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Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine

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https://www.readbyqxmd.com/read/28866978/peripheral-venoarterial-extracorporeal-membrane-oxygenation-for-severe-hyperlactataemia-after-cardiac-surgery-a-pilot-study
#1
Peter Biesenbach, Rashmi Ghanpur, Johan Mårtensson, Marco Crisman, Steven Lindstrom, Andrew Hilton, George Matalanis, Rinaldo Bellomo
BACKGROUND: Severe hyperlactataemia in patients after cardiac surgery is associated with poor prognosis and implies possible splanchnic hypoperfusion. Peripheral venoarterial extracorporeal membrane oxygenation (splanchnic ECMO) may be more effective at reducing lactic acidosis for these patients. OBJECTIVE: To investigate whether splanchnic ECMO attenuates hyperlactataemia and liver enzyme release in these patients, despite them having a cardiac index > 2 L/min/m(2) and a mixed venous oxygen saturation > 55%...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866977/intensity-of-early-correction-of-hyperglycaemia-and-outcome-of-critically-ill-patients-with-diabetic-ketoacidosis
#2
Johan Mårtensson, Michael Bailey, Balasubramanian Venkatesh, David Pilcher, Adam Deane, Yasmine Ali Abdelhamid, Marco Crisman, Brij Verma, Christopher MacIsaac, Geoffrey Wigmore, Yahya Shehabi, Takafumi Suzuki, Craig French, Neil Orford, Nima Kakho, Johannes Prins, Elif I Ekinci, Rinaldo Bellomo
OBJECTIVES: To determine the impact of the intensity of early correction of hyperglycaemia on outcomes in patients with diabetic ketoacidosis (DKA) admitted to the intensive care unit. METHODS: We studied adult patients with DKA admitted to 171 ICUs in Australia and New Zealand from 2000 to 2013. We used their blood glucose levels (BGLs) in the first 24 hours after ICU admission to determine whether intensive early correction of hyperglycemia to ≤ 180 mg/dL was independently associated with hypoglycaemia, hypokalaemia, hypo-osmolarity or mortality, compared with partial early correction to > 180 mg/dL as recommended by DKA-specific guidelines...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866976/a-cross-sectional-survey-of-australian-and-new-zealand-public-opinion-on-methods-totriage-intensive-care-patients-in-an-influenza-pandemic
#3
Winston Cheung, John Myburgh, Shay McGuinness, Debra Chalmers, Rachael Parke, Fiona Blyth, Ian Seppelt, Michael Parr, Claire Hooker, Nikki Blackwell, Shannon DeMonte, Kalpesh Gandhi, Mark Kol, Ian Kerridge, Priya Nair, Nicholas M Saunders, Manoj K Saxena, Govindasamy Thanakrishnan, Vasi Naganathan
BACKGROUND AND OBJECTIVE: An influenza pandemic has the potential to overwhelm intensive care resources, but the views of the general public on how resources should be allocated in such a scenario were unknown. We aimed to determine Australian and New Zealand public opinion on how intensive care unit beds should be allocated during an influenza pandemic. DESIGN, SETTING, AND PARTICIPANTS: A postal questionnaire was sent to 4000 randomly selected registered voters; 2000 people each from the Australian Electoral Commission and New Zealand Electoral Commission rolls...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866975/influence-of-changing-endotracheal-tube-cuff-management-on-antibiotic-use-for-ventilator-associated-pneumonia-in-a-tertiary-intensive-care-unit
#4
Jai N Darvall, Irani Thevarajan, Simon Iles, Thomas Rechnitzer, Tim Spelman, Nerina Harley
BACKGROUND: Routine deflation of the endotracheal tube (ETT) cuff of critically ill patients receiving MV is common in Australia and New Zealand. Literature about ventilatorassociated pneumonia (VAP) and antibiotic use rates with different ETT cuff maintenance practices is lacking. OBJECTIVE: To determine the impact of a change in ETT cuff maintenance from a minimal leak technique to pressure manometry on the administration of antibiotics for VAP. DESIGN, SETTING AND PARTICIPANTS: A prospective, pre- post observational study conducted in a metropolitan tertiary referral intensive care unit...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866974/the-plasma-lyte-148-v-saline-plus-study-protocol-a-multicentre-randomised-controlled-trial-of-the-effect-of-intensive-care-fluid-therapy-on-mortality
#5
Naomi E Hammond, Rinaldo Bellomo, Martin Gallagher, David Gattas, Parisa Glass, Diane Mackle, Sharon Micallef, John Myburgh, Manoj Saxena, Colman Taylor, Paul Young, Simon Finfer
