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Rinaldo Bellomo

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https://www.readbyqxmd.com/read/28601273/potential-impact-of-the-2016-consensus-definitions-of-sepsis-and-septic-shock-on-future-sepsis-research
#1
Sandra L Peake, Anthony Delaney, Michael Bailey, Rinaldo Bellomo
STUDY OBJECTIVE: The influence of the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) on the conduct of future sepsis research is unknown. We seek to examine the potential effect of the new definitions on the identification and outcomes of patients enrolled in a sepsis trial. METHODS: This was a post hoc analysis of the Australasian Resuscitation in Sepsis Evaluation (ARISE) trial of early goal-directed therapy that recruited 1,591 adult patients presenting to the emergency department (ED) with early septic shock diagnosed by greater than or equal to 2 systemic inflammatory response syndrome criteria and either refractory hypotension or hyperlactatemia...
June 7, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28600756/how-to-improve-the-care-of-patients-with-acute-kidney-injury
#2
EDITORIAL
Rinaldo Bellomo, Suvi T Vaara, John A Kellum
No abstract text is available yet for this article.
June 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28599199/the-haemodynamic-effects-of-bolus-versus-slower-infusion-of-intravenous-crystalloid-in-healthy-volunteers
#3
Ida F Ukor, Andrew K Hilton, Michael J Bailey, Rinaldo Bellomo
PURPOSE: This pilot study aimed to characterise the haemodynamic effect of 1L of IV normal saline (NS) administered as a rapid versus slow infusion on cardiac output (CO), heart rate (HR), systemic blood pressures, and carotid blood flow in six healthy volunteers. MATERIALS AND METHODS: Six healthy male volunteers aged 18-65years were randomized to receive 1L NS given over 30min or 120min. On a subsequent study session the alternate fluid regimen was administered...
May 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28597505/renal-effects-of-an-emergency-department-chloride-restrictive-intravenous-fluid-strategy-in-patients-admitted-to-hospital-for-more-than-48-hours
#4
Nor'azim Mohd Yunos, Rinaldo Bellomo, David McD Taylor, Simon Judkins, Fergus Kerr, Harvey Sutcliffe, Colin Hegarty, Michael Bailey
OBJECTIVE: Patients commonly receive i.v. fluids in the ED. It is still unclear whether the choice of i.v. fluids in this setting influences renal or patient outcomes. We aimed to assess the effects of restricting i.v. chloride administration in the ED on the incidence of acute kidney injury (AKI). METHODS: We conducted a before-and-after trial with 5008 consecutive ED-treated hospital admissions in the control period and 5146 consecutive admissions in the intervention period...
June 8, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28590358/erythropoietin-in-patients-with-traumatic-brain-injury-and-extracranial-injury-a-post-hoc-analysis-of-the-epo-tbi-trial
#5
Markus B Skrifvars, Michael Bailey, Craig French, Jeffrey Presneill, Alistair Nichol, Lorraine Little, Jacques Duranteau, Olivier Huet, Samir Haddad, Yaseen Arabi, Colin McArthur, D James Cooper, Rinaldo Bellomo
BACKGROUND: Erythropoietin (EPO) may reduce mortality after traumatic brain injury (TBI). Secondary brain injury is exacerbated by multiple trauma, and possibly modifiable by EPO. We hypothesized that EPO decreases mortality more in TBI patients with multiple trauma, than in patients with TBI alone. METHODS: A post hoc analysis of the EPO-TBI randomised controlled trial conducted in 2009 to 2014. To evaluate the impact of injuries outside the brain, we calculated an extracranial injury severity score (ISS) that included the same components of the ISS, excluding head and face components...
June 6, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28583149/effect-sizes-in-ongoing-randomized-controlled-critical-care-trials
#6
Elliott E Ridgeon, Rinaldo Bellomo, Scott K Aberegg, Rob Mac Sweeney, Rachel S Varughese, Giovanni Landoni, Paul J Young
BACKGROUND: An important limitation of many critical care trial designs is that they hypothesize large, and potentially implausible, reductions in mortality. Interpretation of trial results could be improved by systematic assessment of the plausibility of trial hypotheses; however, such assessment has not been attempted in the field of critical care medicine. The purpose of this study was to determine clinicians' views about prior probabilities and plausible effect sizes for ongoing critical care trials where the primary endpoint is landmark mortality...
