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Rise of the machines - the growing influence of the Asia-Pacific in the world of mechanical support.
Authors: Fraser JF, Bellomo R PMID: 29084494 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Appraising extracorporeal life support - current and future roles in adult intensive care.
Authors: Shekar K, Brodie D, Fraser J, MacLaren G PMID: 29084495 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Incremental research approach to describing the pharmacokinetics of ciprofloxacin during extracorporeal membrane oxygenation.
CONCLUSIONS: We provide preliminary evidence that ciprofloxacin dosing in ECMO patients should remain in line with the recommended dosing strategies for critically ill patients not receiving ECMO. PMID: 29084496 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Extracorporeal membrane oxygenation in adult congenital heart disease: a case series and literature review.
CONCLUSION: ECMO is a promising temporary rescue intervention for patients with ACHD and cardiogenic shock. The extracorporeal cardiac support is a useful bridge to recovery. PMID: 29084497 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

To be or not to be on ECMO: can survival prediction models solve the question?
Authors: Rozencwajg S, Fraser J, Montero S, Combes A, Schmidt M Abstract Over the past decade, there has been growing interest in extracorporeal membrane oxygenation (ECMO) as a rescue therapy for patients with severe acute respiratory distress syndrome (ARDS) and cardiogenic shock. Although survival of ECMO-treated patients has improved recently, the incidence of ECMO-related complications such as bleeding and nosocomial infections remains unacceptably high. In addition, patients often experience long-term physiological and psychological sequelae. Hence, identifying patients who will most likely benefit from ECMO ...
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

A pilot, randomised controlled trial of a rotational thromboelastometry-based algorithm to treat bleeding episodes in extracorporeal life support: the TEM Protocol in ECLS Study (TEMPEST).
Authors: Buscher H, Zhang D, Nair P Abstract OBJECTIVES: Minimal evidence to guide haemostatic therapy for bleeding in extracorporeal life support (ECLS) has resulted in wide variability in practice. We aimed to show that a goal-directed algorithm incorporating results from thromboelastometry (TEM) is feasible and safe for the timely management of bleeding episodes in adult patients receiving ECLS. DESIGN AND PARTICIPANTS: A pilot randomised controlled trial involving 16 adult patients who underwent ECLS, randomised over 10 months. INTERVENTION: The intervention group was treated according to a goal-directe...
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

The impact of venovenous extracorporeal membrane oxygenation on cytokine levels in patients with severe acute respiratory distress syndrome: a prospective, observational study.
CONCLUSION: Cytokine levels, on average, fall rapidly after initiation of VV ECMO, which may be related to the reduction of invasiveness of mechanical ventilation. Higher cytokine levels are associated with extrapulmonary causes of ARDS, more aggressive mechanical ventilation before VV ECMO, and mortality. PMID: 29084500 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Acquired von Willebrand syndrome in respiratory extracorporeal life support: a systematic review of the literature.
CONCLUSION: The prevalence of AvWF among patients on VV ECMO or ECCO2R is high, but only a limited number of studies are reported in the literature. AvWS testing should be performed, including vWF multimer analysis, vWF activity and vWF antigen concentration. The extent to which vWF contributes to bleeding during ECMO, or how much changes in ECMO management can influence high molecular weight vWF multimer levels, cannot be answered from the currently available evidence and there remains a need for future studies. PMID: 29084501 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

In-hospital outcome of post-cardiotomy extracorporeal life support in adult patients: the 2007-2017 Maastricht experience.
CONCLUSIONS: Our experience confirms an increased use of PC-ECLS during the last 10 years and shows that, by carefully addressing patient management and complications, survival rat e may be satisfactory, and improved outcome may be achieved in such a challenging ECLS setting. PMID: 29084502 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

The evolving role and practical application of extracorporeal carbon dioxide removal in critical care.
Authors: Barrett NA, Camporota L Abstract OBJECTIVE: Extracorporeal venovenous carbon dioxide removal (ECCO2R) is increasingly used to facilitate ultraprotective mechanical ventilation, or to prevent or avoid mechanical ventilation in selected patients. This review focuses on how extracorporeal devices clear CO2, their impact on native pulmonary physiology, and systemic gas exchange. Finally, we discuss the modifications to patient management required while on ECCO2R. PMID: 29084503 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Nosocomial infections acquired by patients treated with extracorporeal membrane oxygenation.
CONCLUSIONS: Infectious complications are common in ECMO patients and are associated with longer durations of hospital admission. Isolated pathogens were predominantly hospital-acquired Gram-negative bacteria and yeasts. Immunosuppression and treatment with VA ECMO were found to be specific risk factors for infection. PMID: 29084504 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Management strategies in venovenous extracorporeal membrane oxygenation: a retrospective comparison from five European centres.
CONCLUSION: There is great diversity in management modalities for ventilator and ECMO settings for patients with bacterial pneumonia. Our study emphasises the lack of clinical consensus in VV ECMO management. PMID: 29084505 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Glycaemic control in diabetic ketoacidosis: Too much of a good thing?
Authors: McArthur C PMID: 28866968 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

