Crit Care Resusc
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Randomized Controlled Trial Comparative Study
A randomised controlled trial of standard transfusion versus fresher red blood cell use in intensive care (TRANSFUSE): protocol and statistical analysis plan.
To determine if using freshest available rather than standard-issue red blood cells (RBCs) can reduce mortality in critically ill intensive care unit patients. Our study is the largest ongoing randomised controlled trial (RCT) of RBC age in critically ill patients and will help determine if the use of the freshest available RBCs should become standard policy for the critically ill. ⋯ The pragmatic protocol design has been chosen to facilitate translation of the trial results into practice. The TRANSFUSE trial will have important clinical and policy implications, regardless of the outcome.
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Randomized Controlled Trial
The CALORIES trial: statistical analysis plan.
The CALORIES trial is a pragmatic, open, multicentre, randomised controlled trial (RCT) of the clinical effectiveness and cost-effectiveness of early nutritional support via the parenteral route compared with early nutritional support via the enteral route in unplanned admissions to adult general critical care units (CCUs) in the United Kingdom. The trial derives from the need for a large, pragmatic RCT to determine the optimal route of delivery for early nutritional support in the critically ill. ⋯ In keeping with best trial practice, we have developed, described and published a statistical analysis plan for the CALORIES trial and are placing it in the public domain before inspecting data from the trial.
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To determine the proportion of computed tomography pulmonary angiograms (CTPAs), performed after medical emergency team (MET) calls, that are positive for pulmonary embolism (PE), and whether there are useful clinical predictors of positive CTPA results. ⋯ Clinical decision rules and MET indications were not significantly associated with the presence of PE on CTPA. However, an abnormal chest x-ray has a high negative predictive value and therefore may be helpful in preventing unnecessary CTPAs.
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To describe the awareness of intensive care unit patients and their next of kin (NoK) about invasive procedures and their expectations of informed consent for procedures in the ICU. ⋯ Our results suggest there is a limited degree of support for routine procedural consent from ICU patients and their NoK.
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The College of Intensive Care Medicine provides the standards for training and certification of intensive care medicine specialists in Australia and New Zealand. After reviewing and revising its training program, the College recently launched a new training curriculum for all trainees registering from 2014, aimed at maintaining quality. In this article, we aim to outline the context, changes and future directions for intensive care medicine training in Australia and New Zealand.