Crit Care Resusc
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The objective of this study was to describe current use, clinical practice, and outcomes of continuous renal replacement therapy (CRRT) in children in the intensive care unit (ICU) in Australia and New Zealand. ⋯ CRRT is used less frequently than PD in smaller children and in those with CHD. In all other cohorts, it is the predominant mode of RRT. ICU mortality rates were higher for CRRT than for PD, with a large variation in mortality rates across age and diagnostic groups. The CRRT mortality in ICU decreased over the 5 years of the study.
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To describe the six-month functional outcomes of patients who received extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest (IHCA) in Australia. ⋯ One in three patients who received ECPR following IHCA were alive at six months and most had a good functional outcome. However, survivors reported higher levels of disability and a worse health status at six months compared with the baseline and ongoing complications were common.
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Patients in the intensive care unit (ICU) frequently develop hyperactive delirium, which may be accompanied by behaviour that increases clinical risks to themselves as well as other patients and staff. There is a paucity of evidence to inform the urgent enteral administration of antipsychotic drugs to treat such hyperactive delirium and behavioural disturbances. ⋯ This trial will compare the effect of enteral olanzapine to quetiapine in critically ill adults with hyperactive delirium on an important indicator of patient outcome.
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Severe intensive care unit-acquired hypernatraemia (ICU-AH) is a serious complication of critical illness. However, there is no detailed information on how this condition develops. ⋯ Severe hypernatraemia occurred in the setting of inability to drink, near-absent measurement of urinary free water losses, diuretic therapy, fever, renal impairment, and near-absent or limited or delayed water administration. Correction was slow.
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To describe the incidence of bleeding and thrombotic complications in VA-ECMO according to anticoagulation strategy. ⋯ Available literature assessing the association between anticoagulation strategies in VA-ECMO, and bleeding and thrombosis is of limited quality. We identified a substantially higher incidence of major bleeding events than a previous meta-analysis. Limited numbers of patients anticoagulated with alternatives to heparin were reported. Patients with additional mechanical LV unloading represent a cohort at particular risk of bleeding and thrombotic complications.