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Rinaldo Bellomo

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https://www.readbyqxmd.com/read/29454582/predictors-and-outcomes-of-cardiac-surgery-associated-delirium-a-single-centre-retrospective-cohort-study
#1
Daryl Jones, George Matalanis, Johan Mårtensson, Raymond Robbins, Margaret Shaw, Siven Seevanayagam, Dean Cowie, Rinaldo Bellomo
BACKGROUND: The predictors and independent outcome association of delirium after cardiac surgery are important and yet poorly characterised. METHODS: We performed a retrospective observational study of cardiac surgery patients between January 2009 and March 2016. We defined delirium using ICD-10 diagnostic codes. Multivariable analysis was conducted to find independent associations between baseline variables, delirium, and key clinical outcomes. RESULTS: We studied 2447 study patients (28...
February 8, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29428606/influence-of-ward-round-order-on-critically-ill-patient-outcomes
#2
Steve Evans, Jai Darvall, Alexandra Gorelik, Rinaldo Bellomo
PURPOSE: To examine the effect of order in which patients are seen on an Intensive Care Unit (ICU) ward round on ICU length of stay (LOS), mortality and duration of mechanical ventilation. MATERIALS AND METHODS: Retrospective observational study in a tertiary metropolitan ICU over a 12month period. All patients who occupied the first and last three bed spaces of the ICU ward round, without having moved bed spaces during admission, were included. Separate analyses were performed for the absolute first and last patients...
February 3, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29413729/characteristics-incidence-and-outcome-of-patients-admitted-to-the-intensive-care-unit-with-myasthenia-gravis
#3
Wisam Al-Bassam, Mark Kubicki, Michael Bailey, Laurence Walker, Paul Young, David V Pilcher, Rinaldo Bellomo
BACKGROUND: There are limited data on the characteristics, incidence, and mortality of patients with myasthenia gravis (MG) admitted to the ICU. AIMS: To study the epidemiology, characteristics and outcome of patients with MG in Australian and New Zealand (ANZ) ICUs over a decade. METHODS: We performed a retrospective observational, cross sectional study of data from the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD)...
January 7, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29413724/characteristics-incidence-and-outcome-of-patients-admitted-to-intensive-care-unit-with-guillain-barre-syndrome-in-australia-and-new-zealand
#4
Paolo Ancona, Michael Bailey, Rinaldo Bellomo
PURPOSE: To describe characteristics, incidence and outcome of patients with Guillain-Barre syndrome (GBS) admitted to ICU. METHODS: We conducted a binational, retrospective, observational, epidemiological study. We compared the baseline characteristics, physiological conditions and outcomes for GBS patients with or without mechanical ventilation (MV) and of survivors and non-survivors. RESULTS: We studied 711 patients admitted to 173 ICUs between 2005 and 2015...
January 29, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29382510/preoperative-renal-functional-reserve-predicts-risk-of-acute-kidney-injury-after-cardiac-surgery
#5
Faeq Husain-Syed, Fiorenza Ferrari, Aashish Sharma, Tommaso Hinna Danesi, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Massimo de Cal, Valentina Corradi, Grazia Maria Virzì, Silvia De Rosa, María Jimena Muciño Bermejo, Carla Estremadoyro, Gianluca Villa, Jose J Zaragoza, Carlotta Caprara, Alessandra Brocca, Horst-Walter Birk, Hans-Dieter Walmrath, Werner Seeger, Federico Nalesso, Monica Zanella, Alessandra Brendolan, Davide Giavarina, Loris Salvador, Rinaldo Bellomo, Mitchell H Rosner, John A Kellum, Claudio Ronco
BACKGROUND: Although acute kidney injury (AKI) frequently complicates cardiac surgery, methods to determine AKI risk in patients without underlying kidney disease are lacking. Renal functional reserve (RFR) can be used to measure the capacity of the kidney to increase glomerular filtration rate under conditions of physiological stress and may serve as a functional marker that assesses susceptibility to injury. We sought to determine whether preoperative RFR predicts postoperative AKI...
