Crit Care Resusc
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The epidemiology of patients admitted to the intensive care unit after a drug overdose (OD) is poorly defined. We aimed to study the incidence, characteristics and outcomes of patients admitted to the ICU because of OD in Australia and New Zealand. ⋯ Drug OD accounts for an increasing proportion of ICU admissions in Australia and New Zealand. Its population incidence is increasing overall, particularly in Indigenous Australians.
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To investigate the frequency, characteristics and timing of objectively measured clinical instability in adult ward patients in the 24 hours preceding activation of the medical emergency team (MET). We also examined ward clinician responses to documented clinical instability. ⋯ Patients commonly and repeatedly breached objectively measured UCR criteria in the 24 hours preceding MET activation, providing numerous opportunities for clinicians to recognise and respond to early clinical deterioration. The high incidence of pre- MET afferent limb failure requires further exploration.
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To describe the use of imaging studies (four-vessel angiography or radionuclide scan) for brain death determination in South Australian intensive care units, and to determine the rates of adherence with The ANZICS statement on death and organ donation of the Australian and New Zealand Intensive Care Society (ANZICS). ⋯ Therapeutic hypothermia, terminal serum sodium level ≥ 150 mmol/L and cause of death were independent predictors of brain death determination by imaging study. Documentation of imaging indication was poor, particularly after hypoxic brain injury. This may reflect emerging indications for imaging, poor adherence to ANZICS recommendations, or simple omissions.
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Randomized Controlled Trial
Exogenous glucagon-like peptide-1 attenuates glucose absorption and reduces blood glucose concentration after small intestinal glucose delivery in critical illness.
To evaluate the effect of exogenous glucagonlike peptide-1 (GLP-1) on small intestinal glucose absorption and blood glucose concentrations during critical illness. ⋯ Short-term administration of exogenous GLP-1 reduces small intestinal glucose absorption for up to 4 hours during critical illness. This is likely to be an additional mechanism for the glucose-lowering effect of this agent.