Crit Care Resusc
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Randomized Controlled Trial Multicenter Study Comparative Study
Temperature management in patients with acute neurological lesions: an Australian and New Zealand point prevalence study.
Given the scientific uncertainty of the efficacy and safety of normothermia (36.0°C to 37.5°C) on disability and death after acute neurological lesions, we sought to understand how temperature is managed in usual clinical care for this patient population in Australia and New Zealand. ⋯ Temperature readings above 37.5°C are common. Further cohort studies are required to validate these preliminary, exploratory findings.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomised controlled trial of induced hypermagnesaemia following aneurysmal subarachnoid haemorrhage.
The effect of serum magnesium concentration on the incidence of cerebral arterial vasospasm following aneurysmal subarachnoid haemorrhage (SAH) is unclear. ⋯ Patients assigned a higher serum magnesium concentration had a reduced incidence of vasospasm as seen by angiography, but the difference was not statistically significant. Clinically significant outcomes were not different between groups. A firm recommendation for induced hypermagnesaemia cannot be made from this study.
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Randomized Controlled Trial Multicenter Study Comparative Study
Safety evaluation of a trial of lipocalin-directed sodium bicarbonate infusion for renal protection in at-risk critically ill patients.
Urine alkalinisation with sodium bicarbonate decreases renal oxidative stress and might attenuate sepsisassociated acute kidney injury (s-AKI). The safety and feasibility of urine alkalinisation in patients at risk of s-AKI has never been tested. ⋯ Administration of sodium bicarbonate and sodium chloride solutions to patients at risk of s-AKI was associated with frequent major electrolyte abnormalities and early protocol cessation. The tested protocol does not appear safe or feasible.
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Randomized Controlled Trial Multicenter Study Comparative Study
The ADRENAL study protocol: adjunctive corticosteroid treatment in critically ill patients with septic shock.
There is considerable global uncertainty on the role of low-dose corticosteroids in septic shock, which translates into variations in prescribing practices. ⋯ The run-in phase has been completed and the main trial commenced in February 2013. The trial should generate results that will inform and influence prescribing of corticosteroids in septic shock.
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Review
Treatment goals: health care improvement through setting and measuring patient-centred outcomes.
To determine how frequently stress ulcer prophylaxis (SUP) medications prescribed in the intensive care unit are inappropriately continued on the ward and on hospital discharge. ⋯ SUP medications commenced in ICU are frequently continued unnecessarily, both in the wards and on hospital discharge.