Crit Care Resusc
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To estimate the impact of adopting the proposed new diagnostic criteria for sepsis, based on Sequential Organ Failure Assessment (SOFA) criteria, on the diagnosis and apparent mortality of sepsis in Australian and New Zealand intensive care units. ⋯ Adopting the SOFA criteria will increase the apparent incidence of sepsis in patients admitted to the ICU with infective conditions without affecting the mortality rate. Prospective evaluation of the effect of adopting the new definition of sepsis is required.
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Pleural effusion adversely affects the pressuregenerating capacity of the diaphragm. It uncouples the lung and chest wall, which may result in diaphragmatic dysfunction. Information on the effects of effusion drainage on diaphragmatic function is limited, but several studies report relief of dyspnoea after drainage, which was attributed to improved diaphragmatic mechanics, even if this issue was never formally addressed. ⋯ Drainage of a unilateral pleural effusion during weaning from mechanical ventilation improves diaphragmatic contractile activity and respiratory system performance.
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The epidemiology of patients admitted to the intensive care unit after a drug overdose (OD) is poorly defined. We aimed to study the incidence, characteristics and outcomes of patients admitted to the ICU because of OD in Australia and New Zealand. ⋯ Drug OD accounts for an increasing proportion of ICU admissions in Australia and New Zealand. Its population incidence is increasing overall, particularly in Indigenous Australians.
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Observational Study
Longitudinal changes in anthropometrics and impact on self-reported physical function after traumatic brain injury.
Patients admitted to the ICU with a traumatic brain injury (TBI) are at risk of muscle wasting but this has not been quantified. Our aims were to describe longitudinal changes in anthropometrical data, compare the accuracy of non-invasive methodologies to the validated dual-energy x-ray absorptiometry (DXA), and assess the relationships between anthropometrical data and self-reported physical function. ⋯ Patients with a TBI lose muscle thickness while in the ICU but the trajectory of loss stabilises after ICU discharge. Ultrasound-derived QMLT is related to total lean mass and physical function after discharge. Further studies are needed to confirm that ultrasound measurement of QMLT is a useful surrogate measure of muscle mass and functional outcomes after trauma and critical illness.
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To describe the characteristics, pattern of injury and outcome of children admitted to a paediatric intensive care unit (PICU) following an inflicted injury. ⋯ The majority of children admitted to intensive care following an inflicted injury are aged under 12 months. Children most commonly require intensive care for management of a head injury. Many children have radiological findings suggestive of pre-existing inflicted injury. Despite high mortality, the majority of children survive. While most are likely to be independent, many children will have residual disabilities.