Crit Care Resusc
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Biography Historical Article
19th century pioneering of intensive therapy in North America. Part 3: the Fell-O'Dwyer apparatus and William P Northrup.
Two previous articles in this series have described the reintroduction of forced respiration for ventilatory difficulties, particularly in opiate poisoning (by George Fell), and successful use of intralaryngeal tubes designed for treating airway obstruction in diphtheritic acute laryngitis (by Joseph O'Dwyer). In 1891, O'Dwyer extended the applications of Fell's system, introducing a longer orolaryngeal tube, replacing Fell's methods of inflating the lungs, which had been with a somewhat unsatisfactory facemask or through a tracheotomy tube. ⋯ Although the apparatus was used beyond New York (eg, in New Orleans by J D Bloom, especially for neonatal apnoea), it is difficult to find other than nonspecific references. Matas and Bloom improved O'Dwyer's original system, but after the clinical success of Charles Elsberg's continuous insufflation anaesthesia for thoracic surgery, 1909, American anaesthetists came to prefer that.
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Randomized Controlled Trial Multicenter Study
The NICE-SUGAR (Normoglycaemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation) Study: statistical analysis plan.
The Normoglycaemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) Study is the largest study to date of glycaemic control in critically ill patients. ⋯ We have developed a pre-determined statistical analysis plan for the NICE-SUGAR Study. This plan will be followed to avoid analysis bias arising from prior knowledge of the study findings.
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To determine whether operators with less than 3 months' formal anaesthesiology training have higher rates of complications when performing endotracheal intubation (ETI) in the intensive care unit than operators with longer formal anaesthesiology training. ⋯ ETIs performed in the ICU where the initial operator has less than 3 months' formal training in anaesthesiology appear not to be associated with more complications. However, this may be attributable to less experienced operators having more assistance and supervision, and to patient selection.
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To determine whether the introduction of a weekly multidisciplinary team meeting (MDTM) to a general intensive care unit improved selected clinical indicators of patient outcome, and staff satisfaction with patient care. ⋯ The introduction of a weekly MDTM to a general ICU did not improve selected clinical indicators of patient outcome or staff satisfaction with patient care.
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Randomized Controlled Trial Multicenter Study
The RENAL (Randomised Evaluation of Normal vs. Augmented Level of Replacement Therapy) study: statistical analysis plan.
The Randomised Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study is the largest interventional trial ever conducted in patients with acute renal failure. ⋯ We have developed a pre-determined statistical analysis plan for the RENAL trial. This plan will be adhered to in order to avoid introducing any analysis bias associated with prior knowledge of study findings.