Crit Care Resusc
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Despite extensive work to improve early recognition of and response to abnormal vital signs, a failure or delay in response to clinical deterioration by activating a medical emergency team (MET) can affect patient safety. ⋯ Despite one in seven patients fulfilling MET criteria, MET activation occurred infrequently. The presence of MET criteria was associated with a doubling of the hospital LOS. Escalation of care in response to detection of MET criteria fulfillment was variable. Further research tracking patient management is needed to understand the decision-making process that occurs in the presence of clinical deterioration.
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Randomized Controlled Trial
Statistical analysis plan for the HEAT trial: a multicentre randomised placebo-controlled trial of intravenous paracetamol in intensive care unit patients with fever and infection.
We describe the statistical analysis plan (SAP) for the Permissive Hyperthermia through Avoidance of Paracetamol in Known or Suspected Infection in the Intensive Care Unit (HEAT) trial, a 700-patient, prospective, randomised, Phase 2b, multicentre, double-blind, parallel-groups, placebo-controlled trial of paracetamol administration for the treatment of fever in critically ill patients with known or suspected infection. ⋯ We developed an SAP for the HEAT trial, and produced a mock Consolidated Standards of Reporting Trials diagram and tables. Our prespecified SAP accords with high-quality standards of internal validity and should minimise future analysis bias.
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Most studies of the rapid response team (RRT) investigate the effect of introducing an RRT on outcomes of all hospitalised patients. Less information exists on RRT patient epidemiology, or changes in RRT call numbers with time. ⋯ Annual RRT calls are increasing in many Australian hospitals, and now affect more than 14 700 patients annually. Inhospital mortality of RRT patients is about 25%, and about 20% of patients who die in hospital are reviewed by the RRT. Further research is needed to understand the reason for the high inhospital mortality of RRT patients.