • Septic shock is a life-threatening condition when the body’s response to an infection damages vital organs and leads to a dangerous decrease in blood pressure. The objective of this study is to investigate the effect of using higher chloride vs lower chloride fluids in critically ill patients with septic shock.
  • 75 participants enrolled
• Treatment optimization

  ARBS-CORONA II

  • ARBs CORONA II: Host Response Mediators in Coronavirus (COVID-19) Infection
  • 3 participants enrolled

  ARBS-CAPTIVATE

  • 417 participants enrolled

  CARDIA-AI

  • CCTA to Optimize Diagnostic Yield of Invasive Angiography With AI
  • 74 participants enrolled

  CANCOV

  • CANCOV: The Canadian COVID-19 Prospective Cohort Study
  • 9 participants enrolled

  COREG

  • COREG: Coronavirus (COVID-19) Registry
  • 500 participants enrolled

  CRC.9 (COBRA)

  • COBRA: Phase II/III Study of Circulating tumor DNA as a Predictive Biomarker in Adjuvant Chemotherapy in Patients in Stage IIA Colon Cancer
  • 12 participants enrolled

  DIAL-MAG

  • Dial-Mag: Outcomes of a Higher vs. Lower Hemodialysate Magnesium Concentration

  GenOMICC

  • GenOMICC: Genetics of Mortality in Critical Care
  • 89 participants enrolled

  HARM 2

  • HARM2: Hospital characteristics & Adverse event Rate Measurement-2 Evaluated
  • 525 participants enrolled

  HARP

  • Heart Attack Research Program – Imaging Study
  • Most heart attacks are caused by blocked arteries, but some patients have no severe blockage on an angiogram, making the cause unclear. In these cases, further tests may reveal a different issue, such as inflammation, infection, or another condition. This study will perform two additional tests on patients without severe blockages to better understand their heart event.
  • 8 participants enrolled

  LONG-COVID-10

  • Improving the recognition and care of patients with long-term health complications of COVID-19
  • 500 participants enrolled

  NCT00003833

  • NCT00003833: Genetic Study in Patients With Stage II or Stage III Colon Cancer

  NCT01423890

  • NCT01423890: A Prospective Cohort Study to Evaluate the Oncotype DX® Test in Early Stage Breast Cancer (ONCOTYPEDX)

  PROTECT-HF

  • Prevalence of Subclinical Atrial Fibrillation in High Risk Heart Failure Patients and the Temporal Connection with Hospital Readmission for Heart Failure
  • 3 participants enrolled

  SC.7

  • SC.7: A Randomized Double-Blind Efficacy, Safety and Pharmacokinetic Study of Six Doses of the Antiemetic BMY-25801 and Methylprednisone Along Out-Patients Receiving Moderately Emetogenic Chemotherapy

  SC.8

  • SC.8: A Double-Blind Comparator Study for the Prophylactic Use of Granisetron Both Alone and in Combination With Dexamethasone Over a 7 Day Period in Controlling Nausea and Vomiting Associated With High Dose Cisplatin Therapy in Patients With Malignant Disease

  SC.9

  • SC.9: An Assessment of the Effect of Schedule and Maintenance on the Antiemetic Efficacy and Safety of Ondansetron Combined With Dexamethasone as Acute and Maintenance Therapy in Patients Receiving Moderately Emetogenic Chemotherapy

  SC.11

  • SC.11: A Phase III Double-Blind Comparison of Dolasetron Mesylate With Ondansetron and an Evaluation of the Additive Role of Dexamethasone in the Prevention of Acute (IV) and Delayed (Oral) Emesis Due to Moderately Emetogenic Chemotherapy

  SPRINT-SARI

  • SPRINT SARI: Short PeRiod IncideNce sTudy of Severe Acute Respiratory Infection
  • 93 participants enrolled

  VIRTUES

  • VIRTUES: COVID-19 Virtual Care at Home
  • 24 participants enrolled
• Transfusion strategies

  STRATUS

  • STRATUS: Small-Volume Tubes to Reduce Anemia and Transfusion: A Pragmatic Stepped Wedge Cluster Randomized Trial
  • 1278 participants enrolled
• Rehabilitation, recovery and physical activity

  CO.21 (CHALLENGE)

  • CHALLENGE: A Phase III Study of the Impact of a Physical Activity Program on Disease-Free Survival in Patients with High Risk Stage II or Stage III Colon Cancer: A Randomized Controlled Trial
  • 16 participants enrolled

  CYCLE

  • CYCLE: An international, multi-centre, randomized clinical trial of early in-bed cycling for mechanically ventilated participants
  • 15 participants enrolled

  LISA

  • LISA: Lifestyle Intervention Study in Adjuvant Treatment of Early Breast Cancer
  • 25 participants enrolled

  NCT002010929

  • NCT00201929: A Decision Aid for Women With Early Stage Breast Cancer

  NCT01286233

  • NCT01286233: Biobehavioral Mechanisms of Fatigue in Patients Treated on NCIC CTG MA.32: A Phase III Randomized Trial of Metformin Versus Placebo on Recurrence and Survival in Early Stage Breast Cancer
  • 9 participants enrolled

  REVIVe

  • REVIVe: Frailty, Rehabilitation, and Outcomes in Critically Ill Adult and Pediatric Survivors of COVID-19 or ARI
  • 17 participants enrolled
• Prevention strategies

  NCT00238316

  • NCT00238316: A Randomized Feasibility Study of Letrozole in Postmenopausal Women at Increased Risk for Development of Breast Cancer as Evidenced by High Breast Density
  • 8 participants enrolled

  PROSPECT

  • PROSPECT: PRObiotics: Prevention of Severe Pneumonia and Endotracheal Colonization Trial
  • 53 participants enrolled

  REVISE

  • REVISE: Re-EValuating the Inhibition of Stress Erosions in the critically ill
  • 272 participants enrolled

  Ventilation strategies

  • COSMIC
  • COSMIC: Cuff Leak Test and Airway Obstruction in Mechanically Ventilated ICU Patients: A Vanguard Pilot Randomized Controlled Trial
  • 5 participants enrolled

  COVI-PRONE

  • COVI-PRONE: Awake Prone Position in Hypoxemic Participants with Coronavirus Disease 19
  • 8 participants enrolled

  EXTUBE

  • EXTUBE: EXtubation related complications - an international observational study To Understand the impact and BEst practices in the operating room and intensive care unit
  • 7 participants enrolled

  FAST

  • FAST: The Frequency of Screening and SBT Technique Trial
  • 4 participants enrolled