June 5, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28534110/the-impact-of-disability-in-survivors-of-critical-illness
#7
Carol L Hodgson, Andrew A Udy, Michael Bailey, Jonathan Barrett, Rinaldo Bellomo, Tracey Bucknall, Belinda J Gabbe, Alisa M Higgins, Theodore J Iwashyna, Julian Hunt-Smith, Lynne J Murray, Paul S Myles, Jennie Ponsford, David Pilcher, Craig Walker, Meredith Young, D J Cooper
PURPOSE: To use the World Health Organisation's International Classification of Functioning to measure disability following critical illness using patient-reported outcomes. METHODS: A prospective, multicentre cohort study conducted in five metropolitan intensive care units (ICU). Participants were adults who had been admitted to the ICU, received more than 24 h of mechanical ventilation and survived to hospital discharge. The primary outcome was measurement of disability using the World Health Organisation's Disability Assessment Schedule 2...
May 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28533194/mortality-in-cardiac-surgery-myriad-a-randomized-controlled-trial-of-volatile-anesthetics-rationale-and-design
#8
Giovanni Landoni, Vladimir Lomivorotov, Antonio Pisano, Caetano Nigro Neto, Umberto Benedetto, Giuseppe Biondi Zoccai, Marco Gemma, Samuele Frassoni, Felice Eugenio Agrò, Massimo Baiocchi, Filomena R Barbosa Gomes Galas, Andrei Bautin, Nikola Bradic, Cristiana Carollo, Giuseppe Crescenzi, Abeer M Elnakera, Mohamed R El-Tahan, Evgeny Fominskiy, Ahmed G Farag, Gordana Gazivoda, Stefano Gianni, Evgeny Grigoryev, Fabio Guarracino, Sidik Hanafi, Weiqing Huang, Gudrun Kunst, Jan Kunstyr, Chong Lei, Rosalba Lembo, Zhi-Jian Li, Valery Likhvantsev, Andrey Lozovskiy, Jun Ma, Fabrizio Monaco, Paolo Navalesi, Bukamal Nazar, Vadim Pasyuga, Elena Porteri, Colin Royse, Laura Ruggeri, Hynek Riha, Fernanda Santos Silva, Luca Severi, Vladimir Shmyrev, Nikolay Uvaliev, Cheng Bin Wang, Chew-Yin Wang, Dario Winterton, Chow-Yen Yong, Jingui Yu, Rinaldo Bellomo, Alberto Zangrillo
OBJECTIVE: There is initial evidence that the use of volatile anesthetics can reduce the postoperative release of cardiac troponin I, the need for inotropic support, and the number of patients requiring prolonged hospitalization following coronary artery bypass graft (CABG) surgery. Nevertheless, small randomized controlled trials have failed to demonstrate a survival advantage. Thus, whether volatile anesthetics improve the postoperative outcome of cardiac surgical patients remains uncertain...
May 19, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28528561/angiotensin-ii-for-the-treatment-of-vasodilatory-shock
#9
Ashish Khanna, Shane W English, Xueyuan S Wang, Kealy Ham, James Tumlin, Harold Szerlip, Laurence W Busse, Laith Altaweel, Timothy E Albertson, Caleb Mackey, Michael T McCurdy, David W Boldt, Stefan Chock, Paul J Young, Kenneth Krell, Richard G Wunderink, Marlies Ostermann, Raghavan Murugan, Michelle N Gong, Rakshit Panwar, Johanna Hästbacka, Raphael Favory, Balasubramanian Venkatesh, B Taylor Thompson, Rinaldo Bellomo, Jeffrey Jensen, Stew Kroll, Lakhmir S Chawla, George F Tidmarsh, Adam M Deane
Background Vasodilatory shock that does not respond to high-dose vasopressors is associated with high mortality. We investigated the effectiveness of angiotensin II for the treatment of patients with this condition. Methods We randomly assigned patients with vasodilatory shock who were receiving more than 0.2 μg of norepinephrine per kilogram of body weight per minute or the equivalent dose of another vasopressor to receive infusions of either angiotensin II or placebo. The primary end point was a response with respect to mean arterial pressure at hour 3 after the start of infusion, with response defined as an increase from baseline of at least 10 mm Hg or an increase to at least 75 mm Hg, without an increase in the dose of background vasopressors...
May 21, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28505485/interventions-affecting-mortality-in-critically-ill-and-perioperative-patients-a-systematic-review-of-contemporary-trials
#10
Martina Baiardo Redaelli, Giovanni Landoni, Stefania Di Sanzo, Samuele Frassoni, Chiara Sartini, Luca Cabrini, Giacomo Monti, Mara Scandroglio, Alberto Zangrillo, Rinaldo Bellomo
PURPOSE: Confounders in randomized controlled trials (RCTs) reporting significant effects on mortality in critically ill patients using non-surgical techniques have not been systematically explored. We aimed to identify factors unrelated to the reported intervention that might have affected the findings and robustness of such trials. METHODS: We searched Pubmed/MEDLINE for all RCTs on any non-surgical interventions reporting an effect on unadjusted mortality in critically ill patients between 1/1/2000 and 1/12/2015...