A scoping review of use of wearable devices to evaluate outcomes in survivors of critical illness.
Authors: Gluck S, Chapple LS, Chapman MJ, Iwashyna TJ, Deane AM Abstract 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. We performed a scoping review of studies fou...
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Calprotectin as an early biomarker of bacterial infections in critically ill patients: an exploratory cohort assessment.
Authors: Jonsson N, Nilsen T, Gille-Johnson P, Bell M, Martling CR, Larsson A, Mårtensson J Abstract 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 pa...
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Rapid response team calls that overlap in time: incidence, consequences and patient outcomes.
Authors: Flabouris A, Mesecke M Abstract 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). The median number of daily calls per 10...
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Comparison of continous-wave Doppler ultrasound monitor and echocardiography to assess cardiac output in intensive care patients.
Authors: Elgendy A, Seppelt IM, Lane AS Abstract 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), wh...
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Identification and assessment of potentially high-mortality intensive care units using the ANZICS Centre for Outcome and Resource Evaluation clinical registry.
CONCLUSIONS: A combination of routine monitoring techniques, statistical analysis and contextual interpretation of findings is required to ensure potential outlier ICUs are appropriately identified. This ensures engagement and understanding from clinicians and jurisdictional health departments, while contributing to the improvement of ICU practices throughout Australia and New Zealand. PMID: 28866973 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

The Plasma-Lyte 148 v Saline (PLUS) study protocol: a multicentre, randomised controlled trial of the effect of intensive care fluid therapy on mortality.
CONCLUSIONS: The PLUS study will provide high-quality data on the comparative safety and efficacy of Plasma-Lyte 148 compared with saline for resuscitation and compatible crystalloid fluid therapy in critically ill adult patients. PMID: 28866974 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Influence of changing endotracheal tube cuff management on antibiotic use for ventilator-associated pneumonia in a tertiary intensive care unit.
Authors: Darvall JN, Thevarajan I, Iles S, Rechnitzer T, Spelman T, Harley N Abstract 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 stu...
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

A cross-sectional survey of Australian and New Zealand public opinion on methods totriage intensive care patients in an influenza pandemic.
CONCLUSION: In an influenza pandemic, when ICU resources would be overwhelmed, survey respondents preferred that ICU triage be performed by a senior doctor, but also perceived the use of pre-determined triage criteria to be fair. PMID: 28866976 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Intensity of early correction of hyperglycaemia and outcome of critically ill patients with diabetic ketoacidosis.
Authors: Mårtensson J, Bailey M, Venkatesh B, Pilcher D, Deane A, Abdelhamid YA, Crisman M, Verma B, MacIsaac C, Wigmore G, Shehabi Y, Suzuki T, French C, Orford N, Kakho N, Prins J, Ekinci EI, Bellomo R Abstract 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 whet...
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Peripheral venoarterial extracorporeal membrane oxygenation for severe hyperlactataemia after cardiac surgery: a pilot study.
Authors: Biesenbach P, Ghanpur R, Mårtensson J, Crisman M, Lindstrom S, Hilton A, Matalanis G, Bellomo R Abstract 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 oxyge...
Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Co-enrolment for the TAME and TTM-2 trials: the cerebral option.
Authors: Parke RL, McGuinness S, Eastwood GM, Nichol A, Nielsen N, Dankiewicz J, Bellomo R PMID: 28651502 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

To co-enrol or not to co-enrol: that is the question.
Authors: Presneill JJ PMID: 28651503 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Critical care management of aneurysmal subarachnoid haemorrhage in Australia and New Zealand: what are we doing, and where to from here?
Authors: Udy AA, Schweikert S, Anstey J, Anstey M, Cohen J, Flower O, Saxby E, Poll AV, Delaney A Abstract Patients with an aneurysmal subarachnoid haemorrhage (SAH) frequently require admission to the intensive care unit. There, a variety of therapeutic strategies are initiated, in addition to definitive procedures aimed at securing the aneurysm. Despite a substantial investment in caring for these patients, outcomes for this group remain poor. Although the severity of the initial bleed is crucial in this context, many patients undergo further deterioration in the ICU. Delayed cerebral ischaemia is a significant c...
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Considerations for co-enrolment in randomised controlled effectiveness trials in critical care: the SPICE-8 co-enrolment guidelines.
Authors: Reade MC, Bass F, Howe B, Seppelt I, Shehabi Y Abstract The Australian and New Zealand Intensive Care Society Clinical Trials Group and other investigator-led trials groups in critical care publish policies and guidelines outlining the rationale for considering co-enrolment in large, randomised controlled trials in intensive care medicine. However, none present a checklist of criteria by which a request for permission to co-enrol in an existing trial can be assessed. Consequently, such requests tend to be made and assessed on an ad hoc basis. Based on our experience in the SPICE III randomised controlled t...
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

