Publications by authors named "Mark Finnis"
Article Synopsis
- Critically ill patients with traumatic brain injury (TBI) may face extended ICU stays, but the effect of increased enteral nutrition energy delivery on their quality of life is unclear.
- This study aimed to compare the quality of life of TBI survivors on an augmented energy diet (1.5 kcal/ml) versus a routine diet (1.0 kcal/ml) at six months post-admission, while also examining energy delivery, gastrointestinal tolerance, and mortality outcomes.
- Results showed no significant difference in quality of life between the two groups, though those on augmented nutrition received more energy without increased gastrointestinal issues.
Objective: Critically ill patients suffer disrupted sleep. Hypnotic medications may improve sleep; however, local epidemiological data regarding the amount of nocturnal time awake and the use of such medications is needed.
Design: Point prevalence study.
Article Synopsis
- The study evaluates the effectiveness of ROTEM sigma, a point-of-care coagulation test, in assessing coagulation in patients with isolated traumatic brain injuries (TBI) compared to traditional lab tests.
- Out of 36 patients tested, 22% exhibited a hypocoagulable state, which correlated with a higher death rate from head injuries, indicating the prognostic value of ROTEM sigma.
- ROTEM tests provided faster results than standard tests, demonstrating that ROTEM parameters can quickly and accurately predict the risk of head injury-related death.
Objectives: The most efficient way to adjust skeletal muscle area (SMA) derived from chest CT to body size remains unclear. We hypothesized that vertebral body area (VBA) measurement would allow such efficient adjustment.
Methods: We conducted a retrospective observational study of chest CT imaging in a cohort of critically ill COVID-19 patients.
Article Synopsis
- The study investigates ascorbate (vitamin C) levels in plasma and cerebrospinal fluid (CSF) following aneurysmal subarachnoid hemorrhage (aSAH) in patients, comparing them to levels in pregnant women.
- Results show that ascorbate levels in both plasma and CSF are significantly lower in aSAH patients than in controls, indicating a potential deficiency.
- Additionally, patients who developed vasospasm had notably lower CSF ascorbate levels, suggesting a link between ascorbate concentration and the severity of post-aSAH complications.
To quantify current protein prescription and delivery in critically ill adults in Australia and New Zealand and compare it with international guidelines. Prospective, multicentre, observational study. Five intensive care units (ICUs) across Australia and New Zealand.
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- Family members of people who die in the ICU often feel really sad or stressed afterward.
- This study looked at whether special support programs could help these family members feel better.
- After reviewing several studies, the results showed that these programs didn't make a big difference in how family members felt.
Article Synopsis
- The TARGET Protein trial will assess whether increasing dietary protein intake in ICU patients, as recommended by international guidelines, leads to better health outcomes compared to current practices.
- This clinical trial involves eight ICUs in Australia and New Zealand, where each ICU will switch between two different enteral nutrition formulas over a period of 12 months.
- The main goal is to see if higher protein intake reduces the number of days patients spend in the hospital and improves survival rates at 90 days post-admission.
Objective: Optimal resuscitation of sepsis-induced hypotension is uncertain, particularly the role of restrictive fluid strategies, leading to variability in usual practice. The objective of this study is to understand resuscitation practices in patients presenting to ED with early sepsis.
Methods: Design, participants and setting: Prospective, observational, multicentre, single-day, point-prevalence study enrolling adult patients present in 51 Australian and New Zealand ICUs at 10.
Introduction: Blood pressure (BP) management is common in patients with aneurysmal subarachnoid hemorrhage (SAH) admitted to an intensive care unit. However, the practice patterns of BP management (timing, dose, and duration) have not been studied locally.
Methods: This post hoc analysis explored BP management goals (defined as the setting of a minimum systolic BP target or application of induced hypertension) in patients enrolled into the PROMOTE-SAH study in eleven neurosurgical centers in Australia and New Zealand.
Background: Hypovitamin B1 occurs frequently during critical illness but is challenging to predict or rapidly diagnose. The aim of this study was to evaluate whether plasma phosphate concentrations predict hypovitamin B1, enteral nutrition prevents hypovitamin B1 and intravenous thiamine supplementation achieves supraphysiological concentrations in critically ill patients.
Methods: Thirty-two enterally fed critically ill patients, with a plasma phosphate concentration ≤0.
Objective: To evaluate the association between time from ED presentation to intensive care unit (ICU) transfer on mortality in patients presenting with septic shock.
