Crit Care Resusc
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Randomized Controlled Trial Multicenter Study Comparative Study
A protocol for a multicentre randomised controlled trial of continuous beta-lactam infusion compared with intermittent beta-lactam dosing in critically ill patients with severe sepsis: the BLING II study.
Beta-lactam antibiotics are largely administered by bolus dosing, despite displaying time-dependent pharmacokinetics and pharmacodynamics and there being a strong rationale for continuous administration. The randomised controlled trials conducted to date comparing the mode of betalactam administration have been inconclusive and limited by non-equivalent dosing, unblinded administration and small sample sizes. ⋯ The study started in July 2012 and will provide clinical evidence as to whether continuous infusion of beta-lactam antibiotics is superior to intermittent bolus administration in critically ill patients with severe sepsis. A Phase III study powered for a survival end point may be justified, based on the results of our study.
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Review Meta Analysis
Effects of non-invasive ventilation on reintubation rate: a systematic review and meta-analysis of randomised studies of patients undergoing cardiothoracic surgery.
To estimate the effect of non-invasive mechanical ventilation (NIV) on the rate of reintubation among patients undergoing cardiothoracic surgery. ⋯ NIV seems to be effective in reducing reintubation rate after cardiothoracic surgery. The results of this meta-analysis should be confirmed by large randomised controlled studies.
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Review Meta Analysis
A meta-analysis of complications and mortality of extracorporeal membrane oxygenation.
To comprehensively assess published peer-reviewed studies related to extracorporeal membrane oxygenation (ECMO), focusing on outcomes and complications of ECMO in adult patients. ⋯ Even with conditions usually associated with a high chance of death, almost 50% of patients receiving ECMO survive up to discharge. Complications are frequent and most often comprise renal failure, pneumonia or sepsis, and bleeding.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomised controlled trial of plasma filtration in severe paediatric sepsis.
To determine whether plasma filtration improves 28-day survival in infants and children with severe sepsis. ⋯ Our study did not recruit enough patients to test the hypothesis that addition of plasma filtration to our standard care protocol reduces 28-day mortality in children with severe sepsis. However, mortality in the treatment and control groups was not significantly different after adjustment for severity of illness at the time of randomisation.
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Multicenter Study Comparative Study
Development and validation of the critical care outcome prediction equation, version 4.
To revise and validate the accuracy of the critical care outcome prediction equation (COPE) model, version 4. ⋯ COPE-4 model prediction of hospital mortality for ICU admissions has satisfactory performance for use as a risk-adjustment tool in Victoria. Model refinement may further improve its performance.