January 27, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29366580/urinary-biomarkers-may-provide-prognostic-information-for-subclinical-acute-kidney-injury-after-cardiac-surgery
#6
Christian Albert, Annemarie Albert, Johanna Kube, Rinaldo Bellomo, Nicholas Wettersten, Hermann Kuppe, Sabine Westphal, Michael Haase, Anja Haase-Fielitz
OBJECTIVE: This study aimed to determine the biomarker-specific outcome patterns and short-and long-term prognosis of cardiac surgery-asoociated acute kidney injury (AKI) identified by standard criteria and/or urinary kidney biomarkers. METHODS: Patients enrolled (N = 200), originated a German multicenter study (NCT00672334). Standard risk injury, failure, loss, and end-stage renal disease classification (RIFLE) criteria (including serum creatinine and urine output) and urinary kidney biomarker test result (neutrophil gelatinase-associated lipocalin, midkine, interleukin 6, and proteinuria) were used for diagnosis of postoperative AKI...
December 22, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29353118/magnesium-supplementation-pharmacokinetics-in-cardiac-surgery-patients-with-normal-renal-function
#7
Peter Biesenbach, Johan Mårtensson, Eduardo Osawa, Glenn Eastwood, Salvatore Cutuli, Jessica Fairley, George Matalanis, Rinaldo Bellomo
BACKGROUND: Intravenous magnesium is routinely administered in intensive care units (ICU) to treat arrhythmias after cardiothoracic surgery. There are no data on the pharmacokinetics of continuous magnesium infusion therapy. OBJECTIVE: To investigate the pharmacokinetics of continuous magnesium infusion, focusing on serum and urinary magnesium concentration, volume of distribution and half-life. METHODS: We administered a 10 mmol bolus of magnesium-sulfate followed by a continuous infusion of 3 mmol/h for 12 h in twenty cardiac surgery patients...
January 11, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29351759/tracheal-intubation-in-critically-ill-patients-a-comprehensive-systematic-review-of-randomized-trials
#8
Luca Cabrini, Giovanni Landoni, Martina Baiardo Radaelli, Omar Saleh, Carmine D Votta, Evgeny Fominskiy, Alessandro Putzu, Cézar Daniel Snak de Souza, Massimo Antonelli, Rinaldo Bellomo, Paolo Pelosi, Alberto Zangrillo
BACKGROUND: We performed a systematic review of randomized controlled studies evaluating any drug, technique or device aimed at improving the success rate or safety of tracheal intubation in the critically ill. METHODS: We searched PubMed, BioMed Central, Embase and the Cochrane Central Register of Clinical Trials and references of retrieved articles. Finally, pertinent reviews were also scanned to detect further studies until May 2017. The following inclusion criteria were considered: tracheal intubation in adult critically ill patients; randomized controlled trial; study performed in Intensive Care Unit, Emergency Department or ordinary ward; and work published in the last 20 years...
January 20, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29347874/adjunctive-glucocorticoid-therapy-in-patients-with-septic-shock
#9
Balasubramanian Venkatesh, Simon Finfer, Jeremy Cohen, Dorrilyn Rajbhandari, Yaseen Arabi, Rinaldo Bellomo, Laurent Billot, Maryam Correa, Parisa Glass, Meg Harward, Christopher Joyce, Qiang Li, Colin McArthur, Anders Perner, Andrew Rhodes, Kelly Thompson, Steve Webb, John Myburgh
Background Whether hydrocortisone reduces mortality among patients with septic shock is unclear. Methods We randomly assigned patients with septic shock who were undergoing mechanical ventilation to receive hydrocortisone (at a dose of 200 mg per day) or placebo for 7 days or until death or discharge from the intensive care unit (ICU), whichever came first. The primary outcome was death from any cause at 90 days. Results From March 2013 through April 2017, a total of 3800 patients underwent randomization. Status with respect to the primary outcome was ascertained in 3658 patients (1832 of whom had been assigned to the hydrocortisone group and 1826 to the placebo group)...
