Crit Care Resusc
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Case Reports
Paradoxical and severe hypotension in response to adrenaline infusions in massive quetiapine overdose.
Atypical antipsychotics (quetiapine, olanzapine, risperidone and clozapine) are increasingly prescribed in Australia, and emergency departments report growing rates of overdose of these agents. As these drugs are comparatively new, the spectrum of toxicity may be unfamiliar to critical care physicians. Severe hypotension is a recognised consequence of quetiapine poisoning. ⋯ The pharmacodynamics of quetiapine and the literature on overdose are reviewed. We present these cases to broaden the knowledge of physicians treating quetiapine overdose and to publicise the potential deleterious interaction with adrenaline. We recommend use of noradrenaline in preference to adrenaline in pharmacological management of shock in these patients.
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Editorial Comment
Why predict time to death after withdrawal of life-sustaining therapy?
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Multicenter Study
Renal replacement therapy for acute kidney injury in Australian and New Zealand intensive care units: a practice survey.
There are few published data on the practice of renal replacement therapy (RRT) in Australian and New Zealand intensive care units. These data are essential for designing trials to compare new treatment approaches with "standard care". ⋯ These findings provide insight into RRT practice in ICUs in Australia and New Zealand, as well as useful data to assess whether the control group in the RENAL trial receives "standard" therapy as delivered in Australian and New Zealand trial centres at the time.