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Use Cluster Waiver Consent For Unit Policies
- Use waiver-of-consent cluster designs when an ICU-wide prophylactic policy must be tested and individual consent is impractical.
- Ensure unit leadership and infectious disease specialists agree to protocol and monitoring before implementation.
Track Adherence By Ventilator-Days
- Measure adherence as proportion of ventilator-days receiving topical SDD components and document justified omissions.
- Aim for high nursing-delivered compliance; SuDDICU achieved ~87% topical-dose compliance across ventilator-days.
Meta-Analysis Strengthens Mortality Signal
- A Bayesian meta-analysis including SuDDICU pooled 30 trials and estimated a pooled RR 0.91 (credible interval 0.82–0.99), favoring SDD for hospital mortality.
- Posterior probability that SDD lowers mortality was high (≈99.3%), especially when an IV component was included in the regimen.