Crit Care Resusc
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A reported association between extubation failure (EF) and increased hospital length of stay and mortality led us to assess outcome of EF in an Australian intensive care unit. ⋯ Our findings confirm an increased risk of adverse outcomes for patients with EF. We observed a comparatively low EF rate. Confirmation in similar patient cohorts is required.
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Comparative Study
Enteral nutrition versus glucose-based or lipid-based parenteral nutrition and tight glycaemic control in critically ill patients.
Early administration of nutrition and attention to tight glycaemic control are both associated with improved outcomes in critically ill patients. We hypothesized that blood glucose control would be better achieved in patients receiving enteral rather than parenteral nutrition and, in the latter group, would be better achieved using a "balanced" glucose plus lipid solution than a dextrose-based solution as calorie source. ⋯ When used in association with a tight glycaemic control regimen, PN is not associated with poorer glycaemic control in critically ill patients than EN.
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Out-of-hospital cardiac arrest (OHCA) is a significant cause of death, but there is little published information on its incidence and outcomes in Australia. ⋯ Survival from OHCA in Sydney is low, and lower in patients aged 80 years or older. The incidence of OHCA in Sydney is similar to that in the rest of the world. Mortality occurs early after OHCA. Hence, for interventions to be effective in improving survival, they need to be targeted at the early stages of OHCA.
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To generate baseline data describing Australasian intra-aortic balloon counterpulsation (IABP) weaning practice. ⋯ The Australasian approach to IABP weaning is eclectic. While ratio reduction weaning appears the most successful manner of support withdrawal, it may be a consequence of a volume-outcome relationship, with high- end users achieving better results through IABP familiarity.