Crit Care Resusc
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Observational Study
Pharmacodynamics of intravenous frusemide bolus in critically ill patients.
To assess the physiological, biochemical and haemodynamic response to a single intravenous (IV) dose of frusemide in critically patients. ⋯ In a cohort of critically ill patients without chronic renal impairment, frusemide increased UO and urinary sodium, potassium and chloride losses, and induced hypochloraemia and metabolic alkalosis. However, its diuretic effects were extremely variable and were modified by age, MAP and creatinine and albumin levels.
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Review Meta Analysis Comparative Study
Protein delivery and clinical outcomes in the critically ill: a systematic review and meta-analysis.
Protein is a fundamental component of critical care nutrition, but there has been uncertainty about the optimal amount. We undertook this systematic review and meta-analysis to examine the relationship between delivered protein and mortality in randomised controlled trials (RCTs) of nutritional interventions involving critically ill adults. Secondary outcomes included the effect of protein dose on lengths of stay, mechanical ventilation and incidence of infections. ⋯ Delivery of varying amounts of nutritional protein was not associated with any effect on mortality.
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Randomized Controlled Trial Multicenter Study Comparative Study
Study protocol for the Balanced Solution versus Saline in Intensive Care Study (BaSICS): a factorial randomised trial.
The effectiveness and safety of balanced crystalloid fluids compared with saline (0.9% sodium chloride) as a fluid of choice in critically ill patients remain unclear. The effects of different fluid infusion rates on outcomes are also unknown. ⋯ The BaSICS trial will provide robust evidence on whether a balanced crystalloid, compared with saline, improves important patient outcomes in critically ill patients. BaSICS will also provide relevant information on whether bolus infusion rate affects outcomes in this population.
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Randomized Controlled Trial Multicenter Study Comparative Study
Critical care management of aneurysmal subarachnoid haemorrhage in Australia and New Zealand: what are we doing, and where to from here?
Patients with an aneurysmal subarachnoid haemorrhage (SAH) frequently require admission to the intensive care unit. There, a variety of therapeutic strategies are initiated, in addition to definitive procedures aimed at securing the aneurysm. Despite a substantial investment in caring for these patients, outcomes for this group remain poor. ⋯ Delayed cerebral ischaemia is a significant cause of longterm morbidity and mortality after SAH. There are limited data supporting much of the critical care provided to patients with SAH in the ICU, leading to substantial institutional and practitioner variation in treatment. Whether this influences patient outcomes is unknown, although it represents a major knowledge gap in neurocritical practice in Australia and New Zealand.