Actively Recruiting
Canadian Critical Care Comparative Effectiveness Platform for Vasopressor, Platelet, and Nutrition Interventions in ICU Care
Led by Université de Sherbrooke · Updated on 2026-03-27
5500
Participants Needed
8
Research Sites
25 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
The trial investigates supportive care treatments commonly used in intensive care units (ICUs) worldwide, focusing on vasopressors, platelet transfusions, and nutrition methods. This platform trial aims to improve understanding of how these routine but resource-intensive interventions affect critically ill patients, especially those in cardiovascular shock or with thrombocytopenia, by evaluating different treatment strategies. The study is part of a large international effort to generate stronger evidence for ICU care practices. Participants will be assigned to different treatment groups depending on their medical needs. In the vasopressor domain, patients receive medications to maintain blood pressure within specific target ranges. In the platelet domain, critically ill patients with low platelet counts undergoing certain procedures will receive transfusions based on assigned platelet thresholds. In the nutrition domain, participants will receive enteral feeding either as bolus doses three times daily or continuously over 24 hours. Treatments are administered as part of usual ICU care, with dosing and protocols tailored to each domain. Participants will be closely monitored during their ICU stay with assessments including mortality rates, organ function, bleeding events, nutritional intake, and quality of life. Data will be collected up to 90 days or longer depending on the domain. The study measures how these interventions impact patient outcomes, resource use, and safety. The trial is randomized and adaptive, allowing for adjustments based on emerging results, with a planned end date in 2030.
CONDITIONS
Brief Title
Canadian Critical Care Comparative Effectiveness Platform
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Ongoing vasopressor infusion or planned use for clinician-defined hypotension
- Mean arterial pressure below 75 mmHg or lower than local target ranges
- Expected ICU stay longer than 48 hours
- Adult patients (18 years or older) admitted to ICU with platelet count below 50 x 10^9/L
- Planned low to moderate bleeding risk invasive procedure
- Critically ill adults 18 years or older who are invasively mechanically ventilated
- Have an orogastric/nasogastric or percutaneous gastric feeding tube in place
- Treating team has started or plans to provide enteral nutrition
You will not qualify if you...
- No equipoise for at least two contiguous blood pressure target ranges in vasopressor domain
- Acute traumatic brain injury within 7 days or ongoing treatment for elevated intracranial pressure
- Acute subarachnoid hemorrhage within 21 days
- Acute spinal cord injury within 7 days or ongoing vasopressor for spinal cord ischemia
- Recent lung, heart, liver, or kidney transplant within 7 days
- More than 24 hours since meeting vasopressor inclusion criteria in ICU
- Previous randomization in vasopressor domain or confounding trial
- Ongoing major hemorrhage needing blood products or surgery
- Intracranial hemorrhage within prior 72 hours
- Contraindications to platelet transfusion (e.g. thrombotic microangiopathies, heparin-induced thrombocytopenia)
- Advance decision refusing blood transfusions
- Acute promyelocytic leukemia
- Death perceived as imminent or admission for palliation
- Previous randomization in platelet domain or related trials
- Patients not ready for bolus nutrition after recent gastrointestinal surgery
- Active bowel obstruction or ischemia
- Post-pyloric small bowel feeding tube in place
- Active gastrointestinal bleeding
- Chronically receiving enteral nutrition already
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 screening and enrollment visit
Duration - Up to 90 days or length of ICU stay
Participants receive interventions based on their assigned domain: vasopressors titrated to specific blood pressure targets, platelet transfusions given according to assigned platelet count thresholds before planned procedures, or enteral nutrition provided either as boluses three times a day or continuously over 24 hours.
Daily assessments during ICU stay up to ICU day 90
Duration - Up to 1 year
Participants are monitored for outcomes including mortality, organ dysfunction, bleeding events, transfusion complications, and nutritional status up to 1 year after randomization.
Periodic follow-up visits up to 1 year
Trial Site Locations
Total: 8 locations
1
Hamilton Health Sciences - Juravinski Hospital
Hamilton, Ontario, Canada, L8V 1C3
Actively Recruiting
2
The Ottawa Hospital
Ottawa, Ontario, Canada, K1H 8L6
Actively Recruiting
3
Scarborough Health Network
Scarborough Village, Ontario, Canada, M1P 2V5
Actively Recruiting
4
Niagara Health
St. Catharines, Ontario, Canada, L2S 0A9
Actively Recruiting
5
Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada, M4N 3M5
Actively Recruiting
6
CIUSSS de l'Estrie - CHUS
Sherbrooke, Quebec, Canada, J1H 5N4
Actively Recruiting
7
Auckland City Hospital
Auckland, New Zealand
Not Yet Recruiting
8
Intensive Care National Audit and Research Centre (coordinating centre for sites in UK. Sites to be determined)
London, United Kingdom
Not Yet Recruiting
Research Team
M
Marie-Helene Masse, RRT, MSc
How is the study designed?
Study Type
INTERVENTIONAL
Masking
NONE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
TREATMENT
Number of Arms
3
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