Crit Care Resusc
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Randomized Controlled Trial Multicenter Study
The relationship between hypophosphataemia and outcomes during low-intensity and high-intensity continuous renal replacement therapy.
To identify risk factors for development of hypophosphataemia in patients treated with two different intensities of continuous renal replacement therapy (CRRT) and to assess the independent association of hypophosphataemia with major clinical outcomes. ⋯ Hypophosphataemia is common during CRRT and its incidence increases with greater CRRT intensity. Hypophosphataemia is not a robust independent predictor of mortality. Its greater incidence in the higher intensity CRRT arm of the Randomised Evaluation of Normal vs Augmented Level trial does not explain the lack of improved outcomes with such treatment.
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Multicenter Study Comparative Study
A brief review of recent trends in Victorian intensive care, 2000-2011.
Review of resource use and patient outcomes of intensive care unit services over time provides insights into service delivery and safety. ⋯ There was an increase in ICU resource availability and evidence of improvement in hospital survival, suggesting improved quality of care. These evaluation methods may be useful in monitoring statewide capacity, service delivery and patient safety.
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Comparative Study
Continuous intra-arterial blood glucose monitoring using quenched fluorescence sensing: a product development study.
Continuous glucose monitoring (CGM) has the potential to improve the management of blood glucose (BG) and so improve patient safety and outcomes in intensive care units. The GluCath Intravascular CGM (IV-CGM) System (GluMetrics) uses a novel quenched chemical fluorescence sensing mechanism to measure BG. ⋯ In this product development study, use of the GluCath system for 24 hours after cardiac surgery had no adverse effect on haemodynamic monitoring, arterial blood sampling or clinical care. Overall accuracy was acceptable in the context of the first phase of a product development study.
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The medical emergency team (MET) is now common in many hospitals. Apart from early identification and management of patients who are potentially unwell on the ward, the MET may also be involved in end-of-life (EOL) care. It is not known how often METs perform EOL interventions. ⋯ We show that EOL care is commonly delivered during MET calls, and should be emphasised in training for MET members.
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Comparative Study
Invasive blood pressure recording comparing nursing charts with an electronic monitor: a technical report.
Blood pressure management (assessed using nursing charts) in the early phase of septic shock may have an effect on renal outcomes. Assessment of mean arterial pressure (MAP) values as recorded on nursing charts may be inaccurate. ⋯ With multiple measurements over time, mean blood pressure as recorded on nursing charts reasonably approximates mean blood pressure recorded on the monitor.