Articles: cations.
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The application of a surgical face mask over oxygen delivery devices is now a widespread recommendation in the setting of the Coronavirus disease pandemic. This addition is designed to reduce droplet spread, but this also changes the nature of these devices, and may alter the amount of oxygen delivered to a patient. This research investigated how placing a surgical face mask over both a simple plastic mask ("Hudson mask") and nasal cannula altered the concentration of available oxygen measured at the nares. ⋯ The addition of a surgical face mask over both nasal cannula and a Hudson mask resulted in an increased available oxygen concentration. This may be valuable where more advanced oxygen devices are not available, or alternatively providing adequate supplemental oxygen at lower flow rates and thus making critical savings in oxygen usage.
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Introduction: Membrane-based therapeutic plasma exchange (mTPE) has been used to treat various diseases in the intensive care unit (ICU) setting. However, there is a lack of clinical data regarding the practice of mTPE from Australian ICUs. Objectives: To determine factors contributing to complications in patients undergoing mTPE in the ICU. ⋯ During mTPE treatment, 87.2% of patients did not experience any complications. On logistical regression analysis, replacement fluid type (P = 0.03), lower initial blood flow (OR, 0.9; 95% CI, 0.9-1.0; P = 0.04) and higher exchange volume (OR, 8.9; 95% CI, 1.6-48.7; P = 0.01) were predictors of patient complications. Conclusion: During mTPE, pre-treatment ionised calcium level, male sex, duration of mTPE and diagnostic categories were predictors of circuit complications, while replacement fluid type, initial blood flow and higher exchange volume were predictors of patient complications.
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Objective: To compare the characteristics, treatments and 6-month functional outcomes of patients with coronavirus disease 2019 (COVID-19) versus non-COVID-19 viral pneumonitis supported by venovenous extracorporeal membrane oxygenation (VV-ECMO). Design: Prospective, observational cohort study in seven intensive care units (ICUs) across Australia. Participants: Patients admitted to participating ICUs with laboratory-confirmed COVID-19 or viral pneumonitis requiring VV-ECMO. ⋯ Overall disability, health-related quality of life, and mortality were similar, but ICU and hospital length of stay were significantly longer in patients with COVID-19. Conclusions: Six-month functional outcomes and mortality were similar between COVID-19 and viral pneumonitis patients treated with VV-ECMO. However, length of stay was longer in COVID-19 patients, which may have resource implications.
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Randomized Controlled Trial
Novel Way to Improve Satisfaction, Comprehension, and Anxiety in Caregivers: A Randomized Trial Exploring the Use of Comprehensive, Illustrated Children's Books for Pediatric Surgical Populations.
Surgery generates anxiety and stress, which can negatively impact informed consent and postoperative outcomes. This study assessed whether educational, illustrated children's books improve comprehension, satisfaction, and anxiety of caregivers in pediatric surgical populations. ⋯ The use of illustrated educational children's books to explain pathophysiology and surgical care is a novel method to improve comprehension, satisfaction, and anxiety of caregivers. This could benefit informed consent, understanding, and postoperative outcomes.