Crit Care Resusc
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Observational Study
Survival and functional outcomes of patients with metastatic solid organ cancer admitted to the intensive care unit of a tertiary centre.
Metastatic solid organ cancer is associated with a poor prognosis, and admission of patients with these cancers to the intensive care unit remains a dilemma. We aimed to assess outcomesin a cohort of these patients who were admitted to the ICU of a general tertiary centre. ⋯ Survival is poor in patients with metastatic cancer after emergent ICU admission, although functional state is often recovered by 3 months in surviving patients. Albumin level, white cell count and ECOG grade are simple prognostic markers of survival.
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Practice Guideline Randomized Controlled Trial
Considerations for co-enrolment in randomised controlled effectiveness trials in critical care: the SPICE-8 co-enrolment guidelines.
The Australian and New Zealand Intensive Care Society Clinical Trials Group and other investigator-led trials groups in critical care publish policies and guidelines outlining the rationale for considering co-enrolment in large, randomised controlled trials in intensive care medicine. However, none present a checklist of criteria by which a request for permission to co-enrol in an existing trial can be assessed. ⋯ Reporting co-enrolment in trials, for regulatory purposes and in publications, is uncommon, partly because of the complexity involved in explaining a lack of a plausible coenrolment effect. We suggest that noting compliance with these criteria would simplify such reporting and enhance transparency.
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Observational Study
Pharmacodynamics of intravenous frusemide bolus in critically ill patients.
To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients. ⋯ In a cohort of critically ill patients without chronic renal impairment, frusemide increased UO and urinary sodium, potassium and chloride losses, and induced hypochloraemia and metabolic alkalosis. However, its diuretic effects were extremely variable and were modified by age, MAP and creatinine and albumin levels.
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Review Meta Analysis Comparative Study
Protein delivery and clinical outcomes in the critically ill: a systematic review and meta-analysis.
Protein is a fundamental component of critical care nutrition, but there has been uncertainty about the optimal amount. We undertook this systematic review and meta-analysis to examine the relationship between delivered protein and mortality in randomised controlled trials (RCTs) of nutritional interventions involving critically ill adults. Secondary outcomes included the effect of protein dose on lengths of stay, mechanical ventilation and incidence of infections. ⋯ Delivery of varying amounts of nutritional protein was not associated with any effect on mortality.