An observational study on the practice of noninvasive ventilation at a tertiary level Australian intensive care unit.

Background: Failure of Non-Invasive Ventilation (NIV) is associated with increased morbidity and mortality among critically ill patients. Although there is evidence of association between disease related factors and NIV failure, it is unclear whether factors related to NIV application contribute to NIV failure.

Objectives: To evaluate NIV failure rate and factors associated with NIV failure.

Arterial carbon dioxide tension and outcome in patients admitted to the intensive care unit after cardiac arrest.

Background: Arterial carbon dioxide tension (PaCO2) affects neuronal function and cerebral blood flow. However, its association with outcome in patients admitted to intensive care unit (ICU) after cardiac arrest (CA) has not been evaluated.

Methods And Results: Observational cohort study using data from the Australian New Zealand (ANZ) Intensive Care Society Adult-Patient-Database (ANZICS-APD).

Plasma-Lyte 148 vs 0.9% saline for fluid resuscitation in diabetic ketoacidosis.

Purpose: The purpose of the study was to determine the effects of Plasma-Lyte 148 (PL) vs 0.9% saline (NS) fluid resuscitation in diabetic ketoacidosis (DKA).

Methods: A multicenter retrospective analysis of adults admitted for DKA to the intensive care unit, who received almost exclusively PL or NS infusion up until 12 hours, was performed.

Dynamic lactate indices as predictors of outcome in critically ill patients.

Introduction: Dynamic changes in lactate concentrations in the critically ill may predict patient outcome more accurately than static indices. We aimed to compare the predictive value of dynamic indices of lactatemia in the first 24 hours of intensive care unit (ICU) admission with the value of more commonly used static indices.

Methods: This was a retrospective observational study of a prospectively obtained intensive care database of 5,041 consecutive critically ill patients from four Australian university hospitals.

Ionized calcium concentration and outcome in critical illness.

Objective: To assess the association of abnormalities of ionized calcium levels with mortality in a heterogeneous cohort of critically ill patients.

Design: Retrospective, combined clinical and biochemical study.

Setting: Four combined medical/surgical intensive care units.

The interaction of chronic and acute glycemia with mortality in critically ill patients with diabetes.

Objectives: The relationship between hyperglycemia and mortality is altered by the presence of diabetes mellitus. Biological adjustment to preexisting hyperglycemia might explain this phenomenon. We tested whether the degree of preexisting hyperglycemia would modulate the association between glycemia and outcome during critical illness in patients with diabetes mellitus.

Relative hyperlactatemia and hospital mortality in critically ill patients: a retrospective multi-centre study.

Introduction: Higher lactate concentrations within the normal reference range (relative hyperlactatemia) are not considered clinically significant. We tested the hypothesis that relative hyperlactatemia is independently associated with an increased risk of hospital death.

Methods: This observational study examined a prospectively obtained intensive care database of 7,155 consecutive critically ill patients admitted to the Intensive Care Units (ICUs) of four Australian university hospitals.

Hypoglycemia and outcome in critically ill patients.

Objective: To determine whether mild or moderate hypoglycemia that occurs in critically ill patients is independently associated with an increased risk of death.

Patients And Methods: Of patients admitted to 2 hospital intensive care units (ICUs) in Melbourne and Sydney, Australia, from January 1, 2000, to October 14, 2004, we analyzed all those who had at least 1 episode of hypoglycemia (glucose concentration, <81 mg/dL). The independent association between hypoglycemia and outcome was statistically assessed.

Blood glucose concentration and outcome of critical illness: the impact of diabetes.

Objective: To study the impact of diabetes mellitus on the relationship between glycemia and mortality in critically ill patients.

Design: Retrospective observational study.

Setting: Intensive care units of two university hospitals.

Circadian rhythm of blood glucose values in critically ill patients.

Objective: To test whether there is a circadian rhythm of blood glucose control in critically ill patients and whether morning blood glucose is an accurate surrogate of overall blood glucose control.

Design: Retrospective multiple-center observational study.

Setting: Intensive care units of three tertiary hospitals and one affiliated private hospital.

Variability of blood glucose concentration and short-term mortality in critically ill patients.

Background: Intensive insulin therapy may reduce mortality and morbidity in selected surgical patients. Intensive insulin therapy also reduced the SD of blood glucose concentration, an accepted measure of variability. There is no information on the possible significance of variability in glucose concentration.

Intensive insulin therapy in postoperative intensive care unit patients: a decision analysis.

Rationale: Intensive insulin therapy (IIT) may reduce mortality in mechanically ventilated postoperative patients.

Objectives: To assess the risks and benefits of IIT in different institutions.

Design: Retrospective, blinded-to-outcome selection of patient cohorts from four hospitals.

Delayed neurologic sequelae resulting from epidemic diethylene glycol poisoning.

Background: Diethylene glycol (DEG) is a well-known metabolic and renal toxin usually ingested accidentally as an ethanol substitute or as a contaminant in various medicinals. To date, most poisonings have occurred in third-world countries where early death from renal failure is very common. We report a series of seven patients presenting with epidemic DEG poisoning from a correctional facility with varying degrees of metabolic acidemia and acute renal impairment responding to emergent hemodialysis (HD).