Crit Care Resusc
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Comparative Study Clinical Trial
Evaluation of a continuous glucose monitor in an unselected general intensive care population.
To assess the accuracy of the Guardian REALTime continuous glucose monitoring system (Medtronic MiniMed, Northridge, Calif, USA) in critically ill adults compared with standard bedside point-of-care testing of capillary and arterial blood glucose levels. ⋯ The Guardian REAL-Time continuous glucose monitoring system cannot replace current methods of blood glucose measurement at a glucose threshold of +/-1mmol/L. It may have role as an early warning detection system for hypo- or hyperglycaemia, but this needs to be evaluated in a prospective study of extremes of blood glucose levels in a critically ill population. Glucose measurements in arterial and capillary blood samples with a point-of-care glucometer also showed wide discrepancies.
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Clinical Trial
Prospective observational study of levosimendan and weaning of difficult-to-wean ventilator dependent intensive care patients.
To evaluate the role of levosimendan in improving cardiac performance and the success rate of weaning from mechanical ventilation in ventilatordependent, difficult-to-wean patients with impaired cardiac function in the intensive care unit. ⋯ Levosimendan may provide significant benefit to ventilator-dependent patients with impaired left ventricular function. Randomised controlled trials appear justified.
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Clinical Trial
Implementation and outcomes of a severe sepsis protocol in an Australian tertiary hospital.
To evaluate the effect of implementation of a sepsis protocol. ⋯ Implementation of a sepsis protocol led to a change in the delivery of care with no reduction in mortality in patients with severe sepsis and septic shock admitted to a Level III ICU in a tertiary hospital.
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There is evidence that intensive glycaemic control decreases morbidity and mortality in surgical intensive care unit patients. In traumatic brain injury, hyperglycaemia is a prognostic indicator. ⋯ The intensive insulin protocol was effective in lowering blood glucose in neurosurgical ICU patients.
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Multicenter Study
Renal replacement therapy for acute kidney injury in Australian and New Zealand intensive care units: a practice survey.
There are few published data on the practice of renal replacement therapy (RRT) in Australian and New Zealand intensive care units. These data are essential for designing trials to compare new treatment approaches with "standard care". ⋯ These findings provide insight into RRT practice in ICUs in Australia and New Zealand, as well as useful data to assess whether the control group in the RENAL trial receives "standard" therapy as delivered in Australian and New Zealand trial centres at the time.