BACKGROUND: 0.9% sodium chloride (saline) is the most commonly administered resuscitation fluid on a global basis but emerging evidence suggests that its high chloride content may have important adverse effects. OBJECTIVE: To describe the study protocol for the Plasma- Lyte 148 v Saline study, which will test the hypothesis that in critically ill adult patients the use of Plasma-Lyte 148 (a buffered crystalloid solution) for fluid therapy results in different 90-day all-cause mortality when compared with saline...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866973/identification-and-assessment-of-potentially-high-mortality-intensive-care-units-using-the-anzics-centre-for-outcome-and-resource-evaluation-clinical-registry
#6
Kerry McClean, Daniel Mullany, Sue Huckson, Allison van Lint, Shaila Chavan, Peter Hicks, Graeme Hart, Eldho Paul, David Pilcher
PURPOSE: A hospital's highest-risk patients are managed in the intensive care unit. Outcomes are determined by patients' severity of illness, existing comorbidities and by processes of care delivered. The Australian and New Zealand Intensive Care Society (ANZICS) Centre for Outcome and Resource Evaluation (CORE) manages a binational clinical registry to benchmark performance, and report and assess ICUs which appear to have worse outcomes than others. METHODS: A descriptive retrospective cohort study was undertaken to detail processes, outcomes, limitations and practical lessons learnt from monitoring ICU performance throughout Australia and New Zealand...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866972/comparison-of-continous-wave-doppler-ultrasound-monitor-and-echocardiography-to-assess-cardiac-output-in-intensive-care-patients
#7
Ahmad Elgendy, Ian M Seppelt, Andrew S Lane
BACKGROUND: Continuous-wave Doppler (CWD) ultrasound through the left ventricular outflow tract is one modality used for non-invasive cardiac output measurement. The ultrasonic cardiac output monitor (USCOM) is a relatively new monitor which uses a small, transcutaneous ultrasound probe to measure cardiac output with CWD via the suprasternal window. It is faster and less complex to train new users than conventional echocardiography. In addition to stroke volume (SV), the USCOM can calculate stroke volume variation (SVV) and the Smith-Madigan inotropy index (SMII), which is an estimate of the pre-load independent contractility of the myocardium...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866971/rapid-response-team-calls-that-overlap-in-time-incidence-consequences-and-patient-outcomes
#8
Arthas Flabouris, Michelle Mesecke
OBJECTIVE: To investigate overlap rapid response team (RRT) calls, factors associated with overlap calls, and their impact on RRT call times and patient outcomes. DESIGN AND SETTING: Review of prospectively collected, linked clinical and administrative datasets, at a public adult tertiary hospital during July 2013 to May 2016. RESULTS: There were 11 669 RRT calls to 7223 patients, of which 10 868 calls (93.1%) were to inpatients. The median number of daily calls was 12 (interquartile range [IQR], 9-15 calls; range, 2-29 calls)...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866970/calprotectin-as-an-early-biomarker-of-bacterial-infections-in-critically-ill-patients-an-exploratory-cohort-assessment
#9
Niklas Jonsson, Tom Nilsen, Patrik Gille-Johnson, Max Bell, Claes-Roland Martling, Anders Larsson, Johan Mårtensson
BACKGROUND: Calprotectin is the most abundant protein in the cytosolic fraction of neutrophils, and neutrophil degranulation is a major response to bacterial infections. OBJECTIVES: To assess the value of plasma calprotectin as an early marker of bacterial infections in critically ill patients and compare it with the corresponding values for procalcitonin (PCT), C-reactive protein (CRP) and white blood cell count (WBC). METHODS: We measured daily plasma calprotectin levels in 110 intensive care unit patients using a newly developed turbidimetric assay run on clinical chemistry analysers...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866969/a-scoping-review-of-use-of-wearable-devices-to-evaluate-outcomes-in-survivors-of-critical-illness
#10
Samuel Gluck, Lee-Anne S Chapple, Marianne J Chapman, Theodore J Iwashyna, Adam M Deane
OBJECTIVE: Wearable devices using new technology may be a cost-effective method to assess functional outcomes in survivors of critical illness. Our primary objective was to review the extent to which wearable devices such as smartphones, pedometers, accelerometers and global positioning systems have been used to evaluate outcomes in survivors of an intensive care unit admission. DESIGN: We included studies of patients surviving an ICU admission and which measured outcomes using wearable devices...
