Crit Care Resusc
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Randomized Controlled Trial
Sodium bicarbonate therapy for metabolic acidosis in critically ill patients: a survey of Australian and New Zealand intensive care clinicians.
To help shape the design of a future double blind placebo-controlled randomised clinical trial of bicarbonate therapy for metabolic acidosis, based on opinions of intensive care clinicians in Australia and New Zealand. ⋯ This survey offers important insights into the preferences of Australian and New Zealand clinicians in regards to any future randomised controlled trial of bicarbonate therapy for metabolic acidosis in the critically ill.
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Randomized Controlled Trial
Cytokine and lipid metabolome effects of low-dose acetylsalicylic acid in critically ill patients with systemic inflammation: a pilot, feasibility, multicentre, randomised, placebo-controlled trial.
The systemic inflammatory response syndrome (SIRS) is a dysregulated response that contributes to critical illness. Adjunctive acetylsalicylic acid (ASA) treatment may offer beneficial effects by increasing the synthesis of specialised proresolving mediators (a subset of polyunsaturated fatty acid-derived lipid mediators). ⋯ In ICU patients with SIRS, low-dose ASA did not significantly alter serum IL-6 concentrations, but it did affect plasma concentrations of certain lipid mediators. The ability to measure lipid mediators in clinical samples and to monitor the effect of ASA on their levels unlocks a potential area of biological investigation in critical care.
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To describe the characteristics and outcomes of adults with a subarachnoid haemorrhage (SAH) admitted to Australian and New Zealand intensive care units (ICUs) with a cardiac arrest in the preceding 24 hours. ⋯ Almost one in five SAH patients who had a documented cardiac arrest in the 24 hours preceding ICU admission to an Australian and New Zealand ICU survived to hospital discharge, with around a quarter of these survivors discharged home. The neurological outcomes of these patients are uncertain, and understanding the burden of disability in survivors is an important area for further research.
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To quantify aerosol generation from respiratory interventions and the effectiveness of their removal by a personal ventilation hood. ⋯ In this human volunteer study, the administration of O2 15 L/min by face mask and 60 L/min nasal therapy did not increase aerosol generation beyond low levels. Non-invasive ventilation caused moderate aerosol generation and nebulisation therapy very high aerosol generation. The personal ventilation hood reduced the aerosol counts by at least 98%.