Crit Care Resusc
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Multicenter Study Comparative Study
Hyperoxia in the intensive care unit and outcome after out-of-hospital ventricular fibrillation cardiac arrest.
Laboratory and clinical studies have suggested that hyperoxia early after resuscitation from cardiac arrest may increase neurological injury and worsen outcome. Previous clinical studies have been small or have not included relevant prehospital data. We aimed to determine in a larger cohort of patients whether hyperoxia in the intensive care unit in patients admitted after out-of-hospital cardiac arrest (OHCA) was associated with increased mortality rate after correction for prehospital variables. ⋯ Hyperoxia within the first 24 hours was not associated with increased hospital mortality in patients admitted to ICU following out-of-hospital ventricular fibrillation cardiac arrest.
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Randomized Controlled Trial Multicenter Study Comparative Study
Temperature management in patients with acute neurological lesions: an Australian and New Zealand point prevalence study.
Given the scientific uncertainty of the efficacy and safety of normothermia (36.0°C to 37.5°C) on disability and death after acute neurological lesions, we sought to understand how temperature is managed in usual clinical care for this patient population in Australia and New Zealand. ⋯ Temperature readings above 37.5°C are common. Further cohort studies are required to validate these preliminary, exploratory findings.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomised controlled trial of induced hypermagnesaemia following aneurysmal subarachnoid haemorrhage.
The effect of serum magnesium concentration on the incidence of cerebral arterial vasospasm following aneurysmal subarachnoid haemorrhage (SAH) is unclear. ⋯ Patients assigned a higher serum magnesium concentration had a reduced incidence of vasospasm as seen by angiography, but the difference was not statistically significant. Clinically significant outcomes were not different between groups. A firm recommendation for induced hypermagnesaemia cannot be made from this study.
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Randomized Controlled Trial Multicenter Study Comparative Study
Safety evaluation of a trial of lipocalin-directed sodium bicarbonate infusion for renal protection in at-risk critically ill patients.
Urine alkalinisation with sodium bicarbonate decreases renal oxidative stress and might attenuate sepsisassociated acute kidney injury (s-AKI). The safety and feasibility of urine alkalinisation in patients at risk of s-AKI has never been tested. ⋯ Administration of sodium bicarbonate and sodium chloride solutions to patients at risk of s-AKI was associated with frequent major electrolyte abnormalities and early protocol cessation. The tested protocol does not appear safe or feasible.
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Randomized Controlled Trial Multicenter Study Comparative Study
The ADRENAL study protocol: adjunctive corticosteroid treatment in critically ill patients with septic shock.
There is considerable global uncertainty on the role of low-dose corticosteroids in septic shock, which translates into variations in prescribing practices. ⋯ The run-in phase has been completed and the main trial commenced in February 2013. The trial should generate results that will inform and influence prescribing of corticosteroids in septic shock.