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28866968/glycaemic-control-in-diabetic-ketoacidosis-too-much-of-a-good-thing
#11
Colin McArthur
No abstract text is available yet for this article.
September 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651516/correction-direct-cerebral-perfusion-and-cooling-in-experimental-cardiac-arrest-crit-care-resusc-2016-18-255-60
#12
Rinaldo Bellomo, Bruno Marino, Peter Angelopoulos, Scott Carson, Glenn Eastwood, Junko Kosaka, Naoya Iguchi, Andrew Hilton, Clive May
No abstract text is available yet for this article.
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651515/statistical-analysis-plan-for-the-adjunctive-corticosteroid-treatment-in-critically-ill-patients-with-septic-shock-adrenal-trial
#13
RANDOMIZED CONTROLLED TRIAL
Laurent Billot, Balasubramanian Venkatesh, John Myburgh, Simon Finfer, Jeremy Cohen, Steve Webb, Colin McArthur, Christopher Joyce, Rinaldo Bellomo, Andrew Rhodes, Anders Perner, Yaseen Arabi, Dorrilyn Rajbhandari, Parisa Glass, Kelly Thompson, Maryam Correa, Meg Harward
BACKGROUND: The Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial, a 3800-patient, multicentre, randomised controlled trial, will be the largest study to date of corticosteroid therapy in patients with septic shock. OBJECTIVE: To describe a statistical analysis plan (SAP) and make it public before completion of patient recruitment and data collection. The SAP will be adhered to for the final data analysis of this trial, to avoid analysis bias arising from knowledge of study findings...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651514/study-protocol-for-the-balanced-solution-versus-saline-in-intensive-care-study-basics-a-factorial-randomised-trial
#14
RANDOMIZED CONTROLLED TRIAL
Fernando G Zampieri, Luciano C P Azevedo, Thiago D Corrêa, Maicon Falavigna, Flavia R Machado, Murillo S C de Assunção, Suzana M A Lobo, Letícia K Dourado, Otavio Berwanger, John A Kellum, Nilton Brandão, Alexandre B Cavalcanti
BACKGROUND: The effectiveness and safety of balanced crystalloid fluids compared with saline (0.9% sodium chloride) as a fluid of choice in critically ill patients remain unclear. The effects of different fluid infusion rates on outcomes are also unknown. OBJECTIVES: To test the hypothesis that a balanced crystalloid solution, compared with saline, decreases 90-day all-cause mortality among critically ill patients; and to test the hypothesis that slow, compared with rapid, infusion rate decreases 90-day mortality in this population of patients...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651513/the-performance-of-flash-glucose-monitoring-in-critically-ill-patients-with-diabetes
#15
Paolo Ancona, Glenn M Eastwood, Luca Lucchetta, Elif I Ekinci, Rinaldo Bellomo, Johan Mårtensson
OBJECTIVE: Frequent glucose monitoring may improve glycaemic control in critically ill patients with diabetes. We aimed to assess the accuracy of a novel subcutaneous flash glucose monitor (FreeStyle Libre [Abbott Diabetes Care]) in these patients. METHODS: We applied the FreeStyle Libre sensor to the upper arm of eight patients with diabetes in the intensive care unit and obtained hourly flash glucose measurements. Duplicate recordings were obtained to assess test-retest reliability...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651512/survival-and-functional-outcomes-of-patients-with-metastatic-solid-organ-cancer-admitted-to-the-intensive-care-unit-of-a-tertiary-centre
#16
Francis J Ha, Andrew J Weickhardt, Sagun Parakh, Andrew D Vincent, Neil J Glassford, Stephen Warrillow, Daryl Jones
