Crit Care Resusc
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The objective of this study was to describe current use, clinical practice, and outcomes of continuous renal replacement therapy (CRRT) in children in the intensive care unit (ICU) in Australia and New Zealand. ⋯ CRRT is used less frequently than PD in smaller children and in those with CHD. In all other cohorts, it is the predominant mode of RRT. ICU mortality rates were higher for CRRT than for PD, with a large variation in mortality rates across age and diagnostic groups. The CRRT mortality in ICU decreased over the 5 years of the study.
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There is uncertainty about whether early infusion of intravenous amino acids confers clinical benefits in critically ill patients. In this study, we aimed to test the hypothesis that intravenous amino acids could improve 90-day mortality in critically ill patients with normal kidney function. ⋯ This study protocol was registered with the Chinese Clinical Trial Registry, and the identifier is ChiCTR2100053359 (https://www.chictr.org.cn/hvshowprojectEN.html?id=257327&v=1.7).
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Patients in the intensive care unit (ICU) frequently develop hyperactive delirium, which may be accompanied by behaviour that increases clinical risks to themselves as well as other patients and staff. There is a paucity of evidence to inform the urgent enteral administration of antipsychotic drugs to treat such hyperactive delirium and behavioural disturbances. ⋯ This trial will compare the effect of enteral olanzapine to quetiapine in critically ill adults with hyperactive delirium on an important indicator of patient outcome.
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To describe the epidemiology and clinical features of pressure injury (PI) development in adult patients supported with extracorporeal membrane oxygenation (ECMO). ⋯ A significant proportion of patients develop PIs while receiving ECMO. Vigilance on the prevention of medical device related PI is required. Gender, renal replacement therapy, oral diet, and length of mechanical ventilation were independent predictors for PI development in this population.
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The optimal timing of vasopressin initiation as an adjunctive vasopressor remains unclear. We aimed to study the association between the timing of vasopressin commencement, pre-specified physiological parameters, and hospital mortality. ⋯ In patients with septic shock, early adjunctive vasopressin initiation was independently associated with lower hospital mortality. Vasopressin starting at any time was also associated with reduced tachycardia, acidosis, and hyperlactatemia.