Publications by authors named "Eastwood G"
Objective: To compare the effects of fluid bolus therapy (FBT) with 20% albumin to crystalloid FBT on the incidence of cardiac surgery-associated acute kidney injury (CSA-AKI) and its severity and duration.
Design: Secondary analysis of the multicenter, parallel-group, open-label, randomized HAS FLAIR-II trial.
Setting: Six intensive care units.
Objective: To describe the six-month functional outcomes of patients who received extracorporeal cardiopulmonary resuscitation (ECPR) following in-hospital cardiac arrest (IHCA) in Australia.
Design: Secondary analysis of EXCEL registry data.
Setting: EXCEL is a high-quality, prospective, binational registry including adult patients who receive extracorporeal membrane oxygenation (ECMO) in Australia and New Zealand.
Introduction: Angiotensin II may reduce muscle ischemia during intermittent hemodialysis and thereby decrease the incidence and/or intensity of intradialytic muscle cramps. We aimed to test whether angiotensin II infusion during intermittent hemodialysis is safe, feasible, and effective in the attenuation of muscle cramps.
Methods: We performed a pilot, single-blinded, randomized crossover trial of patients receiving intermittent hemodialysis who frequently experience intradialytic muscle cramps.
Background: 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.
Objective: The aim of this study is to test the efficacy and safety of administering enteral olanzapine when compared to quetiapine in critically ill patients with hyperactive delirium.
Background: Severe intensive care unit-acquired hypernatraemia (ICU-AH) is a serious complication of critical illness. However, there is no detailed information on how this condition develops.
Objectives: The objective of this study was to study the prevalence, risk factors, trajectory, management, and outcome of severe ICU-AH (≥155 mmol·L).
Objective: 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.
Design: We conducted a multicentre, retrospective, observational study.
Background: Hypernatremia is relatively common in acutely ill patients and associated with mortality. Guidelines recommend a slow rate of correction (≤ 0.5 mmol/L per hour).
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- Acute kidney injury (AKI) is a common and serious problem following out-of-hospital cardiac arrest (OHCA), particularly influenced by post-resuscitation cardiogenic shock (CS).
- A study compared two groups of patients—those receiving targeted mild hypercapnia and those receiving targeted normocapnia—to see if higher carbon dioxide tension impacted AKI rates and other outcomes.
- Results showed that approximately 72.1% of patients developed AKI regardless of treatment, with CS significantly increasing the likelihood of AKI, but carbon dioxide levels did not alter this relationship.
Purpose: Furosemide is the most commonly used diuretic in intensive care units (ICU). We aimed to evaluate the physiological effects of adjunctive acetazolamide with furosemide on diuresis and the prevention of potential furosemide-induced metabolic alkalosis.
Materials And Methods: We performed a two-center, pilot, open-label, randomized trial.
Purpose: Hyperoxemia is common in patients resuscitated after out-of-hospital cardiac arrest (OHCA) admitted to the intensive care unit (ICU) and may increase the risk of mortality. However, the effect of hyperoxemia on functional outcome, specifically related to the timing of exposure to hyperoxemia, remains unclear.
Methods: The secondary analysis of the Target Temperature Management 2 (TTM-2) randomized trial.
Introduction: Paracetamol (acetaminophen)-induced acute liver failure (ALF) with severe hyperammonemia (ammonia >100 µmol⋅L-1) is a life-threatening condition. A strategy based on high-intensity continuous renal replacement therapy (CRRT) without early (up to day seven) transplantation may enable clinicians to safely identify which patients can recover and survive and which patients require transplantation.
Methods: We conducted a single-center, retrospective cohort study of patients with severely hyperammonemic paracetamol-induced ALF.
Background: In Europe, approximately 291,000 cardiac arrests occur annually. Despite critical care therapy, hospital mortality remains high. This systematic review assessed whether, in comatose survivors of cardiac arrest, any drug therapy, compared to placebo or usual care, improves outcomes.
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- Neuroimaging using MRI can help assess brain injuries in comatose adults after cardiac arrest, but data on its use is limited.
- In a study involving 1,639 patients from the TAME trial, only 9% underwent MRI, showing key differences in age, time to resuscitation, and lactate levels compared to those who did not.
