Crit Care Resusc
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Randomized Controlled Trial Multicenter Study Comparative Study
A protocol for a multicentre randomised controlled trial of continuous beta-lactam infusion compared with intermittent beta-lactam dosing in critically ill patients with severe sepsis: the BLING II study.
Beta-lactam antibiotics are largely administered by bolus dosing, despite displaying time-dependent pharmacokinetics and pharmacodynamics and there being a strong rationale for continuous administration. The randomised controlled trials conducted to date comparing the mode of betalactam administration have been inconclusive and limited by non-equivalent dosing, unblinded administration and small sample sizes. ⋯ The study started in July 2012 and will provide clinical evidence as to whether continuous infusion of beta-lactam antibiotics is superior to intermittent bolus administration in critically ill patients with severe sepsis. A Phase III study powered for a survival end point may be justified, based on the results of our study.
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Randomized Controlled Trial Multicenter Study Comparative Study
A randomised controlled trial of plasma filtration in severe paediatric sepsis.
To determine whether plasma filtration improves 28-day survival in infants and children with severe sepsis. ⋯ Our study did not recruit enough patients to test the hypothesis that addition of plasma filtration to our standard care protocol reduces 28-day mortality in children with severe sepsis. However, mortality in the treatment and control groups was not significantly different after adjustment for severity of illness at the time of randomisation.
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Randomized Controlled Trial Multicenter Study Comparative Study
Patient comfort in the intensive care unit: a multicentre, binational point prevalence study of analgesia, sedation and delirium management.
To measure the prevalence of assessment and management practices for analgesia, sedation and delirium in patients in Australian and New Zealand intensive care units. ⋯ Only two-thirds of sedated patients had their sedation levels formally assessed, half had pain assessed and very few had formal assessment of delirium. Our description of current practices, and other observational data, may help in planning further research in this area.
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Comparative Study
205 Comparison of the measurement properties of the AQoL and SF-6D in critical illness.
Multiattribute utility (MAU) instruments are short instruments measuring quality of life, health utility scores and treatment cost-effectiveness. Many studies have compared MAU instruments, but few have involved intensive care unit patients. Our aim was to compare the measurement properties of two MAUs, the assessment of quality of life (AQoL) and Medical Outcomes Study Short Form 6D (SF-6D), in a sample of patients with critical illness. ⋯ The AQoL and SF-6D demonstrated acceptable measurement properties in the ICU population, but the findings raised questions about the reliability and predictive power of the SF-6D. Further research is required to determine the most appropriate instrument for use in measuring health utility in the ICU population.
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Multicenter Study Comparative Study
Development and validation of the critical care outcome prediction equation, version 4.
To revise and validate the accuracy of the critical care outcome prediction equation (COPE) model, version 4. ⋯ COPE-4 model prediction of hospital mortality for ICU admissions has satisfactory performance for use as a risk-adjustment tool in Victoria. Model refinement may further improve its performance.