Crit Care Resusc
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Development and validation of a critical care outcome prediction equation (COPE) using data that are collected routinely for administrative purposes. ⋯ The COPE model is a simple, robust, riskadjusted outcome prediction tool based on five fields from data that are routinely collected for administrative purposes.
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A number of recent therapeutic advances have resulted from basic science research. With the change in medical education and practice towards evidence-based medicine, we wished to determine the role of basic science research in Australian intensive care practice. We believe this is the first survey of Australian intensivists and trainees to assess the influence of basic science research on their clinical duties. We discuss the importance and influence of basic science in intensive care practice and the development of postgraduate appreciation of basic science, highlight the impact of some of the changes in medical education on basic science undergraduate teaching, and discuss the clinical applicability and current participation in basic science research. ⋯ Critical care practitioners consider basic science research to be relevant and important to their practice. There is interest in clinically applicable basic science research, but few people regularly review basic science articles at journal clubs. Reassuringly, participation in basic science research increases throughout intensive care training, despite changes in medical education and lack of protected time for research.
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To assess current practice in acute stress ulceration (ASU) prophylaxis in adult intensive care units in Victoria, Australia, in 1997 and 2005. ⋯ Use of ASU prophylaxis for patients admitted to Victorian ICUs increased significantly from 1997 to 2005, with an associated increase in the presence of protocols or guidelines for ASU prophylaxis. Although agents currently used for ASU prophylaxis in Victorian ICUs are consistent with available evidence, we are concerned that ASU prophylaxis is given to all patients admitted to the ICU rather than targeted to patients in high-risk categories.
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The Fencl-Stewart approach to acid-base physiology allows detailed, quantitative insights into acid-base disorders. We tested the hypothesis that this type of analysis would reveal complex acid-base changes in patients after liver transplantation that differed from those in a general intensive care unit population. ⋯ The Fencl-Stewart approach allowed us to quantitatively assess the factors contributing to patients' acid-base status. We found complex acid-base changes in patients immediately after liver transplantation.
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Recommendations exist to guide the design and construction of adult intensive care units, but current guidelines are hampered by the paucity of high-quality research. Much of the current literature on ICU design has focused on patient-centred outcomes, such as nosocomial infections, aspects of psychological and physiological wellbeing, and patient satisfaction, but the design of the ICU environment also affects health care workers. ⋯ For most aspects of ICU design, more research is required before definite conclusions can be drawn. This article discusses the application of evidence-based design to improve the ICU environment and reviews some of the controversial issues and concepts.