Crit Care Resusc
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Extracorporeal membrane oxygenation (ECMO) is a promising adjunct to cardiopulmonary resuscitation (CPR) in refractory cardiac arrest (CA). Factors associated with outcome are incompletely characterised. The aim of our study was to identify pre-ECMO factors associated with in-hospital mortality after extracorporeal CPR (ECPR). ⋯ Following ECPR, the factors most strongly associated with mortality were ongoing CPR at the time of ECMO initiation and arrest to ECMO cannulation time. Interventions aimed at reducing time to ECMO initiation may lead to improved outcomes.
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There has recently been a surge of interest in intravenous (IV) vitamin C as a potential therapy in intensive care unit (ICU) patients, particularly in those with septic shock. Establishing the safety and efficacy of IV vitamin C therapy through rigorously conducted randomised controlled trials is a priority. A key logistical issue for such trials is to establish the stability of IV vitamin C solutions prepared for infusion ahead of time. Accordingly, we aimed to assess the stability of IV vitamin C solutions over time using doses of vitamin C from previous pilot trials. ⋯ Our findings suggest that vitamin C solutions of 1.5 g per 50 mL of 0.9% saline and 2.5 g per 50 mL of D5W remain stable for up to 96 hours and do not need to be protected from light.
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Health care-associated infections are a major cause of morbidity and mortality in intensive care patients. The effect of daily washing with chlorhexidine on these infections is controversial. ⋯ In this real-world, long term ICU study, implementation of a unit-level policy of daily washing with chlorhexidine impregnated cloths was not associated with a reduction in the rates of ICU-associated clinically significant positive blood cultures, blood culture contamination, newly acquired MDRO isolates, and CDIs.
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Body temperature measurement methods and targets in Australian and New Zealand intensive care units.
In Australian and New Zealand (ANZ) intensive care units (ICUs), the preferred measurement methods and targets for temperature remain uncertain, but are crucial for future interventional studies. We aimed to investigate the reported use of temperature measurement methods and targets in ANZ ICUs. ⋯ In ANZ ICUs, preferred temperature measurement methods and targets are typically not governed by protocol, vary greatly and differ between doctors and nurses. Targeted temperature management after cardiac arrest is not fully established. Future studies of the comparative accuracy of non-invasive temperature measurements methods and practice in patients with cardiac arrest appear important.