May 4, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28497374/the-effect-of-insulin-administration-on-c-peptide-in-critically-ill-patients-with-type-2-diabetes
#11
Marco Crisman, Luca Lucchetta, Nora Luethi, Luca Cioccari, Que Lam, Glenn M Eastwood, Rinaldo Bellomo, Johan Mårtensson
BACKGROUND: In critically ill patients with permissive hyperglycemia, it is uncertain whether exogenous insulin administration suppresses or enhances c-peptide secretion (a marker of pancreatic beta-cell response). We aimed to explore this effect in patients with type 2 diabetes. METHODS: We prospectively enrolled a cohort of 45 critically ill patients with type 2 diabetes managed according to a liberal glucose protocol (target blood glucose 10-14 mmol/l). We recorded the administration of insulin and oral hypoglycemic agents and measured plasma c-peptide as surrogate marker of endogenous insulin secretion on the first two consecutive days in ICU...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28474317/acute-kidney-injury-in-the-icu-from-injury-to-recovery-reports-from-the-5th-paris-international-conference
#12
REVIEW
Rinaldo Bellomo, Claudio Ronco, Ravindra L Mehta, Pierre Asfar, Julie Boisramé-Helms, Michael Darmon, Jean-Luc Diehl, Jacques Duranteau, Eric A J Hoste, Joannes-Boyau Olivier, Matthieu Legrand, Nicolas Lerolle, Manu L N G Malbrain, Johan Mårtensson, Heleen M Oudemans-van Straaten, Jean-Jacques Parienti, Didier Payen, Sophie Perinel, Esther Peters, Peter Pickkers, Eric Rondeau, Miet Schetz, Christophe Vinsonneau, Julia Wendon, Ling Zhang, Pierre-François Laterre
The French Intensive Care Society organized its yearly Paris International Conference in intensive care on June 18-19, 2015. The main purpose of this meeting is to gather the best experts in the field in order to provide the highest quality update on a chosen topic. In 2015, the selected theme was: "Acute Renal Failure in the ICU: from injury to recovery." The conference program covered multiple aspects of renal failure, including epidemiology, diagnosis, treatment and kidney support system, prognosis and recovery together with acute renal failure in specific settings...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28432843/vitamin-b1-in-critically-ill-patients-needs-and-challenges
#13
REVIEW
Jake T B Collie, Ronda F Greaves, Oliver A H Jones, Que Lam, Glenn M Eastwood, Rinaldo Bellomo
BACKGROUND: Thiamine has a crucial role in energy production, and consequently thiamine deficiency (TD) has been associated with cardiac failure, neurological disorders, oxidative stress (lactic acidosis and sepsis) and refeeding syndrome (RFS). This review aims to explore analytical methodologies of thiamine compound quantification and highlight similarities, variances and limitations of current techniques and how they may be relevant to patients. CONTENT: An electronic search of Medline, PubMed and Embase databases for original articles published in peer-reviewed journals was conducted...
April 22, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28364303/acute-kidney-injury-in-sepsis
#14
REVIEW
Rinaldo Bellomo, John A Kellum, Claudio Ronco, Ron Wald, Johan Martensson, Matthew Maiden, Sean M Bagshaw, Neil J Glassford, Yugeesh Lankadeva, Suvi T Vaara, Antoine Schneider
Acute kidney injury (AKI) and sepsis carry consensus definitions. The simultaneous presence of both identifies septic AKI. Septic AKI is the most common AKI syndrome in ICU and accounts for approximately half of all such AKI. Its pathophysiology remains poorly understood, but animal models and lack of histological changes suggest that, at least initially, septic AKI may be a functional phenomenon with combined microvascular shunting and tubular cell stress. The diagnosis remains based on clinical assessment and measurement of urinary output and serum creatinine...
March 31, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28327171/the-association-of-time-and-medications-with-changes-in-bone-mineral-density-in-the-2%C3%A2-years-after-critical-illness
#15
Neil R Orford, Michael Bailey, Rinaldo Bellomo, Julie A Pasco, Claire Cattigan, Tania Elderkin, Sharon L Brennan-Olsen, David J Cooper, Mark A Kotowicz
BACKGROUND: Critical illness is associated with increased risk of fragility fracture and loss of bone mineral density (BMD), although the impact of medication exposures (bone anti-fracture therapy or glucocorticoids) and time remain unexplored. The objective of this study was to describe the association of time after ICU admission, and post-ICU administration of bone anti-fracture therapy or glucocorticoids after critical illness, with change in BMD. METHODS: In this prospective observational study, conducted in a tertiary hospital ICU, we studied adult patients requiring mechanical ventilation for at least 24 hours and measured BMD annually for 2 years after ICU discharge...
