Crit Care Resusc
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Case Reports
Normothermic extracorporeal human liver perfusion following donation after cardiac death.
Liver transplantation is a major life-saving procedure and donation after cardiac death (DCD) has increased the pool of potential liver donors. However, livers procured after DCD are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers. ⋯ We achieved NELP with evidence of liver function (bile production, paracetamol removal and control of ammonia, bilirubin and lactate levels) for 3 hours. There was essentially normal liver and biliary tract histology after 8 hours of perfusion. Our experiment justifies further investigation of the feasibility and efficacy of human DCD liver preservation by NELP.
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Randomized Controlled Trial Multicenter Study Comparative Study
Temperature management in patients with acute neurological lesions: an Australian and New Zealand point prevalence study.
Given the scientific uncertainty of the efficacy and safety of normothermia (36.0°C to 37.5°C) on disability and death after acute neurological lesions, we sought to understand how temperature is managed in usual clinical care for this patient population in Australia and New Zealand. ⋯ Temperature readings above 37.5°C are common. Further cohort studies are required to validate these preliminary, exploratory findings.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomised controlled trial of induced hypermagnesaemia following aneurysmal subarachnoid haemorrhage.
The effect of serum magnesium concentration on the incidence of cerebral arterial vasospasm following aneurysmal subarachnoid haemorrhage (SAH) is unclear. ⋯ Patients assigned a higher serum magnesium concentration had a reduced incidence of vasospasm as seen by angiography, but the difference was not statistically significant. Clinically significant outcomes were not different between groups. A firm recommendation for induced hypermagnesaemia cannot be made from this study.