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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/29852855/repeated-sensor-use-for-regional-cerebral-oxygenation-measurements-by-near-infrared-spectroscopy-a-technical-report
#1
Paolo Ancona, Christopher T Eyeington, Salvatore L Cutuli, Neil J Glassford, Glenn M Eastwood, Rinaldo Bellomo
OBJECTIVE: Near-infrared spectroscopy (NIRS) has been used in clinical practice to assess regional cerebral tissue oxygen saturation (StcO2 ). There is no evidence whether repeated use of the same sensor affects StcO2 measurements. We aimed to assess whether there was a significant systematic decrease or increase in StcO2 when NIRS sensors were reused. DESIGN: Participants were divided into three groups (A, B and C). StcO2 was recorded over 5 minutes daily for 5 days in Groups A and B ("new-sensor" [NS] period; sensor age, 1-5 days) and in Groups A and C, with the sensor previously used for A ("extended-use" [EU] period; sensor age, 6-10 days)...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852854/effect-of-active-temperature-management-on-mortality-in-intensive-care-unit-patients
#2
Jonathan Dallimore, Stefan Ebmeier, Darmiga Thayabaran, Rinaldo Bellomo, Gordon Bernard, Frédérique Schortgen, Manoj Saxena, Richard Beasley, Mark Weatherall, Paul Young
OBJECTIVE: To evaluate the effect of active temperature management on mortality, intensive care unit (ICU) and hospital length of stay, as well as the relative efficacy of antipyretic medications and physical cooling devices for achieving reductions in temperature in critically ill adults. DESIGN, SETTING AND PARTICIPANTS: Systematic review and meta-analysis of randomised controlled trials (RCTs) investigating treatments administered to febrile patients in order to reduce body temperature...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852853/permissive-hypercapnia-alveolar-recruitment-and-low-airway-pressure-pharlap-a-protocol-for-a-phase-2-trial-in-patients-with-acute-respiratory-distress-syndrome
#3
Carol Hodgson, David Jamie Cooper, Yaseen Arabi, Victoria Bennett, Andrew Bersten, Kathy Brickell, Andrew Davies, Ciara Fahey, John Fraser, Shay McGuinness, Lynne Murray, Rachael Parke, David Tuxen, Shirley Vallance, Meredith Young, Alistair D Nichol
BACKGROUND: Mechanical ventilation is a life-saving intervention that maintains gas exchange in patients with acute respiratory distress syndrome (ARDS); however, it is associated with high mortality and it may augment, or even initiate, lung injury. An open lung ventilation strategy that combines alveolar recruitment manoeuvres with individually titrated positive end-expiratory pressure (PEEP) and targeting lower tidal volumes, or driving pressures by a permissive approach to hypercapnia, may reduce the lung injury associated with mechanical ventilation...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852852/fluid-bolus-therapy-in-critically-ill-children-a-survey-of-practice-among-paediatric-intensive-care-doctors-in-australia-and-new-zealand
#4
Ben Gelbart, Luregn Schlapbach, Anusha Ganeshalingham, Subodh Ganu, Simon Erickson, Felix Oberender, Monsurul Hoq, Gary Williams, Shane George, Marino Festa
OBJECTIVE: Fluid bolus therapy (FBT) is a widely used intervention in paediatric critical illness. The aim of this study was to describe the attitudes and practices towards FBT of paediatric intensive care doctors in Australia and New Zealand. DESIGN: An internet-based survey of paediatric intensive care doctors in Australia and New Zealand between 7 and 30 November 2016. SETTING: Paediatric intensive care units with greater than 400 admissions annually...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852851/the-comparative-effects-of-3-saline-and-0-5m-sodium-lactate-on-cardiac-function-a-randomised-crossover-study-in-volunteers
#5
Marek Nalos, Euguenia Kholodniak, Louise Smith, Sam Orde, Iris Ting, Michel Slama, Ian Seppelt, Anthony S McLean, Stephen Huang
OBJECTIVE: To investigate the metabolic and cardiac effects of intravenous administration of two hypertonic solutions - 3% saline (SAL) and 0.5M sodium lactate (LAC). DESIGN, SETTING AND PARTICIPANTS: A randomised, doubleblind, crossover study in ten human volunteers. Intravenous bolus of either SAL or LAC at 3 mL/kg over 20 min followed by a 2 mL/kg infusion over 60 min. MAIN OUTCOME MEASURES: Acid base parameters and echocardiographic indices of cardiac function, cardiac output (CO), left ventricular ejection fraction (LVEF) and mitral annular peak systolic velocity (Sm) before and after infusion of SAL or LAC...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852850/sample-size-calculations-for-cluster-randomised-crossover-trials-in-australian-and-new-zealand-intensive-care-research
#6
Sarah J Arnup, Joanne E McKenzie, David Pilcher, Rinaldo Bellomo, Andrew B Forbes
