The goal of the OVATION program of research is to determine a safe blood pressure target for most patients with vasodilatory hypotension requiring vasopressors.
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There is a lack of clinical research to guide the treatment of hypotension in critical illness with vasopressors, drugs that can reverse hypotension. Unfortunately, the safety profile of vasopressors and the extreme vulnerability of critically-ill patients leave treating physicians no margin of error. We have an opportunity with the OVATION program to advance our understanding of, and to translate into practice, the optimal strategy to improve outcomes for these patients.
Among critically ill adults aged 65 years and older with vasodilatory hypotension, does minimizing vasopressor use by applying lower MAP targets (≤ 65 mmHg as tolerated) vs. 75-80 mmHg (typical of usual care) reduce the proportion of patients who are either dead or dependent on life-sustaining therapies at day 28?
OVATION Retrospective Cohort Study
OVATION Pilot Trial
The OVATION Pilot Trial was recently completed more than one year ahead of schedule! This study addressses the feasibility of the larger definitive study (see below). The pilot enabled us to develop and test implement measures to optimize protocol adherence for the study. We have established an efficient infrastructure for both Canadian and international participation in the study.
For further information on the pilot refer to our Pilot Trial page.
OVATION Observational Trial
The OVATION Observational trial, was conducted in parallel to the Pilot study, and is also complate. The purpose of the Observational trial was to describe standard practices in the ICU with regards to vasopressor dosing. Across 6 Canadian centers, the trial recruited 60 critically ill, hypotensive adults receiving vasopressors.
OVATION Trial (Definitive Study)
We have submitted an application to obtain funding to conduct the larger definitive trial of 810 patients across 23 Canadian centres. The results of this trial will provide a stronger foundation for establishing the most suitable treatment strategy for critically ill adults aged 65 years and older with vasodilatory hypotension.
This trial will be conducted under the auspices of the Canadian Critical Care Trials Group, in partnership with the Canadian Critical Care Society (CCCS), the Canadian Association of Critical Care Nurses (CACCN) and the Institute for Safer Medication Practices (ISMP) Canada. Other organization support the OVATION Program and will play specific roles moving forward such as the Canadian Society of Hospital Pharmacists (CSHP), the Canadian Association of Emergency Physicians (CAEP), and the Canadian Agency for Drugs and Technologies in Health (CADTH). We are welcoming input from ICU survivors and healthy citizens. The OPTICS Project described below was designed for this purpose.
The Outcome PrioriTies In crItical Care Studies (OPTICS) program is an ongoing project embeded in OVATION through which we will engage ICU survivors and healthy citizens and ask them to rank the clinical outcomes in OVATION relative to one another.
The goal is to enable the public to express how they value different outcomes measured in critical care studies like OVATION. We believe that the interpretation of the study results should take into consideration the preferences of the broader population who ultimately is the sponsor of this research and its primary beneficiary.