- Six months later, only 16% of MRI patients had a favorable neurological outcome, highlighting concerns about the effectiveness of MRI in this context.
Background: Some patients experience early (within 48 h) clinical deterioration and medical emergency team (MET) review following intensive care unit (ICU) discharge. Few studies have explored early MET review, despite it being a recognised quality and safety indicator.
Aims: To evaluate the (i) proportion of patients discharged from ICU receiving MET review and timing of reviews; (ii) characteristics of patients who received early MET review and (iii) predictors of early MET review and associations with clinical outcomes.
Background And Aims: Prone positioning is commonly applied to improve gas exchange in mechanically ventilated patients with coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome (ARDS). Whilst prone positioning is effective, specific complications may arise. We aimed to assess the prevalence of specific complications related to prone positioning in patients mechanically ventilated for COVID-19-related ARDS.
View Article and Find Full Text PDFObjective: Targeted mild hypercapnia is a potential neuroprotective therapy after cardiac arrest. In this exploratory observational study, we aimed to explore the effects of targeted mild hypercapnia on cerebral microvascular resistance assessed by middle cerebral artery pulsatility index (MCA PI) and intracranial pressure estimated by optic nerve sheath diameter (ONSD) in resuscitated out-of-hospital cardiac arrest (OHCA) patients.
Design Setting Participants And Interventions: Comatose adults resuscitated from OHCA were randomly allocated to targeted mild hypercapnia (PaCO 50-55 mmHg) or targeted normocapnia (PaCO 35-45 mmHg) for 24 h in the TAME trial.
Little is known about the role of horse flies in potential pathogen transmission in Chile. This study provides evidence of the molecular detection of microorganisms in southern Chile. In the present study, adult Osca lata horse flies were trapped from Punucapa (39°45'06"S/73°16'08"W, Región de Los Ríos) and Puyehue (40°39'10"S/72°10'57"W, Región de Los Lagos), Chile.
View Article and Find Full Text PDFBackground: Normothermic machine perfusion (NMP) aims to reduce ischemia-reperfusion injury in donor livers and its clinical manifestation, early allograft dysfunction (EAD) by maintaining perfusion and oxygenation. However, there is limited data on which NMP perfusate biomarkers might be associated with such EAD and the role of perfusate hemoglobin has not been assessed.
Methods: We performed a pilot retrospective analysis of adult donor livers undergoing NMP between 2020 and 2022 at our center.
Article Synopsis
- Higher nitric oxide (NO) levels are linked to worse outcomes in sepsis, but measuring them is difficult; Methemoglobin (MetHb), a byproduct of NO, may provide a solution.
- In a study of 7,724 ICU patients with sepsis, 1,046 had MetHb measurements, revealing that those with levels of 1.6% or higher had significantly increased mortality rates and fewer days spent out of the hospital by day 28.
- The results indicate that MetHb levels of 1.6% or above can independently predict higher 28-day mortality, suggesting that MetHb measurement from arterial blood gases could improve sepsis risk assessment.
Article Synopsis
- Airway management is vital in treating out-of-hospital cardiac arrest (OHCA), focusing on whether tracheal intubation (TI) or supraglottic airway devices (SGA) lead to better patient outcomes.
- A secondary analysis of the TTM2 trial included 1702 adult OHCA patients and found that most (71.6%) received TI, while 28.4% were managed with SGA.
- Results indicated that the type of airway management did not significantly affect outcomes like ventilator-free days, neurological status, or mortality rates after 26 days.
Article Synopsis
- The study investigated chloride mass transfer (JS,Cl) during continuous renal replacement therapy (CRRT) in ICU patients, examining differences between two techniques: continuous veno-venous hemofiltration (CVVH) and continuous veno-venous hemodialysis (CVVHD).
- Results showed that plasma chloride levels were significantly higher and JS,Cl lower in CVVHD compared to CVVH, while factors like net ultrafiltration and plasma chloride concentration were found to influence chloride mass transfer.
- The study concluded that CVVHD with regional citrate anticoagulation leads to greater chloride mass transfer towards the patient compared to CVVH, highlighting the importance of CRRT technique on electrolyte management.