OBJECTIVE: The cluster randomised crossover (CRXO) design provides an opportunity to conduct randomised controlled trials to evaluate low risk interventions in the intensive care setting. Our aim is to provide a tutorial on how to perform a sample size calculation for a CRXO trial, focusing on the meaning of the elements required for the calculations, with application to intensive care trials. DATA SOURCES: We use all-cause in-hospital mortality from the Australian and New Zealand Intensive Care Society Adult Patient Database clinical registry to illustrate the sample size calculations...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852849/impact-of-unit-wide-chlorhexidine-bathing-in-intensive-care-on-bloodstream-infection-and-drug-resistant-organism-acquisition
#7
Karen F Urbancic, Johan Mårtensson, Neil Glassford, Christopher Eyeington, Raymond Robbins, Peter B Ward, Darren Williams, Paul Dr Johnson, Rinaldo Bellomo
BACKGROUND: Chlorhexidine gluconate (CHG) bathing has been reported to decrease bloodstream infections and colonisation of multidrug-resistant organisms (MROs) in intensive care units (ICUs). However, its effectiveness in an Australian setting has not been assessed. OBJECTIVE: To test whether the introduction of ICU-wide CHG bathing in place of triclosan would affect rates of the primary outcome of central line-associated bloodstream infections (CLABSI), or the secondary outcomes of ICU-acquired positive blood cultures or other clinical specimens, and MRO colonisation including methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE)...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852848/ventilation-management-in-victorian-intensive-care-unit-patients-without-acute-respiratory-distress-syndrome
#8
Christopher T Eyeington, Neil J Glassford, Jai Darvall, Andrew Casamento, Tim Haydon, Gopal Taori, Cameron Knott, Forbes McGain, Joseph Vetro, Nick Simpson, Vineet Sarode, Angus Richardson, Charles Dunnachie, Marco Crisman, Jason Musci, Nicholas Woinarski, Rohan Lynham, Glenn M Eastwood, Rinaldo Bellomo, Dharshi Karalapillai
BACKGROUND: The setting of tidal volume (VT ) during controlled mechanical ventilation (CMV) in critically ill patients without acute respiratory distress syndrome (ARDS) is likely important but currently unknown. We aimed to describe current CMV settings in intensive care units (ICUs) across Victoria. METHODS: We performed a multicentre, prospective, observational study. We collected clinical, ventilatory and arterial blood gas data twice daily for 7 days. We performed subgroup analysis by sex and assessment of arterial partial pressure of carbon dioxide (PaCO2 ) management where hypercapnia was potentially physiologically contraindicated...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852847/hypercapnia-and-hypercapnic-acidosis-in-sepsis-harmful-beneficial-or-unclear
#9
Ravindranath Tiruvoipati, Sachin Gupta, David Pilcher, Michael Bailey
Mortality related to sepsis among critically ill patients remains high. Recent literature suggests that hypercapnia may affect the pathophysiology of sepsis. The effects of hypercapnia on sepsis are largely related to the direct effect of hypercapnic acidosis on immune function and, as a consequence, of increased cardiac output that subsequently leads to improved tissue oxygenation. Appropriate management of hypercapnia may aid in improving the outcomes of sepsis. Our aim was to review the effects of compensated hypercapnia and hypercapnic acidosis on sepsis, with a specific focus on critically ill patients...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852846/the-search-for-biomarkers-in-the-critically-ill-a-cautionary-tale
#10
John L Moran, Patricia J Solomon
The search for biomarkers has been described as a dismal patchwork of fragmented research. We review biomarkers in sepsis in the critically ill in terms of conventional single circulating proteins. Despite sepsis biomarker publications trebling over the past 6 years, currently only one, procalcitonin, has materialised promise. We survey genomic biomarker initiatives, single nucleotide polymorphisms (SNPs) and gene signatures. Despite many SNP associations with sepsis susceptibility and a limited number of genome-wide association studies, the status of these associations is that of genomic signposts only...
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852845/a-wash-twice-a-day-keeps-mrsa-away
#11
Yasmine Ali Abdelhamid
No abstract text is available yet for this article.
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29852844/the-undiscovered-country-therapeutic-targeting-of-carbon-dioxide-levels-in-critically-ill-patients
#12
Alistair D Nichol
No abstract text is available yet for this article.
June 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29458325/comparison-of-continuous-wave-doppler-ultrasound-monitor-and-echocardiography-to-assess-cardiac-output-in-intensive-care-patients
#13
Brendan E Smith, Veronica M Madigan
No abstract text is available yet for this article.