OBJECTIVE: Metastatic solid organ cancer is associated with a poor prognosis, and admission of patients with these cancers to the intensive care unit remains a dilemma. We aimed to assess outcomesin a cohort of these patients who were admitted to the ICU of a general tertiary centre. DESIGN, SETTING AND PATIENTS: A retrospective observational study of patients with incurable metastatic solid organ malignancies who had unplanned admission to a tertiary hospital ICU between 1 January 2010 and 30 June 2015...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651511/outcomes-of-children-admitted-to-intensive-care-after-out-of-hospital-cardiac-arrest-in-victoria-australia
#17
Anri Forrest, Warwick W Butt, Siva P Namachivayam
OBJECTIVES: Paediatric out-of-hospital cardiac arrest (OHCA) is an uncommon event but is associated with high mortality and severe neurological sequelae among survivors. Most studies of paediatric OHCA are population-based, with very few reports on the cohort admitted to the paediatric intensive care unit (PICU). We sought to determine outcomes and predictors of neurologically intact survival in these children admitted to the PICU. DESIGN AND SETTING: Retrospective analysis of data prospectively collected from the PICU and emergency department (ED) databases and cross-checked with medical records and coronial reports for January 2005 to December 2014...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651510/pharmacodynamics-of-intravenous-frusemide-bolus-in-critically-ill-patients
#18
Agnes Huang, Nora Luethi, Johan Mårtensson, Rinaldo Bellomo, Luca Cioccari
OBJECTIVE: To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients. DESIGN, SETTING AND PATIENTS: A prospective observational study of 21 critically ill patients in a tertiary intensive care unit in Australia. INTERVENTIONS: We collected information on urine output (UO), fluid balance, serum and urinary electrolyte levels, serum biochemical levels and haemodynamics...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651509/drivers-of-choice-of-resuscitation-fluid-in-the-intensive-care-unit-a-discrete-choice-experiment
#19
COMPARATIVE STUDY
Colman B Taylor, Naomi E Hammond, Tracey-Lea Laba, Nicola Watts, Kelly Thompson, Manoj Saxena, Sharon Micallef, Simon Finfer, John Myburgh
OBJECTIVE: To understand the fundamental drivers, and their relative importance, of doctors' and nurses' choice of resuscitation fluid in critically ill patients in Australia and New Zealand. DESIGN: A discrete choice experiment (DCE) administered via an online survey. Respondents were presented with one of four randomly selected DCE choice sets, each including five patient scenarios. The respondent chose between two types of hypothetical resuscitation fluid. The fluid type was characterised by several attributes and each attribute had pre-specified levels...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/28651508/quality-sleep-using-earplugs-in-the-intensive-care-unit-the-quiet-pilot-randomised-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Edward Litton, Rosalind Elliott, Janet Ferrier, Steven A R Webb
OBJECTIVE: To assess the feasibility of a definitive, randomised controlled trial of earplugs as a noise-abatement strategy to improve sleep and reduce delirium in patients admitted to the intensive care unit. DESIGN AND SETTING: An open-label trial of 40 patients randomised in a 1:1 ratio to receive earplugs in addition to standard care, or standard care alone, conducted in a 10-bed ICU of a large, private hospital in Perth, Western Australia. PARTICIPANTS AND INTERVENTION: Patients were eligible for participation if they were expected to be undergoing mechanical ventilation (MV) on admission to the ICU...
June 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
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