Crit Care Resusc
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Randomized Controlled Trial Multicenter Study Comparative Study
Temperature management of non-elective intensive care patients without neurological abnormalities: a point prevalence study of practice in Australia and New Zealand.
To determine the frequency of pharmacological and physical cooling in non-elective general intensive care unit patients without neurological abnormalities in Australia and New Zealand, and to establish the indications for antipyretics, the prevalence of fever, and the methods of temperature measurement. ⋯ Pharmacological antipyretics are used regularly for pain management rather than fever management, with paracetamol the most common antipyretic therapy. The use of NSAIDS and physical cooling is rare. Non-core temperature measurements were common.
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Randomized Controlled Trial Multicenter Study
Monitoring Organ Donors to Improve Transplantation Results (MOnIToR) trial methodology.
Despite efforts to increase organ donation, there remain critical shortages in organ donors and organs procured per donor. Our trial is a large-scale, multicentre, randomised controlled trial in brain-dead donors, to compare protocolised care (using minimally invasive haemodynamic monitoring) with usual care. We describe the study design and discuss unique aspects of doing research in this population. ⋯ Several unique challenges for study design and execution can be seen in our trial, and it should generate results that will inform and influence the fields of organ donation and transplantation.
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Randomized Controlled Trial Multicenter Study Comparative Study
Patient comfort in the intensive care unit: a multicentre, binational point prevalence study of analgesia, sedation and delirium management.
To measure the prevalence of assessment and management practices for analgesia, sedation and delirium in patients in Australian and New Zealand intensive care units. ⋯ Only two-thirds of sedated patients had their sedation levels formally assessed, half had pain assessed and very few had formal assessment of delirium. Our description of current practices, and other observational data, may help in planning further research in this area.
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Comparative Study
205 Comparison of the measurement properties of the AQoL and SF-6D in critical illness.
Multiattribute utility (MAU) instruments are short instruments measuring quality of life, health utility scores and treatment cost-effectiveness. Many studies have compared MAU instruments, but few have involved intensive care unit patients. Our aim was to compare the measurement properties of two MAUs, the assessment of quality of life (AQoL) and Medical Outcomes Study Short Form 6D (SF-6D), in a sample of patients with critical illness. ⋯ The AQoL and SF-6D demonstrated acceptable measurement properties in the ICU population, but the findings raised questions about the reliability and predictive power of the SF-6D. Further research is required to determine the most appropriate instrument for use in measuring health utility in the ICU population.
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The Australasian Resuscitation in Sepsis Evaluation (ARISE) study is an international, multicentre, randomised, controlled trial designed to evaluate the effectiveness of early goal-directed therapy compared with standard care for patients presenting to the emergency department with severe sepsis. ⋯ We have developed a statistical analysis plan for the ARISE study, available in the public domain, before the completion of recruitment into the study. This will minimise analytical bias and conforms to current best practice in conducting clinical trials.