Crit Care Resusc
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Magnesium therapy may reduce the risk of atrial fibrillation after cardiac surgery. However, studies are heterogeneous in relation to dosage and method of delivery and no studies have directly compared the biochemical effect of different delivery strategies. ⋯ The strategy of a 10 mmol magnesium bolus followed by a continuous infusion over 12 hours achieved a more sustained and moderately elevated magnesium concentration in comparison to a single 20 mmol bolus, despite increased urinary losses of magnesium. Further studies are required to assess a more extended continuous infusion.
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Pressure injuries are a significant problem for critically ill patients; they increase morbidity, cost, and duration of hospitalisation. Prolonged immobility is a major risk factor, but evidence guiding how frequently patients should be turned to prevent this complication is limited. We aimed to determine the impact of changing from 5-hourly to 3-hourly turns on pressure injury incidence in critically ill patients. ⋯ A change in turn frequency from 5-hourly to 3-hourly was associated with a halved incidence of pressure injuries. Critically ill patients may benefit from more frequent turns.
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There has recently been a surge of interest in intravenous (IV) vitamin C as a potential therapy in intensive care unit (ICU) patients, particularly in those with septic shock. Establishing the safety and efficacy of IV vitamin C therapy through rigorously conducted randomised controlled trials is a priority. A key logistical issue for such trials is to establish the stability of IV vitamin C solutions prepared for infusion ahead of time. Accordingly, we aimed to assess the stability of IV vitamin C solutions over time using doses of vitamin C from previous pilot trials. ⋯ Our findings suggest that vitamin C solutions of 1.5 g per 50 mL of 0.9% saline and 2.5 g per 50 mL of D5W remain stable for up to 96 hours and do not need to be protected from light.
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Health care-associated infections are a major cause of morbidity and mortality in intensive care patients. The effect of daily washing with chlorhexidine on these infections is controversial. ⋯ In this real-world, long term ICU study, implementation of a unit-level policy of daily washing with chlorhexidine impregnated cloths was not associated with a reduction in the rates of ICU-associated clinically significant positive blood cultures, blood culture contamination, newly acquired MDRO isolates, and CDIs.
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Body temperature measurement methods and targets in Australian and New Zealand intensive care units.
In Australian and New Zealand (ANZ) intensive care units (ICUs), the preferred measurement methods and targets for temperature remain uncertain, but are crucial for future interventional studies. We aimed to investigate the reported use of temperature measurement methods and targets in ANZ ICUs. ⋯ In ANZ ICUs, preferred temperature measurement methods and targets are typically not governed by protocol, vary greatly and differ between doctors and nurses. Targeted temperature management after cardiac arrest is not fully established. Future studies of the comparative accuracy of non-invasive temperature measurements methods and practice in patients with cardiac arrest appear important.