Crit Care Resusc
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Randomized Controlled Trial
Pilot randomised double-blind controlled trial of high-dose spironolactone in critically ill patients receiving a frusemide infusion.
Hypernatraemia may develop during intravenous infusion of frusemide. Spironolactone is an aldosterone antagonist that promotes natriuresis and may attenuate such hypernatraemia, but its effect in this setting has not been previously studied. ⋯ In this pilot study, the administration of high-dose spironolactone to ventilated critically ill patients receiving frusemide by infusion had no significant effects on serum sodium level, natriuresis or potassium balance when compared with placebo.
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To determine the effect an intensive care unit liaison nurse service had on ICU patient discharges, readmissions and outcomes. ⋯ The introduction of our ICU liaison nurse service was associated with a trend towards more efficient ICU discharges (increased throughput, decreased ICU step-down days and ICU readmission LOS) and improved survival for ICU patients requiring readmission, but overall ICU and hospital LOS and mortality, and ICU readmission rates were unchanged.
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To investigate the resources and infrastructure available for collecting intensive care unit data in New South Wales for submission to the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database (APD). ⋯ It appears that NSW ICUs are generally not adequately resourced or organised for collecting data, which could significantly affect the quality of data submitted to the ANZICS APD. Further investigation of data quality is warranted, and a follow-up survey of ICU directors is planned. Until the issue of data quality is adequately addressed, outcomes measurement based on these data should be treated with caution.
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To examine practice patterns and workload of practising Australian intensivists and to investigate the risk and prevalence of "burnout syndrome". ⋯ Intensivists are at high risk of burnout syndrome. Recognising the drivers and early signs of burnout and identifying a preventive strategy is a professional priority for ANZICS and the intensive care community.
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A 14-year-old boy with catecholamine-induced polymorphic ventricular tachycardia was treated for hypoxic brain injury after a 25-minute ventricular tachycardia arrest. He had been treated by the local paediatric cardiology service with ?-blockers for syncopal events related to episodes of ventricular tachycardia. ⋯ PtO2 is a reliable and effective clinical assessment tool that can aid in the management of patients with significant cerebral injury. Vasopressin proved a valuable adjunct in treatment of hypoxic brain injury when inotropic agents were contraindicated.