Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Multicenter Study
Donation after circulatory determination of death in western Canada: a multicentre study of donor characteristics and critical care practices.
Donation after circulatory determination of death (DCD) has been performed in Canada since 2006. Numerous aspects of donor management remain controversial. ⋯ There is significant variability in critical care DCD practices in western Canada, but this has not resulted in significant differences in recipient or graft survival. Further research is required to guide optimal management of potential DCD donors.
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Multicenter Study Observational Study
Using bioimpedance analysis to assess intensive care unit patients with sepsis in the post-resuscitation period: a prospective multicentre observational study.
Clinicians lack well-validated, non-invasive, objective tools to guide volume management in the post-resuscitative period. Bioimpedance analysis (BIA) represents a novel method for guiding fluid management. We studied the relationship of BIA vector length (VL), an indicator of volume status, to the need for mechanical ventilation in patients with sepsis. ⋯ An increase in VL over time is associated with a decrease in probability of requiring invasive mechanical ventilation. Vector length correlates with other commonly used volume assessment methods in post-resuscitation patients with sepsis.
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Multicenter Study
Outcomes of hematopoietic cell transplant recipients requiring invasive mechanical ventilation: a two-centre retrospective cohort study.
Outcomes of critically ill, hematopoietic cell transplant patients who require prolonged mechanical ventilation are not well studied. We describe the baseline characteristics, critical care management, and outcomes of this population and explore potential predictors of mortality. ⋯ Our study shows high rates of mortality among hematopoietic cell transplant recipients that require invasive mechanical ventilation, particularly in those post-allogeneic transplant and in those who require prolonged ventilation for more than 21 days.
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Multicenter Study
Simulation-based assessment in anesthesia: an international multicentre validation study.
Simulated clinical events provide a means to evaluate a practitioner's performance in a standardized manner for all candidates that are tested. We sought to provide evidence for the validity of simulation-based assessment tools in simulated pediatric anesthesia emergencies. ⋯ This study supports the validity of our simulation-based anesthesiologist assessment tools in several domains of validity. We also describe some residual challenges regarding the validity of our tools, some notes of caution in terms of the intended consequences of their use, and identify opportunities for further research.
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Multicenter Study
Implementation of population-level screening for frailty among patients admitted to adult intensive care in Alberta, Canada.
A substantial proportion of patients admitted to intensive care units (ICUs) are frail; however, the epidemiology of frailty has not been explored at a population-level. Following implementation of a validated frailty measure into a provincial ICU clinical information system, we describe the population-based prevalence and outcomes of frailty in patients admitted to ICUs. ⋯ A validated measure of frailty can be implemented at the population level in ICU. Frailty is common in ICU patients and has implications for health service use and clinical outcomes.