Crit Care Resusc
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Despite the growing number of older patients having major surgery, the normal resting values for the cardiac index of older patients remain unclear. We aim to derive a normative value for such patients. ⋯ The normal range of the cardiac index in older patients may be lower than previously reported. Its rate of decline with age is uncertain, but likely between 3.5 and 8 mL/min/m2 per year. Data on the normal cardiac index in people older than 80 years are scant.
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Comparative Study
Modifications to predefined rapid response team calling criteria: prevalence, characteristics and associated outcomes.
Standardised rapid response team (RRT) calling criteria may not be applicable to all patients, and thus, modifications of these criteria may be reasonable to prevent unnecessary calls. Little data are available regarding the efficacy or safety of modifying RRT calling criteria; therefore, this study aimed to detail the prevalence and characteristics of modifications to RRT call triggers and explore their relationship with patient outcomes. ⋯ Modifications to standard calling criteria were frequently made, but did not seem to prevent further RRT calls and were associated with increased mortality. These findings suggest that modifications should be made with caution.
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Observational Study
"Likely overassistance" during invasive pressure support ventilation in patients in the intensive care unit: a multicentre prospective observational study.
To evaluate the prevalence of "likely overassistance" (categorised by respiratory rate [RR] ≤ 17 breaths/min or rapid shallow breathing index [RSBI] ≤ 37 breaths/min/L) during invasive pressure support ventilation (PSV), and the additional prevalence of fixed ventilator settings. ⋯ In a cohort of Victorian hospitals in Australia, during invasive PSV, "likely overassistance" was common, and the pressure support level was delivered in a standardised and unadjusted manner at 10 cmH2O, resulting in the frequent delivery of potentially injurious VT.
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Prognostication in patients with post-hypoxic brain injury remains difficult; yet, clinicians are commonly asked to guide decisions regarding withdrawal of life support. We aimed to assess whether electroencephalogram (EEG) is a useful tool in predicting neurological outcome in patients with post-hypoxic myoclonus (PHM). ⋯ This study shows that PHM is associated with a poor but not universally fatal prognosis. Early EEG does not reliably distinguish between good and poor outcomes.
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The purpose of this study was to evaluate if vitamin D deficiency is associated with increased rates of persistent critical illness, and whether repletion of vitamin D among patients with this deficiency leads to decreased persistent critical illness. ⋯ Vitamin D deficiency was not associated with persistent critical illness, nor did supplementation with vitamin D3 mitigate the development of persistent critical illness.