Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine

Publisher: Australasian Academy of Critical Care Medicine, College of Intensive Care Medicine of Australia and New Zealand

Description

  • Impact factor
    1.51
  • 5-year impact
    0.00
  • Cited half-life
    4.40
  • Immediacy index
    0.39
  • Eigenfactor
    0.00
  • Article influence
    0.00
  • Other titles
    Critical care and resuscitation (Online), Journal of the Australasian Academy of Critical Care Medicine
  • ISSN
    1441-2772
  • OCLC
    223326394
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

College of Intensive Care Medicine of Australia and New Zealand

  • Pre-print
    • Author cannot archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Classification
    ​ white

Publications in this journal

  • Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):244.
  • Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):294-5.
  • Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):24.
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    ABSTRACT: To determine if using freshest available rather than standard-issue red blood cells (RBCs) can reduce mortality in critically ill intensive care unit patients. Our study is the largest ongoing randomised controlled trial (RCT) of RBC age in critically ill patients and will help determine if the use of the freshest available RBCs should become standard policy for the critically ill. A double-blind, multicentre, Phase III RCT of 5000 adult ICU patients in Australia, New Zealand, Europe and the Middle East. Transfusion of the freshest available RBCs in place of standard-care RBCs until hospital discharge. The primary outcome measure is 90-day all-cause mortality. Secondary outcome measures are time to death, 28-day and 180-day mortality, persistent organ dysfunction combined with death, days alive and free of mechanical ventilation and renal replacement therapy, bloodstream infection in the ICU, length of stay in the ICU and in hospital, proportion of patients with febrile non-haemolytic transfusion reactions, and quality of life at Day 180. A detailed statistical analysis plan with predefined subgroups and secondary analyses has been finalised before results being available, to ensure an unbiased final analysis. The pragmatic protocol design has been chosen to facilitate translation of the trial results into practice. The TRANSFUSE trial will have important clinical and policy implications, regardless of the outcome.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):255-61.
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    ABSTRACT: 0.9% saline is the most commonly used intravenous (IV) fluid in the world. However, recent data raise the possibility that, compared with buffered crystalloid fluids such as Plasma-Lyte 148, the administration of 0.9% saline to intensive care unit patients might increase their risk of acute kidney injury (AKI). To describe the protocol for the 0.9% Saline v Plasma-Lyte 148 for ICU Fluid Therapy (SPLIT) study. This is a multicentre, cluster-randomised, double crossover feasibility study to be conducted in four New Zealand tertiary ICUs over a 28-week period and will enrol about 2300 participants. All ICU patients who need crystalloid IV fluid therapy (except those with established renal failure needing dialysis and those admitted to the ICU for palliative care) will be enrolled. Participating ICUs will be randomly assigned to 0.9% saline or Plasma-Lyte 148 as the routine crystalloid IV fluid, in a blinded fashion, in four alternating 7-week blocks. The primary outcome will be the proportion of patients who develop AKI in the ICU. Secondary outcomes will include the difference between the most recent serum creatinine level measured before study enrolment and the peak serum creatinine level in the ICU; use of renal replacement therapy; and ICU and inhospital mortality. All analyses will be conducted on an intention-to-treat basis. The SPLIT study started on 1 April 2014 and will provide preliminary data on the comparative effectiveness of using 0.9% saline v Plasma- Lyte 148 as the routine IV fluid therapy in ICU patients.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):274-9.
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    ABSTRACT: To determine the proportion of computed tomography pulmonary angiograms (CTPAs), performed after medical emergency team (MET) calls, that are positive for pulmonary embolism (PE), and whether there are useful clinical predictors of positive CTPA results. All patients from a tertiary referral hospital in Melbourne who had an MET response and an associated CTPA within 6 hours, from 2009 to 2013, were included. We reviewed medical records to assess indications for CTPA, including MET clinical triggers, time of day of the MET (implying the seniority of decision making), chest x-ray results and Wells scores as a clinical decision rule for PE. There were 4578 MET responses (in 3136 patients) over the 5-year study period, from which 70 CTPAs were ordered (2.2% of all patients). A PE was identified in 12 patients (17.1%). The median age of CTPA patients was 70 years (interquartile range, 60-76 years) and most were surgical patients (80%). The major MET triggers for CTPA were hypoxia (42.9%) and hypotension (28.6%). An abnormal chest x-ray was associated with a low likelihood of PE. The Wells scores and MET indications of hypoxia, hypotension and tachycardia were not accurate in predicting the presence or extent of PE. Clinical decision rules and MET indications were not significantly associated with the presence of PE on CTPA. However, an abnormal chest x-ray has a high negative predictive value and therefore may be helpful in preventing unnecessary CTPAs.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):280-4.
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    ABSTRACT: Delirium is a common complication in postoperative, critically ill patients. The mechanism of postoperative delirium is not well understood but many studies have shown significant associations between benzodiazepine use, alcohol withdrawal and cirrhosis, and an increased risk of delirium. We aimed to investigate a possible link with alterations of gamma-aminobutyric acid (GABA) activity. A prospective observational investigation of 40 patients > 20 years old who had undergone elective surgery with general anaesthesia and were expected to need postoperative intensive care for more than 48 hours. We assessed postoperative delirium using the confusion assessment method in the intensive care unit at 1 hour after the operation and on postoperative Day (POD) 1 and POD 2. We collected blood samples for measurement of plasma GABA concentrations before the operation and on POD 1 and 2. Postoperative delirium and perioperative plasma GABA concentrations in patients with and without delirium. Postoperative delirium occurred in 13 of the patients. Patients with delirium had significantly higher Acute Physiology and Chronic Health Evaluation II scores than patients without delirium. The mean plasma GABA concentration on POD 2 was significantly lower in patients with delirium than in those without delirium. After adjustment of relevant variables, plasma GABA concentration on POD 2 was independently associated with postoperative delirium. Plasma GABA level on POD 2 has a significant independent association with postoperative delirium.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):269-73.