The College of Intensive Care Medicine of Australia and New Zealand supports global collaboration and respect.
Authors: Bevan R, Corke C, Raper R, Pinder M, Freebairn R, Venkatesh B, Stephens D, Joynt G, Morley P, Bellomo R, Yong S, Jacobe S, Hawker F, Ashbolt M, Lam S, Varghese B PMID: 28651506 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Protein delivery and clinical outcomes in the critically ill: a systematic review and meta-analysis.
Authors: Davies ML, Chapple LS, Chapman MJ, Moran JL, Peake SL Abstract OBJECTIVES: Protein is a fundamental component of critical care nutrition, but there has been uncertainty about the optimal amount. We undertook this systematic review and meta-analysis to examine the relationship between delivered protein and mortality in randomised controlled trials (RCTs) of nutritional interventions involving critically ill adults. Secondary outcomes included the effect of protein dose on lengths of stay, mechanical ventilation and incidence of infections. METHODS: We reviewed the relevant English-language literature pu...
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Quality sleep using earplugs in the intensive care unit: the QUIET pilot randomised controlled trial.
CONCLUSION: A definitive study of earplugs as a noiseabatement strategy for patients admitted to the ICU is feasible on the basis of participant acceptability of the intervention and protocol compliance. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12615001125516. PMID: 28651508 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Drivers of choice of resuscitation fluid in the intensive care unit: a discrete choice experiment.
CONCLUSIONS: Doctors and nurses rely on different information when choosing resuscitation fluids, although both cohorts are heavily influenced by safety concerns, patient type and fluid type. This information can be used to modify prescribing behaviour. PMID: 28651509 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Pharmacodynamics of intravenous frusemide bolus in critically ill patients.
Authors: Huang A, Luethi N, Mårtensson J, Bellomo R, Cioccari L Abstract 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. We compared data from the 6-hour period before administration of a single IV bolus of...
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Outcomes of children admitted to intensive care after out-of-hospital cardiac arrest in Victoria, Australia.
CONCLUSIONS: Bystander CPR and primary cardiac aetiology had strong associations with survival with a favourable neurological outcome after paediatric OHCA. Maximising CPR education for the community, and targeting people most likely to witness a paediatric OHCA may further improve outcomes. PMID: 28651511 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Survival and functional outcomes of patients with metastatic solid organ cancer admitted to the intensive care unit of a tertiary centre.
CONCLUSIONS: Survival is poor in patients with metastatic cancer after emergent ICU admission, although functional state is often recovered by 3 months in surviving patients. Albumin level, white cell count and ECOG grade are simple prognostic markers of survival. PMID: 28651512 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

The performance of flash glucose monitoring in critically ill patients with diabetes.
CONCLUSIONS: The subcutaneous FreeStyle Libre blood glucose measurement system showed high test-retest reliability and acceptable accuracy when compared with arterial blood glucose measurement in critically ill patients with diabetes. PMID: 28651513 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Study protocol for the Balanced Solution versus Saline in Intensive Care Study (BaSICS): a factorial randomised trial.
CONCLUSIONS: The BaSICS trial will provide robust evidence on whether a balanced crystalloid, compared with saline, improves important patient outcomes in critically ill patients. BaSICS will also provide relevant information on whether bolus infusion rate affects outcomes in this population. TRIAL REGISTRATION: ClinicalTrials.gov NCT02875873. PMID: 28651514 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Statistical analysis plan for the Adjunctive Corticosteroid Treatment in Critically Ill Patients with Septic Shock (ADRENAL) trial.
CONCLUSION: We have developed an SAP for the ADRENAL trial. This plan accords with high-quality standards of internal validity to minimise analysis bias. PMID: 28651515 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Correction: Direct cerebral perfusion and cooling in experimental cardiac arrest (Crit Care Resusc 2016; 18: 255-60).
Authors: Bellomo R, Marino B, Angelopoulos P, Carson S, Eastwood G, Kosaka J, Iguchi N, Hilton A, May C PMID: 28651516 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

