Crit Care Resusc
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To assess the frequency of after-hours discharges of patients from the intensive care unit and its effect on in-hospital mortality. ⋯ A high proportion of patients (34.7%) were discharged from the ICU after-hours. Discharge after-hours was associated with a higher risk of in-hospital mortality than discharge during work hours.
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Metformin, a widely used hypoglycaemic agent in type 2 diabetes mellitus, is uncommonly associated with lactic acidosis, a serious condition with high mortality. ⋯ MALA is a not uncommon cause of ICU admission. Gastrointestinal symptoms predominate in MALA, and the condition is associated with significant morbidity and mortality.
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Acute Physiology and Chronic Health Evaluation (APACHE) III scores have been shown to correlate with outcomes for patients with burn injuries. It is unknown whether they can be used to compare outcomes between intensive care units that admit patients with burns in Australia and New Zealand. ⋯ The APACHE III-j score is a good predictor of death among burns patients admitted to ICUs in Australia and New Zealand. It can be used to compare risk-adjusted outcomes between individual ICUs and over time.
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Extended daily diafiltration (EDDf) is a prolonged intermittent dialysis technique introduced as an alternative to continuous renal replacement therapy in critically ill patients. Although EDDf has the advantages of ease of use, low cost and patient tolerability, there is concern that the high blood and dialysate flow rates used with EDDf may precipitate haemodynamic instability. ⋯ EDDf did not significantly worsen haemodynamic stability in patients with sepsis during their treatment.
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Haemodynamic instability is frequently considered a contraindication to enteral feeding. However, gastrointestinal function and the success of enteral feeding have never been formally examined in patients with shock. ⋯ Despite delayed gastric emptying, protocoldirected enteral feeding can be considered in patients with septic shock.