Crit Care Resusc
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Out-of-hospital cardiac arrest is common and patients who are initially resuscitated by ambulance officers and transported to hospital are usually admitted to the intensive care unit (ICU). In the past, the treatment in the ICU consisted of supportive care only, and most patients remained unconscious due to the severe anoxic neurological injury. It was this neurological injury rather than cardiac complications that caused the high rate of morbidity and mortality. ⋯ The benefit of hypothermia in non-ventricular fibrillation cardiac arrest remains uncertain. Also, the best timing of induction and the duration of hypothermia after cardiac arrest are uncertain. Clinical trials are currently underway to assess these issues.
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To determine ICU registrars' level of awareness regarding measurement of intra-abdominal pressure (IAP), features of intra-abdominal hypertension (IAH), and management of abdominal compartment syndrome (ACS). ⋯ ICU registrars in Australasia appreciate the techniques for, and significance of, IAP measurements and recognise and treat ACS appropriately. Retroperitoneal causes of IAH and the threshold for treatment for ACS were not well understood by the respondents.
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To investigate the incidence, implicating factors and outcome of acute renal failure after cardiopulmonary bypass in patients admitted to a paediatric intensive care unit. ⋯ Acute renal injury is common and occurred in 11% of our children following congenital cardiac surgery, but acute renal failure requiring dialysis is uncommon.
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Conduct of research involving humans in the intensive care unit (ICU) setting is complex and challenging. The vulnerable nature of critically ill patients raises issues of patient safety, and informed consent is difficult. With an increasing global interest in human research ethics, broadened government mandates have targeted improvements in research participant protection and research governance. ⋯ We have developed An Ethics Handbook for Researchers (EH) for the ANZICS CTG for intended use by researchers in Australian and New Zealand ICUs. The purpose of the EH is to act as a practical advisory guide/supplement; to add clarification regarding ethical issues specific to intensive care research, to assist in the expedition of ethics committee research submission and to summarise available useful resources. This article introduces a précis of key issues from the EH including specific ethical difficulties pertaining to ICU research, a summary of the process by which ethics committee decisions in Australia and New Zealand are informed, and the use of ethical checklists to assist researchers.