March 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28320259/levosimendan-for-hemodynamic-support-after-cardiac-surgery
#16
RANDOMIZED CONTROLLED TRIAL
Giovanni Landoni, Vladimir V Lomivorotov, Gabriele Alvaro, Rosetta Lobreglio, Antonio Pisano, Fabio Guarracino, Maria G Calabrò, Evgeny V Grigoryev, Valery V Likhvantsev, Marcello F Salgado-Filho, Alessandro Bianchi, Vadim V Pasyuga, Massimo Baiocchi, Federico Pappalardo, Fabrizio Monaco, Vladimir A Boboshko, Marat N Abubakirov, Bruno Amantea, Rosalba Lembo, Luca Brazzi, Luigi Verniero, Pietro Bertini, Anna M Scandroglio, Tiziana Bove, Alessandro Belletti, Maria G Michienzi, Dmitriy L Shukevich, Tatiana S Zabelina, Rinaldo Bellomo, Alberto Zangrillo
BACKGROUND: Acute left ventricular dysfunction is a major complication of cardiac surgery and is associated with increased mortality. Meta-analyses of small trials suggest that levosimendan may result in a higher rate of survival among patients undergoing cardiac surgery. METHODS: We conducted a multicenter, randomized, double-blind, placebo-controlled trial involving patients in whom perioperative hemodynamic support was indicated after cardiac surgery, according to prespecified criteria...
May 25, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28297080/duration-of-platelet-storage-and-outcomes-of-critically-ill-patients
#17
MULTICENTER STUDY
Andrew Flint, Cécile Aubron, Michael Bailey, Rinaldo Bellomo, David Pilcher, Allen C Cheng, Colin Hegarty, Michael C Reade, Zoe McQuilten
BACKGROUND: The storage duration of platelet (PLT) units is limited to 5 to 7 days. This study investigates whether PLT storage duration is associated with patient outcomes in critically ill patients. STUDY DESIGN AND METHODS: This study was a retrospective analysis of critically ill patients admitted to the intensive care unit (ICU) of two hospitals in Australia who received one or more PLT transfusions from 2008 to 2014. Storage duration was approached in several different ways...
March 2017: Transfusion
https://www.readbyqxmd.com/read/28288655/effect-of-an-automated-notification-system-for-deteriorating-ward-patients-on-clinical-outcomes
#18
Christian P Subbe, Bernd Duller, Rinaldo Bellomo
BACKGROUND: Delayed response to clinical deterioration of ward patients is common. METHODS: We performed a prospective before-and-after study in all patients admitted to two clinical ward areas in a district general hospital in the UK. We examined the effect on clinical outcomes of deploying an electronic automated advisory vital signs monitoring and notification system, which relayed abnormal vital signs to a rapid response team (RRT). RESULTS: We studied 2139 patients before (control) and 2263 after the intervention...
March 14, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28286115/association-between-augmented-renal-clearance-and-clinical-outcomes-in-patients-receiving-%C3%AE-lactam-antibiotic-therapy-by-continuous-or-intermittent-infusion-a-nested-cohort-study-of-the-bling-ii-randomised-placebo-controlled-clinical-trial
#19
Andrew A Udy, Joel M Dulhunty, Jason A Roberts, Joshua S Davis, Steven A R Webb, Rinaldo Bellomo, Charles Gomersall, Charudatt Shirwadkar, Glenn M Eastwood, John Myburgh, David L Paterson, Therese Starr, Sanjoy K Paul, Jeffrey Lipman
Augmented renal clearance (ARC) is known to influence β-lactam antibiotic pharmacokinetics. This substudy of the BLING-II trial aimed to explore the association between ARC and patient outcomes in a large randomised clinical trial. BLING-II enrolled 432 participants with severe sepsis randomised to receive β-lactam therapy by continuous or intermittent infusion. An 8-h creatinine clearance (CLCr) measured on Day 1 was used to identify ARC, defined as CLCr ≥ 130 mL/min. Patients receiving any form of renal replacement therapy were excluded...
May 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28277756/in-hospital-cardiac-arrest-epidemiology-in-a-mature-rapid-response-system
#20
Daryl Jones, Inga Mercer, Melodie Heland, Karen Detering, Sam Radford, Graeme Hart, David O'Donnell, Rinaldo Bellomo
An audit examined the epidemiology of in-hospital cardiac arrests 5 years after a rapid response system was introduced, exploring the frequency of arrests in monitored and unmonitored areas. Details of the initial cardiac rhythm and what proportion of events were preceded by a medical emergency team call were also assessed.
March 2, 2017: British Journal of Hospital Medicine
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