A randomised, controlled, feasibility trial comparing vasopressors infused via peripheral cannula versus central venous access for critically ill adults: The VIPCA trial
Bibliographic record
Abstract
Objective: To determine the feasibility of conducting a definitive randomised trial to determine whether, in critically ill patients requiring intensive care unit admission, early CVC insertion compared with late CVC insertion leads to increased days-alive-and-out-of-hospital at 30 days (DAH-30) post-treatment. Design settings and participants: We conducted a single-centre, parallel-group, feasibility randomised controlled trial with critically ill patients receiving vasopressor infusions randomised in a 1:1 ratio to receive early CVC insertion (within 4 h) or late CVC insertion (after 12 h). All patients received vasopressor infusions via a peripheral intravenous cannula (PIVC) while awaiting CVC insertion. The primary clinical outcome was DAH-30 and the primary feasibility outcome was assessed by evaluating protocol adherence, rates of recruitment, randomisation of eligible patients, retention, follow-up and missing data. Results: We enrolled 40 patients, 20 patients per group between January 2023 and May 2024. Protocol adherence was significantly lower in the early CVC group (55 %) compared to the late CVC group (100 %, p < 0.001). The early CVC group had a median time to CVC insertion of 3.3 h (interquartile range (IQR) 1.2-3.7 h), within the 4-h target. The early and late CVC groups had a median (IQR) of 13.5 (0.0-23.5) and 19.0 (5.0-23.0) DAH-30 respectively (P = 0.18). PIVC complications were similar between the two groups with no severe complications. There were no complications among the 18 CVCs inserted during the trial. Conclusions: Protocol adherence in the early CVC was much lower than the late CVC. Some protocol modifications will be required to enable the conduct of a larger-scale definitive trial. Trial Registration: ACTRN12621000721808 (Australia New Zealand Clinical Trials Registry).
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.010 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".