The ATHOS-3 trial, angiotensin II and The Three Musketeers.
Authors: Bellomo R, Hilton A PMID: 28215124 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Reducing confusion about post-cardiotomy delirium.
Authors: Jones D, Hodgson CL, Shehabi Y, Reade MC PMID: 28215125 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

New sepsis definition changes incidence of sepsis in the intensive care unit.
CONCLUSIONS: Adopting the SOFA criteria will increase the apparent incidence of sepsis in patients admitted to the ICU with infective conditions without affecting the mortality rate. Prospective evaluation of the effect of adopting the new definition of sepsis is required. PMID: 28215126 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Characteristics and outcomes of critically ill patients with drug overdose in Australia and New Zealand.
Authors: Cioccari L, Luethi N, Bailey M, Pilcher D, Bellomo R Abstract OBJECTIVE: The epidemiology of patients admitted to the intensive care unit after a drug overdose (OD) is poorly defined. We aimed to study the incidence, characteristics and outcomes of patients admitted to the ICU because of OD in Australia and New Zealand. DESIGN, SETTING AND PATIENTS: Retrospective study of data from the Australian and New Zealand Intensive Care Society Adult Patient Database, including all patients admitted to an ICU with OD from 2005 to 2013. RESULTS: Overall, of 883 618 patients treated in the ICU during the study...
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

The characteristics, pattern of injury and outcome of children admitted to a paediatric intensive care unit following an inflicted injury.
CONCLUSIONS: The majority of children admitted to intensive care following an inflicted injury are aged under 12 months. Children most commonly require intensive care for management of a head injury. Many children have radiological findings suggestive of pre-existing inflicted injury. Despite high mortality, the majority of children survive. While most are likely to be independent, many children will have residual disabilities. PMID: 28215128 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Longitudinal changes in anthropometrics and impact on self-reported physical function after traumatic brain injury.
CONCLUSIONS: Patients with a TBI lose muscle thickness while in the ICU but the trajectory of loss stabilises after ICU discharge. Ultrasound-derived QMLT is related to total lean mass and physical function after discharge. Further studies are needed to confirm that ultrasound measurement of QMLT is a useful surrogate measure of muscle mass and functional outcomes after trauma and critical illness. PMID: 28215129 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Exogenous glucagon-like peptide-1 attenuates glucose absorption and reduces blood glucose concentration after small intestinal glucose delivery in critical illness.
CONCLUSIONS: Short-term administration of exogenous GLP-1 reduces small intestinal glucose absorption for up to 4 hours during critical illness. This is likely to be an additional mechanism for the glucose-lowering effect of this agent. PMID: 28215130 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Angiotensin II for the Treatment of High-Output Shock 3 (ATHOS-3): protocol for a phase III, double-blind, randomised controlled trial.
CONCLUSION: Our study will investigate the utility of adding ANGII to current SOC vasopressor options to increase the efficacy and safety of CRH therapy. PMID: 28215131 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Physiological antecedents and ward clinician responses before medical emergency team activation.
CONCLUSIONS: Patients commonly and repeatedly breached objectively measured UCR criteria in the 24 hours preceding MET activation, providing numerous opportunities for clinicians to recognise and respond to early clinical deterioration. The high incidence of pre- MET afferent limb failure requires further exploration. PMID: 28215132 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Use of imaging studies for determination of brain death in South Australian intensive care units.
Authors: Sampson BG, Datson LD, Bihari S Abstract OBJECTIVES: To describe the use of imaging studies (four-vessel angiography or radionuclide scan) for brain death determination in South Australian intensive care units, and to determine the rates of adherence with The ANZICS statement on death and organ donation of the Australian and New Zealand Intensive Care Society (ANZICS). DESIGN, PATIENTS AND SETTING: Retrospective case-note review of 190 South Australian adult patients (≥ 18 years) who were brain dead and were organ donors (actual and intended), from 1 January 2008 to 31 December 2014. MAIN OUTCOM...
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Drainage of pleural effusion improves diaphragmatic function in mechanically ventilated patients.
CONCLUSIONS: Drainage of a unilateral pleural effusion during weaning from mechanical ventilation improves diaphragmatic contractile activity and respiratory system performance. PMID: 28215134 [PubMed - in process] (Source: Critical Care and Resuscitation)
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Rapid response team diagnoses: frequencies and related hospital mortality.
Authors: Smith RJ, Santamaria JD, Faraone EE, Holmes JA, Reid DA Abstract OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units. DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes. RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis grou...
Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research