Crit Care Resusc
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To identify the resource usage by patients with influenza A H1N1 admitted to Australian and New Zealand intensive care units during the first wave of the pandemic in June, July and August 2009. ⋯ Low rates of admission of H1N1 patients to ICUs during the 2009 pandemic enabled the intensive care system to cope with the large demand when analysed at a jurisdictional level.
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To evaluate the effect of fluid therapy using Accusol (Baxter Healthcare, McGaw Park, Ill, USA), a crystalloid solution containing sodium bicarbonate and other electrolytes and having a strong ion difference of 35 mEq/L, on acid-base stability after cardiac surgery. ⋯ SBE was more stable in patients treated with Accusol. Further studies are needed to determine whether use of solutions such as Accusol influences important patient outcomes.
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Case Reports
Emergency use of extracorporeal membrane oxygenation for a foreign body obstructing the airway.
We report on the successful emergency use of extracorporeal membrane oxygenation to provide oxygenation and ventilation to a patient with lifethreatening airway obstruction, and then facilitating the removal of a tracheal food bolus by rigid bronchoscopy.
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To assess the frequency of after-hours discharges of patients from the intensive care unit and its effect on in-hospital mortality. ⋯ A high proportion of patients (34.7%) were discharged from the ICU after-hours. Discharge after-hours was associated with a higher risk of in-hospital mortality than discharge during work hours.
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Unplanned admission to the intensive care unit has been shown to significantly increase the risk of inhospital mortality. Medical advances and increased expectations have resulted in a greater number of very elderly patients (80 years and over) being admitted to the ICU. The risk of in-hospital death associated with unplanned admission to the ICU in very elderly patients has not been clearly defined. ⋯ Unplanned admission to the ICU increases the risk of in-hospital mortality in very elderly patients. At least 50% of the risk of in-hospital death in this age group is attributable to a combination of unplanned ICU admission, comorbidity (≥1 comorbid condition), acute renal failure and respiratory failure.