January 19, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29341498/review-article-sepsis-in-the-emergency-department-part-2-investigations-and-monitoring
#10
REVIEW
Amith Shetty, Stephen Pj Macdonald, Gerben Keijzers, Julian M Williams, Benjamin Tang, Bas de Groot, Kelly Thompson, John F Fraser, Simon Finfer, Rinaldo Bellomo, Jonathan Iredell
Sepsis is characterised by organ dysfunction resulting from infection, with no reliable single objective test and current diagnosis based on clinical features and results of investigations. In the ED, investigations may be conducted to diagnose infection as the cause of the presenting illness, identify the source, distinguish sepsis from uncomplicated infection (i.e. without organ dysfunction) and/ or risk stratification. Appropriate sample collection for microbiological testing remains key for subsequent confirmation of diagnosis and rationalisation of antimicrobials...
February 2018: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29327877/levosimendan-in-cardiac-surgery
#11
Giovanni Landoni, Vladimir V Lomivorotov, Rinaldo Bellomo
No abstract text is available yet for this article.
November 9, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29297629/pharmacodynamics-of-intravenous-frusemide-bolus-in-critically-ill-patients
#12
Luca Cioccari, Rinaldo Bellomo
No abstract text is available yet for this article.
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29278529/erythropoietin-does-not-alter-serum-profiles-of-neuronal-and-axonal-biomarkers-after-traumatic-brain-injury-findings-from-the-australian-epo-tbi-clinical-trial
#13
Sarah C Hellewell, Stefania Mondello, Alison Conquest, Gerry Shaw, Irina Madorsky, Jay V Deng, Lorraine Little, Firas Kobeissy, Nicole Bye, Rinaldo Bellomo, David J Cooper, Shirley Vallance, Jasmine Board, Maria C Morganti-Kossmann
OBJECTIVE: To determine profiles of serum ubiquitin carboxy-terminal hydrolase L1 and phosphorylated neurofilament heavy-chain, examine whether erythropoietin administration reduce their concentrations, and whether biomarkers discriminate between erythropoietin and placebo treatment groups. DESIGN: Single-center, prospective observational study. SETTING: A sub-study of the erythropoietin-traumatic brain injury clinical trial, conducted at the Alfred Hospital, Melbourne, Australia...
December 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29223064/patient-characteristics-incidence-technique-outcomes-and-early-prediction-of-tracheostomy-in-the-state-of-victoria-australia
#14
Andrew Casamento, Michael Bailey, Ray Robbins, David Pilcher, Stephen Warrillow, Angaj Ghosh, Rinaldo Bellomo
BACKGROUND: Tracheostomy is a relatively common procedure in Intensive Care Unit (ICU) patients. AIMS: To study the patient characteristics, incidence, technique, outcomes and prediction of tracheostomy in the State of Victoria, Australia. METHODS: We used data from the Australian and New Zealand Intensive Care Society Adult Patient Database (ANZICS APD) and the Victorian Admitted Episode Dataset (VAED) to identify and match patients who had received a tracheostomy from 2004 to 2014...
