Crit Care Resusc
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To determine the feasibility of a pivotal randomised clinical trial of intravenous (IV) iron and erythropoietin in adult survivors of critical illness with anaemia requiring treatment in the intensive care unit. ⋯ The iron and erythropoietin to heal and recover after intensive care (ITHRIVE) pilot demonstrated feasibility based on predefined participant recruitment, study drug administration, and follow-up thresholds.
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The impact of obesity on long-term survival after intensive care unit (ICU) admission with severe coronavirus disease 2019 (COVID-19) is unclear. We aimed to quantify the impact of obesity on time to death up to two years in patients admitted to Australian and New Zealand ICUs. ⋯ The obesity paradox appears to exist beyond hospital discharge in critically ill patients with COVID-19 admitted in Australian and New Zealand ICUs. A BMI ≥40 kg/m2 was associated with a higher survival time of up to two years.
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Intensive care (ICU) beds are scarce and decision-making regarding admission is complex and multi-factorial. This study aimed to characterise differences in admission decision making between Australia and New Zealand and compare to previous data to establish changes over time. ⋯ Our study suggests that New Zealand intensivists may apply more restrictive ICU admission criteria than Australian intensivists. Changes in attitudes to admission since 2009 may reflect increased awareness of the importance of facilitating organ donation and the role of ICU as providers of palliative care.
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To introduce a management guideline for sepsis-related MET calls to increase lactate and blood culture acquisition, as well as prescription of appropriate antibiotics. ⋯ Introducing a sepsis management guideline and enhanced linkage with an AMS program increased blood culture acquisition and decreased broad spectrum antimicrobial use but didn't change in-hospital mortality.
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It is unknown whether increasing dietary protein to 1.2-2.0 g/kg/day as recommended in international guidelines compared to current practice improves outcomes in intensive care unit (ICU) patients. The TARGET Protein trial will evaluate this. ⋯ TARGET Protein aims to determine whether augmented enteral protein delivery reduces days free of the index hospital and alive at day 90.