Crit Care Resusc
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Randomized Controlled Trial
Statistical analysis plan for the HEAT trial: a multicentre randomised placebo-controlled trial of intravenous paracetamol in intensive care unit patients with fever and infection.
We describe the statistical analysis plan (SAP) for the Permissive Hyperthermia through Avoidance of Paracetamol in Known or Suspected Infection in the Intensive Care Unit (HEAT) trial, a 700-patient, prospective, randomised, Phase 2b, multicentre, double-blind, parallel-groups, placebo-controlled trial of paracetamol administration for the treatment of fever in critically ill patients with known or suspected infection. ⋯ We developed an SAP for the HEAT trial, and produced a mock Consolidated Standards of Reporting Trials diagram and tables. Our prespecified SAP accords with high-quality standards of internal validity and should minimise future analysis bias.
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Multicenter Study Observational Study
Oxygen therapy in non-intubated adult intensive care patients: a point prevalence study.
Oxygen is commonly administered to intensive care unit patients. Although there is knowledge of how oxygen is administered to mechanically ventilated patients, there are few data about its use in non-intubated ICU patients. ⋯ Oxygen therapy is commonly administered to non-intubated adult patients in New Zealand and Australian ICUs. Most patients received oxygen by simple nasal cannulae, and oxygen therapy prescriptions were often absent or incomplete. We advise continuing education to ensure that oxygen is prescribed, administered and documented correctly.
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Multicenter Study
Sodium administration in critically ill patients in Australia and New Zealand: a multicentre point prevalence study.
Inadvertent sodium administration in excess of recommended daily requirements has been reported during routine care of critically ill patients. ⋯ This point prevalence study suggests that sodium administration in excess of recommended daily requirements may be common in Australia and New Zealand ICUs. The main sodium source was IV maintenance fluids, followed by fluid boluses and drug boluses.
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Near-infrared spectroscopy of the thenar eminence (NIRSth) can be used at the bedside to assess tissue oxygenation (StO2), the reperfusion response to ischaemia and the tissue haemoglobin index (THI). Its ability to estimate forearm blood flow (FBF) has not previously been assessed. ⋯ NIRSth can be used to estimate FBF. Given its portability and its ability to also measure StO2 and vascular reactivity, NIRSth can assist in providing a comprehensive bedside assessment of the forearm circulation in critically ill patients.
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To develop a comprehensive set of items describing physiotherapy mobilisation practices for critically ill patients, and to document current practices in intensive care units in Australia and New Zealand, focusing on patients having > 48 hours of mechanical ventilation. ⋯ Patient mobilisation was shown to be low in a single-day point prevalence study. Future observational studies are required to confirm the results.