Crit Care Resusc
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Objective: We sought to examine the incidence of low amplitude ventricular fibrillation and its impact on successful cardioversion, duration of resuscitation, and survival to hospital discharge in patients with out-of-hospital cardiac arrest (OHCA). Design: Retrospective analysis from a statewide registry. Setting: Victoria, Australia. ⋯ The duration of resuscitation also increased by 1.7 minutes (95% CI, 1.03-2.36; P < 0.001) for every 0.1 mV increase in final amplitude. Conclusion: More than one-third of initial ventricular fibrillation OHCA cases were low in amplitude. Comparative international data are needed to better understand how low amplitude ventricular fibrillation rhythms confound the measurement of OHCA interventions and international benchmarks for survival outcomes.
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Background: Acute pulmonary oedema is a life-threatening syndrome diagnosed based on radiological and clinical findings. However, to our knowledge, no studies have investigated this syndrome in critically ill patients. Objective: To describe the prevalence of radiologically and clinically diagnosed pulmonary oedema (RCDPO) in critically ill patients, characteristics of diagnosed patients, and treatments and outcomes in this patient population. ⋯ Such patients were sicker and had more comorbidities. The presence of RCDPO was independently associated with higher risk of death. Invasive mechanical ventilation was the only intervention independently associated with greater odds of radiological resolution.
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Objective: The cost of providing care in an intensive care unit (ICU) after brain death to facilitate organ donation is unknown. The objective of this study was to estimate expenditure for the care delivered in the ICU between the diagnosis of brain death and subsequent organ donation. Design: Cohort study of direct and indirect costs using bottom-up and top-down microcosting techniques. ⋯ The mean duration of postdeath care in the ICU was 37.9 hours (standard deviation [SD], 16.5) at a mean total cost of $7520 (SD, $3136) per donor. ICU staff salaries were the greatest contributor to total costs, accounting for a median proportion of 0.72 of total expenditure (interquartile range, 0.68-0.75). Conclusions: Substantial costs are incurred in ICU for the provision of patient care in the interval between brain death and organ donation.
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Serum creatinine and total protein are routinely measured biochemical parameters used in clinical medicine. An abnormal result caused by interference with the assay does not accurately reflect a patient's clinical state and therefore risks misleading clinicians. ⋯ The blood collection was contaminated with intravenous fluid and the patient was receiving piperacillin/tazobactam. Additional laboratory studies demonstrated piperacillin/tazobactam was the cause of the false positive results and the elevation in both serum creatinine and protein level was dependent on the concentration of antibiotic present.