Crit Care Resusc
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Pleural effusions in the intensive care unit (ICU) are clinically important. However, there is limited information regarding effusions in such patients. We aimed to estimate the prevalence, patient characteristics, mortality, effusion duration, radiological resolution, drainage, and reaccumulation rates of pleural effusions in ICU patients. ⋯ Pleural effusions are common in ICU patients and drainage is infrequent. One-third of effusions reaccumulate, even after drainage, and one in six patients with an effusion die in hospital. This information helps clinicians estimate resolution rates, advantages and disadvantages of effusion drainage, and overall prognosis.
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Patients with prolonged cardiac arrest that is not responsive to conventional cardiopulmonary resuscitation have poor outcomes. The use of extracorporeal membrane oxygenation (ECMO) in refractory cardiac arrest has shown promising results in carefully selected cases. We sought to validate the results from an earlier extracorporeal cardiopulmonary resuscitation (ECPR) study (the CHEER trial). ⋯ ECMO for refractory cardiac arrest shows promising survival rates if protocolised care is applied in conjunction with predefined selection criteria.
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Observational Study
Epidemiology and outcomes of obese critically ill patients in Australia and New Zealand.
The apparent survival benefit of being overweight or obese in critically ill patients (the obesity paradox) remains controversial. Our aim is to report on the epidemiology and outcomes of obesity within a large heterogenous critically ill adult population. ⋯ We describe the epidemiology of obesity within a critically ill Australian and New Zealand population and confirm that some level of obesity is associated with lower mortality, both overall and across a range of diagnostic categories and important subgroups. Further research should focus on potential confounders such as nutritional status and the appropriateness of BMI in isolation as an anthropometric measure in critically ill patients.
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To determine patient and perioperative characteristics associated with unexpected postoperative clinical deterioration as determined for the need of a postoperative emergency response team (ERT) activation. ⋯ We identified several patient and procedural characteristics associated with increased likelihood of postoperative ERT activation. ERT intervention is a marker for increased rates of postoperative complications and death.