Crit Care Resusc
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Comparative Study
Improved consistency in interpretation and management of cardiovascular variables by intensive care staff using a computerised decision-support system.
To investigate the potential of a computerised decision-support system (CDSS) to improve consistency of haemodynamic evaluation and treatment suggestions by intensive care unit clinical staff with different levels of expertise and experience. ⋯ Use of a CDSS significantly improved the consistency between categories of clinical ICU staff in assessing the cardiovascular status and making management decisions in postoperative cardiac surgery patients.
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Comparative Study
Measuring visceral fat, subcutaneous fat and skeletal muscle area changes by computed tomography in acute pancreatitis: a retrospective, single-centre study.
To show that body composition of intensive care unit patients can be analysed with existing computed tomography (CT) images. We planned to describe changes in visceral fat area (VFA), subcutaneous fat area (SFA) and muscle area (MA) on analysis of specific CT images during acute pancreatitis requiring an ICU admission. ⋯ The body composition of ICU patients can be analysed through existing CT images. Pancreatitis requiring ICU admission causes a 12% decrease in VFA.
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We present a 16-year-old male with severe acute respiratory and renal failure as a result of Goodpasture syndrome, requiring venovenous extracorporeal membrane oxygenation (VV-ECMO) for pulmonary haemorrhage. The patient received no systemic anticoagulation for 25 of 26 ECMO days (20 days consecutively) and suffered no coagulation-related adverse events. The patient had a subtherapeutic anticoagulation profile according to recommended ECMO guidelines during most of this time. The patient made a full recovery without respiratory compromise, ECMO circuit failure, thrombotic events or the need for ongoing haemodialysis.
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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.