Crit Care Resusc
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Extended daily diafiltration (EDDf) is a prolonged intermittent dialysis technique introduced as an alternative to continuous renal replacement therapy in critically ill patients. Although EDDf has the advantages of ease of use, low cost and patient tolerability, there is concern that the high blood and dialysate flow rates used with EDDf may precipitate haemodynamic instability. ⋯ EDDf did not significantly worsen haemodynamic stability in patients with sepsis during their treatment.
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Infusion of propofol often causes significant vasodilation, which is followed by a profound drop in blood pressure. However, the exact underlying molecular mechanisms of this clinically important phenomenon remain unclear. ⋯ Development of hypotension after systemic administration of propofol is mainly caused by its direct relaxation effect on vascular smooth muscle. This response is mainly mediated by activation of K(ATP) channels.
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Acute Physiology and Chronic Health Evaluation (APACHE) III scores have been shown to correlate with outcomes for patients with burn injuries. It is unknown whether they can be used to compare outcomes between intensive care units that admit patients with burns in Australia and New Zealand. ⋯ The APACHE III-j score is a good predictor of death among burns patients admitted to ICUs in Australia and New Zealand. It can be used to compare risk-adjusted outcomes between individual ICUs and over time.
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Limited information exists on the factors affecting bowel motions and the physical characteristics of stools in mechanically ventilated patients in the intensive care environment. We hypothesised that most stools in critically ill patients are not formed and that both diarrhoea and non-defecation are common. ⋯ Among patients receiving mechanical ventilation for more than 24 hours, lack of bowel motions (non-defecation) was the most common physiological state. However, diarrhoea was also relatively common, and formed stools were rare.
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To evaluate antibiotic prescribing practices in empirical and directed treatment of severe sepsis and septic shock in Australian and New Zealand intensive care units. ⋯ Antibiotic prescribing was largely appropriate, but consideration of site-specific resistance profiles and avoidance of low dosing is advocated to provide appropriate upfront cover, prevent underdosing and reduce the risk of developing resistant organisms.