December 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/29202261/intensive-care-unit-randomised-trial-comparing-two-approaches-to-oxygen-therapy-icu-rox-results-of-the-pilot-phase
#15
RANDOMIZED CONTROLLED TRIAL
Paul J Young, Diane M Mackle, Michael J Bailey, Richard W Beasley, 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, Rinaldo Bellomo
OBJECTIVE: The objective of the intensive care unit randomised trial comparing two approaches to oxygen therapy (ICU-ROX) pilot phase, which included the first 100 patients of an overall sample of 1000, was to examine feasibility. DESIGN: Investigator-initiated, prospective, parallel-group, pilot randomised controlled trial. SETTING: Six medical-surgical intensive care units (ICUs) in Australia and New Zealand, with participants recruited from September 2015 through June 2016...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29202260/interobserver-agreement-for-post-mortem-renal-histopathology-and-diagnosis-of-acute-tubular-necrosis-in-critically-ill-patients
#16
MULTICENTER STUDY
Neil J Glassford, Alison Skene, Maria B Guardiola, Matthew J Chan, Sean M Bagshaw, Rinaldo Bellomo, Kim Solez
BACKGROUND: The renal histopathology of critically ill patients dying with acute kidney injury (AKI) in intensive care units of high income countries remains uncertain. METHODS: Retrospective observational assessment of interobserver agreement in the reporting of renal post mortem histopathology, and the ability of pathologists blinded to the clinical context to independently identify the presence of pre-mortem AKI from digital images of histological sections from 34 critically ill patients dying in teaching hospitals in Australia and Canada...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29202258/the-spice-iii-study-protocol-and-analysis-plan-a-randomised-trial-of-early-goaldirected-sedation-compared-with-standard-care-in-mechanically-ventilated-patients
#17
RANDOMIZED CONTROLLED TRIAL
Yahya Shehabi, Andrew B Forbes, Yaseen Arabi, Frances Bass, Rinaldo Bellomo, Suhaini Kadiman, Belinda D Howe, Colin McArthur, Michael C Reade, Ian Seppelt, Jukka Takala, Steve Webb, Matthew P Wise
BACKGROUND: Sedation strategy in critically ill patients who are mechanically ventilated is influenced by patient-related factors, choice of sedative agent and the intensity or depth of sedation prescribed. The impact of sedation strategy on outcome, in particular when delivered early after initiation of mechanical ventilation, is uncertain. OBJECTIVES: To present the protocol and analysis plan of a large randomised clinical trial investigating the effect of a sedation strategy, in critically ill patients who are mechanically ventilated, based on a protocol targeting light sedation using dexmedetomidine as the primary sedative, termed "early goal-directed sedation", compared with usual practice...
December 2017: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
https://www.readbyqxmd.com/read/29186517/renal-replacement-therapy-intensity-for-acute-kidney-injury-and-recovery-to-dialysis-independence-a-systematic-review-and-individual-patient-data-meta-analysis
#18
Ying Wang, Martin Gallagher, Qiang Li, Serigne Lo, Alan Cass, Simon Finfer, John Myburgh, Catherine Bouman, Robert Faulhaber-Walter, John A Kellum, Paul M Palevsky, Claudio Ronco, Patrick Saudan, Ashita Tolwani, Rinaldo Bellomo
Background: There is no consensus whether higher intensity dose renal replacement therapy (RRT) compared with standard intensity RRT has survival benefit and achieves better renal recovery in acute kidney injury (AKI). Methods: In an individual patient data meta-analysis, we merged individual patient data from randomized controlled trials (RCTs) comparing high with standard intensity RRT in intensive care unit patients with severe AKI. The primary outcome was all-cause mortality...
November 23, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29169799/pharmacokinetics-of-magnesium-bolus-therapy-in-cardiothoracic-surgery
#19
Peter Biesenbach, Johan Mårtensson, Luca Lucchetta, Ravi Bangia, Jessica Fairley, Irmelin Jansen, George Matalanis, Rinaldo Bellomo
OBJECTIVE: To investigate the pharmacokinetics of a 20 mmol magnesium bolus in regards to serum and urinary magnesium concentration, volume of distribution, and half-life. DESIGN: Prospective, experimental study. SETTING: A university-affiliated teaching hospital. PARTICIPANTS: Twenty consecutive cardiac surgery patients treated with magnesium bolus therapy for prevention of arrhythmia. INTERVENTIONS: A 20-mmol bolus of magnesium sulfate was administered intravenously...
September 1, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29161684/higher-versus-lower-continuous-renal-replacement-therapy-intensity-in-critically-ill-patients-with-liver-dysfunction
#20
Zachary O'Brien, Alan Cass, Louise Cole, Simon Finfer, Martin Gallagher, Colin McArthur, Shay McGuiness, John Myburgh, Rinaldo Bellomo, Johan Mårtensson
AIMS: To study the association between higher versus lower continuous renal replacement therapy (CRRT) intensity and mortality in critically ill patients with combined acute kidney injury and liver dysfunction. METHODS: Post-hoc analysis of patients with liver dysfunction (Sequential Organ Failure Assessment liver score ≥2 or diagnosis of liver failure/transplant) included in the Randomized Evaluation of Normal versus Augmented Level renal replacement therapy (RENAL) trial...
November 22, 2017: Blood Purification
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