Crit Care Resusc
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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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Observational Study
The association of plasma gammaaminobutyric acid concentration with postoperative delirium in critically ill patients.
Delirium is a common complication in postoperative, critically ill patients. The mechanism of postoperative delirium is not well understood but many studies have shown significant associations between benzodiazepine use, alcohol withdrawal and cirrhosis, and an increased risk of delirium. We aimed to investigate a possible link with alterations of gamma-aminobutyric acid (GABA) activity. ⋯ Plasma GABA level on POD 2 has a significant independent association with postoperative delirium.
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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.
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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.