Crit Care Resusc
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Observational Study
Prevalence, goals of care and long-term outcomes of patients with life-limiting illness referred to a tertiary ICU.
To describe the prevalence, characteristics, long-term outcomes and goals-of-care discussions of patients with objective indicators of life-limiting illnesses (LLIs) referred to the intensive care unit. ⋯ A high proportion of patients referred to the ICU have an LLI, and this is associated with prolonged hospital length of stay and a high 1-year mortality, and only one-quarter have documented discussions on goals of care. Patients with cancer-related and frailty-related LLIs have the worst survival trajectories.
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Editorial Comment
The importance of establishing goals of care for hospital patients.
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Multicenter Study Observational Study
Maintenance fluid practices in intensive care units in Australia and New Zealand.
Administration of maintenance fluid is common practice in the intensive care unit, contributing to daily fluid and sodium intake and balance. Despite this, there is little evidence to describe clinical practices relating to its administration to ICU patients. ⋯ Administration of maintenance fluids to patients in Australian and New Zealand ICUs is common. Although the volume being delivered has decreased, maintenance fluids contribute over one-third of daily total fluid administration.
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Observational Study
A prospective observational study of the effect of critical illness on ultrastructural and microscopic morphology of duodenal mucosa.
Disturbed intestinal barrier function due to 'leaky' tight junctions may cause secondary sepsis via paracellular translocation across the gut wall. Our objective was to describe the effects of critical illness on duodenal morphology and ultrastructure. ⋯ We did not detect any morphological abnormalities of duodenal tight junctions in critically ill patients. Our results should be interpreted with caution because of the small sample population, but our observations challenge the concept that paracellular translocation facilitates secondary sepsis.