ArticleBMJ open2022
Time-limited trials in the ICU: a mixed-methods sequential explanatory study of intensivists at two academic centres.
Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed.
- [Specialized geriatric care in intensive care units: from frailty to functional prognosis].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- The Challenges of Prognosticating Persistent Critical Illness: A Qualitative Study.CHEST critical care · 2026Article
- Optimising time-limited trials in acute respiratory failure: a multicentre focused ethnography protocol.BMJ open · 2025Article
- Characterizing the Documentation of Time-Limited Trials in Goals of Care Notes.Journal of pain and symptom management · 2025Article
- Time-Limited Trials in Intensive Care Medicine: A Tool for Avoiding Inappropriate Treatment.Deutsches Arzteblatt international · 2025Review
- Characterizing the Use of Time-Limited Trials in Patients With Acute Respiratory Failure: A Prospective, Single-Center Observational Study.Critical care explorations · 2024Observational
- [Time-limited trials (TLT) in the intensive care unit : Recommendations from the ethics section of the DIVI and the ethics section of the DGIIN].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Review
- Review
- Defining the Time-limited Trial for Patients with Critical Illness: An Official American Thoracic Society Workshop Report.Annals of the American Thoracic Society · 2024Article
- An Update on Palliative Care in Neurocritical Care: Providing Goal‑Concordant Care in the Face of Prognostic Uncertainty.Current treatment options in neurology · 2023Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo understand intensivist perceptions of the appropriateness of time-limited trials (TLTs)-a strategy to align life-sustaining care with patient goals and values in the midst of clinical uncertainty.
designWe conducted a mixed-methods sequential explanatory study of intensive care unit (ICU) intensivists regarding appropriateness of utilising TLTs in three vignettes centred on invasive mechanical ventilation (IMV); continuous renal replacement therapy (CRRT); and heated high-flow nasal cannula (HHFNC). Semistructured interviews were conducted using the Tailored Implementation of Chronic Diseases framework. Data were analysed using thematic and matrix analysis.
settingTwo academic medical centres in the USA participated in the randomised surveys and one centre participated in the semistructured interviews.
participantsPulmonary and critical care intensivists and fellows. PRIMARY AND SECONDARY OUTCOMES: To understand intensivists perceptions of the appropriateness in using TLTs.
resultsOf 115 physicians surveyed, 71 initiated the survey and 44 completed the entire survey with a response rate of 38% (N=44/115) and a completion rate of 62% (N=44/71). While 35% (N=23/66) of intensivists had never heard of a TLT, of the intensivists who had heard of a TLT, 77% (N=33/43) had participated in one. In response to the vignettes, appropriateness of using a TLT varied (IMV: 74% (N=46/62); CRRT 78% (N=49/63); HHFNC 92% (N=56/61) as did the durations of the TLT. Semistructured interviews with 11 intensivists revealed having clarity about patient goals and clinical endpoints facilitated successful TLTs while lack of an evidenced-based framework was a barrier.
conclusionMore than half of the physicians who responded had conducted or participated in a TLT. To increase the use of TLTs in the ICU, clinicians desire a more robust, evidence-based framework on how to conduct TLTs.
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Registered trials
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