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    ABSTRACT: The CALORIES trial is a pragmatic, open, multicentre, randomised controlled trial (RCT) of the clinical effectiveness and cost-effectiveness of early nutritional support via the parenteral route compared with early nutritional support via the enteral route in unplanned admissions to adult general critical care units (CCUs) in the United Kingdom. The trial derives from the need for a large, pragmatic RCT to determine the optimal route of delivery for early nutritional support in the critically ill. To describe the proposed statistical analyses for the evaluation of the clinical effectiveness in the CALORIES trial. With the primary and secondary outcomes defined precisely and the approach to safety monitoring and data collection summarised, the planned statistical analyses, including prespecified subgroups and secondary analyses, were developed and are described. The primary outcome is all-cause mortality at 30 days. The primary analysis will be reported as a relative risk and absolute risk reduction and tested with the Fisher exact test. Prespecified subgroup analyses will be based on age, degree of malnutrition, acute severity of illness, mechanical ventilation at admission to the CCU, presence of cancer and time from CCU admission to commencement of early nutritional support. Secondary analyses include adjustment for baseline covariates. In keeping with best trial practice, we have developed, described and published a statistical analysis plan for the CALORIES trial and are placing it in the public domain before inspecting data from the trial.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):248-54.
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    ABSTRACT: To describe the awareness of intensive care unit patients and their next of kin (NoK) about invasive procedures and their expectations of informed consent for procedures in the ICU. A written survey of patients and their NoK in a tertiary, university-affiliated ICU, using multiplechoice questions, Likert scales and comments to generate semiquantitative and qualitative data. Fifty-one ICU patients and 69 NoK completed the survey. Inclusion criteria were unplanned ICU admission, ICU length-of-stay > 24 hours, English speaking and competent to consent to participate. Proportion of procedures respondents were aware had occurred during ICU admission; satisfaction with information received; preferred method of receiving information and giving consent; and expectations of when procedural consent is required. Patients and NoK were unaware of many procedures performed during their admission. Respondents correctly identified 49% (95% CI, 45%-53%) of procedures performed during the patient's ICU admission. Despite this, most patients (80%; 95% CI, 69%-91%) and NoK (94%; 95% CI, 89%-100%) were satisfied with information provided about procedures. Over half of respondents (55%; 95% CI, 46%-64%) only expected consent for procedures that were "risky or not routine". About one-quarter (27%; 95% CI, 23%-31%) expected to give consent before every procedure and 15% (95% CI, 11%-18%) expected no procedural consent process. Patients and NoK strongly preferred a verbal rather than written consent process. Our results suggest there is a limited degree of support for routine procedural consent from ICU patients and their NoK.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):262-8.
  • Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 12/2014; 16(4):246.
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    ABSTRACT: To describe the bowel function of critically ill children.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):202-205.
  • Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):237.
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    ABSTRACT: Intensivists frequently prescribe proton pump inhibitors (PPIs) or histamine-2 receptor blockers (H2RBs) to intensive care unit patients for stress ulcer prophylaxis (SUP). Despite the common use of SUP medicines, there is limited high-level evidence to support the choice between them.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):170-174.
  • Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):233-235.
  • Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):237-238.
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    ABSTRACT: Recent randomised controlled trials have compared the effects of albumin and hydroxyethyl starch (HES) v crystalloids on patient-centred outcomes in critically ill patients. The Saline v Albumin Fluid Evaluation (SAFE) trial reported patient-centred outcomes at 28 days in 6933 patients assigned to fluid resuscitation with either 4% albumin or 0.9% saline; the Crystalloid v Hydroxyethyl Starch Trial (CHEST) reported patient-centred outcomes at 28 days in 6644 patients assigned to fluid resuscitation with either 6% HES (130/0.4) or 0.9% saline. As the two trials used a common reference fluid (0.9% saline) and had most trial methods and data collection points harmonised, a comparison of 4% albumin and 6% HES (130/0.4) on patient-centred outcomes at 28 days in critically ill patients using the individual patient data from the two trials is feasible.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):206-213.
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    ABSTRACT: To investigate screening variables identifying patients at risk of developing intra-abdominal hypertension (IAH) after cardiac surgery.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):214-219.
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    ABSTRACT: To establish the prevalence of emergency responses for clinical deterioration (cardiac arrest team or medical emergency team [MET] activation) within 24 hours of emergency admission, and determine if there were differences in characteristics and outcomes of ward patients whose emergency response was within, or beyond, 24 hours of emergency admission.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):184-189.
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    ABSTRACT: To determine whether aminophylline reduced the duration of respiratory support in children admitted to intensive care with bronchiolitis.
    Critical care and resuscitation: journal of the Australasian Academy of Critical Care Medicine 09/2014; 16(3):220-224.