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29458324/smoking-cessation-therapy-in-australian-and-new-zealand-intensive-care-units-a-multicentre-point-prevalence-study
#14
Forbes McGain, Matthew L Durie, Samantha Bates, Christine M Polmear, Jason Meyer, Craig J French
OBJECTIVE: To obtain an accurate estimate of smoking prevalence and smoking cessation support practices, including nicotine replacement therapy (NRT), in Australian and New Zealand intensive care units (ICUs). DESIGN, SETTING AND PARTICIPANTS: Cross-sectional, observational study using data obtained from adult ICUs participating in the Australian and New Zealand Intensive Care Society Clinical Trials Group Point Prevalence Program in 2016. MAIN OUTCOME MEASURES: Prevalence and intensity of current smoking, baseline characteristics of smokers in comparison with non-smokers and frequency of NRT use while admitted to the ICU...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29458323/a-randomised-controlled-trial-to-determine-the-effectiveness-of-a-radial-arterial-catheter-dressing
#15
Clare Healy, Ian Baldwin, Judy Currey, Andrea Driscoll
OBJECTIVE: To reduce radial arterial catheter failure in patients admitted to an adult intensive care unit (ICU). DESIGN: A randomised controlled trial. SETTING: A single site, large metropolitan tertiary referral public hospital. PARTICIPANTS: Three hundred participants admitted to an adult ICU were enrolled between 25 May and 13 September 2015. INTERVENTIONS: Participants were randomly assigned to one of two treatment groups (a polyurethane adhesive keyhole dressing or a polyurethane adhesive keyhole dressing together with a polyurethane semipermeable transparent dressing)...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29458322/predicting-recovery-from-acute-kidney-injury-in-critically-ill-patients-development-and-validation-of-a-prediction-model
#16
Theis S Itenov, Rasmus Ehrenfried Berthelsen, Jens-Ulrik Jensen, Thomas A Gerds, Lars M Pedersen, Ditte Strange, Katrin Thormar, Jesper Løken, Mads H Andersen, Hamid Tousi, Nanna Reiter, Jens D Lundgren, Morten H Bestle
OBJECTIVE: Intensive care unit (ICU) patients with acute kidney injury (AKI) who recover kidney function within 28 days experience less severe chronic kidney impairment and have increased long term survival. The aims of this study were to develop and validate a risk prediction model to identify these patients. DESIGN: Observational study with development and validation of a risk prediction model. SETTING: Nine academic ICUs in Denmark. PARTICIPANTS: Development cohort of critically ill patients with AKI at ICU admission from the Procalcitonin and Survival Study cohort (n = 568), validation cohort of adult patients with AKI admitted to two university hospitals in Denmark in 2012-13 (n = 766)...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29458321/differential-effects-of-isotonic-and-hypotonic-4-albumin-solution-on-intracranial-pressure-and-renal-perfusion-and-function
#17
Naoya Iguchi, Junko Kosaka, Joseph Bertolini, Clive N May, Yugeesh R Lankadeva, Rinaldo Bellomo
OBJECTIVES: Albumin is used to resuscitate trauma patients but may increase intracranial pressure (ICP). Its effects on renal blood flow and function are unknown. Our aim was to examine the effects of hypertonic albumin on ICP and renal function, and if any effects are due to the hypotonicity of the solution containing albumin or to albumin itself. DESIGN, SETTING AND SUBJECTS: Cross-over, randomised controlled experimental study of six adult Merino ewes in the animal facility of a research institute...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29458320/evaluation-of-urea-and-creatinine-change-during-continuous-renal-replacement-therapy-effect-of-blood-flow-rate
#18
Nigel Fealy, Leanne Aitken, Eugene du Toit, Michael Bailey, Ian Baldwin
OBJECTIVE: To determine if faster blood flow rate (BFR) has an effect on solute maintenance in continuous renal replacement therapy. DESIGN: Prospective randomised controlled trial. SETTING: 24-bed, single centre, tertiary level intensive care unit. PARTICIPANTS: Critically ill adults requiring continuous renal replacement therapy (CRRT). INTERVENTIONS: Patients were randomised to receive one of two BFRs: 150 mL/min or 250 mL/min...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29458319/proportional-assist-ventilation-versus-pressure-support-ventilation-in-weaning-ventilation-a-pilot-randomised-controlled-trial
#19
John Botha, Cameron Green, Ian Carney, Kavi Haji, Sachin Gupta, Ravindranath Tiruvoipati
OBJECTIVE: Proportional assist ventilation with load-adjustable gain factors (PAV+) is a mode of ventilation that provides assistance in proportion to patient effort. This may have physiological and clinical advantages when compared with pressure support ventilation (PSV). Our objective was to compare these two modes in patients being weaned from mechanical ventilation. DESIGN: Prospective randomised controlled trial comparing PSV with PAV+. SETTING: University-affiliated, tertiary referral intensive care unit (ICU)...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29458318/protocol-summary-and-statistical-analysis-plan-for-the-intensive-care-unit-randomised-trial-comparing-two-approaches-to-oxygen-therapy-icu-rox
#20
Diane M Mackle, Michael J Bailey, Richard W Beasley, Rinaldo Bellomo, Victoria L Bennett, Adam M Deane, Glenn M Eastwood, Simon Finfer, Ross C Freebairn, Edward Litton, Natalie J Linke, Colin J McArthur, Shay P McGuinness, Rakshit Panwar, Paul J Young
BACKGROUND: The balance of risks and benefits of conservative v standard care oxygen strategies for patients who are invasively ventilated in the intensive care unit (ICU) is uncertain. OBJECTIVE: To describe the study protocol and statistical analysis plan for the ICU randomised trial comparing two approaches to oxygen therapy (ICU-ROX). DESIGN, SETTING AND PARTICIPANTS: Protocol for a multicentre, randomised, participant and outcome assessor-blinded, standard care-controlled, parallel-group, two-sided superiority trial to be conducted in up to 22 ICUs in Australia and New Zealand...
March 2018: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
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