Crit Care Resusc
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Multicenter Study Observational Study
Nutrition therapy in adult patients receiving extracorporeal membrane oxygenation: a prospective, multicentre, observational study.
To describe current nutrition delivery practices and to identify barriers to nutrition in patients receiving venovenous or venoarterial extracorporeal membrane oxygenation (ECMO) in multiple centres in Australia and New Zealand. ⋯ EN was the most commonly used nutrition-delivery mode during ECMO treatment but was frequently interrupted. Compared with estimated calorie and protein requirements, lesser but reasonably acceptable amounts were delivered, although calorie and protein deficits still existed.
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Elevation of body temperature is common after traumatic brain injury (TBI). Suppressing fever may be beneficial. ⋯ In patients with TBI, a substantial proportion of time is spent with a temperature _37°C. Prospective validation of these data are required.
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Multicenter Study Observational Study
Sodium balance, not fluid balance, is associated with respiratory dysfunction in mechanically ventilated patients: a prospective, multicentre study.
Large positive sodium balances, independent of fluid balance, may lead to expanded extracellular fluid volumes and adverse clinical outcomes in the critically ill, including impaired oxygenation. ⋯ The cumulative positive sodium balance, not the cumulative positive fluid balance, is associated with respiratory dysfunction and an increased length of MV.
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Multicenter Study Observational Study
Efforts to Attenuate the Spread of Infection (EASI): a prospective, observational multicentre survey of ultrasound equipment in Australian emergency departments and intensive care units.
Ultrasound is a common and necessary part of acute care medicine, but may present an infection risk to patients secondary to transfer of infectious agents between patients. Our primary objective was to detect blood contamination on ultrasound equipment in emergency departments (EDs) and intensive care units. Secondary objectives included detection of microbial contamination and determination of factors associated with contamination. ⋯ Our results show significant contamination of ultrasound equipment, and that visual inspection of equipment is neither sufficient nor reliable in excluding contamination. Ultrasound equipment is a possible factor in the transmission of infectious diseases in EDs and ICUs. Guidelines must be formulated, disseminated and rapidly adopted to ensure the safety of the most acutely ill patients exposed to ultrasound procedures in acute care settings.
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Multicenter Study Observational Study
Intravenous fluid use after cardiac surgery: a multicentre, prospective, observational study.
The optimal strategy for fluid replacement after major surgery remains unclear and there is considerable interest in the investigation of more restrictive fluid regimens. ⋯ We showed that fluid boluses are responsible for a large proportion of the positive fluid balance seen in patients after cardiac surgery. These data justify further study to evaluate whether modification of fluid bolus administration can improve patient outcomes.