Methods: Adult patients with suspected septic shock enrolled in the Australasian Resuscitation in Sepsis Evaluation trial were included. The primary outcome of this post-hoc analysis was 90-day mortality.
Article Synopsis
- Diabetes mellitus is a significant risk factor for severe COVID-19, but its effects on the Australian population had not been thoroughly investigated prior to this study.
- The study analyzed 136 ICU patients in Melbourne with COVID-19, finding that 43% had diabetes, and noted that those with diabetes experienced worse outcomes, including longer hospital stays and higher mortality rates.
- The findings underscore the importance of targeted prevention strategies for diabetes management in patients hospitalized with severe COVID-19 in Australia.
Our objective was to describe antiseizure medication (ASM) prescription patterns, and associations between ASM use and death and disability outcomes in patients with aneurysmal subarachnoid haemorrhage (aSAH) admitted to ICU. This was a multi-centre prospective observational study. The study took place in eleven ICUs across Australia and New Zealand.
View Article and Find Full Text PDFBlood glucose concentrations affect outcomes in critically ill patients, but the optimal target blood glucose range in those with type 2 diabetes is unknown. To evaluate the effects of a "liberal" approach to targeted blood glucose range during ICU admission. This mutlicenter, parallel-group, open-label randomized clinical trial included 419 adult patients with type 2 diabetes expected to be in the ICU on at least three consecutive days.
View Article and Find Full Text PDFVenous blood for the analysis of acid-base status in a model of septic shock.
Emerg Med Australas
June 2022
Objective: To determine the relationship between arterial and venous acid-base status in a model of septic shock.
Methods: Paired samples (n = 435) of arterial and femoral venous blood from 57 sheep (47 septic, 10 non-septic) managed with protocol-guided ventilation, sedation, parenteral fluids and inotropic support.
Results: The arterial-venous difference in acid-base parameters was similar with and without sepsis.
Aim: The aim of this study was to investigate the association of hyperoncotic (20%) human albumin solution (HAS) with outcomes among critically ill patients receiving continuous renal replacement therapy (RRT).
Methods: Analysis of the Randomized Evaluation of Normal versus Augmented Level (RENAL) RRT trial data.
Results: Of 1,508 patients, 771 (51%) received albumin.
Background: Frailty is independently associated with morbidity and mortality in critically ill patients. However, the association between preadmission frailty and the degree of treatment received in the intensive care unit (ICU) remains unclear.
Objective: To describe patient length of stay in an ICU and the treatments provided according to the extent of patient frailty.
Background: Hypophosphatemia may be a useful biomarker to identify thiamine deficiency in critically ill enterally-fed patients. The objective was to determine whether intravenous thiamine affects blood lactate, biochemical and clinical outcomes in this group.
Method: This randomized clinical trial was conducted across 5 Intensive Care Units.
Background: Disability is common following critical illness, impacting the quality of life of survivors, and is difficult to measure. 'Participation' can be quantified as involvement in life outside of their home requiring movement from their home to other locations. Participation restriction is a key element of disability, and following critical illness, participation may be diminished.
View Article and Find Full Text PDFObjectives: To investigate the association between plasma sodium concentrations and 6-month neurologic outcome in critically ill patients with aneurysmal subarachnoid hemorrhage.
Design: Prospective cohort study.
Setting: Eleven ICUs in Australia and New Zealand.
Objective: Intravenous antimicrobial therapy within 1 h of the diagnosis of septic shock is recommended in international sepsis guidelines. We aimed to evaluate the association between antimicrobial timing and mortality in patients presenting to the ED with septic shock.
Methods: Post-hoc analysis of 1587 adult participants enrolled in the Australasian Resuscitation in Sepsis Evaluation (ARISE) multicentre trial of early goal-directed therapy for whom the time of initial antimicrobial therapy was recorded.
Self-harm is one of the most common reasons for admission to an intensive care unit (ICU). While most patients with self-harm survive the ICU admission, little is known about their outcomes after hospital discharge. We conducted a retrospective cohort study of patients in the Barwon region in Victoria admitted to the ICU with self-harm (between 1998 and 2018) who survived to hospital discharge.
View Article and Find Full Text PDFPurpose: Examine effects of dexmedetomidine on bladder urinary oxygen tension (PuO) in critically ill patients and delineate mechanisms in an ovine model.
Materials And Methods: In 12 critically ill patients: oxygen-sensing probe inserted in the bladder catheter and dexmedetomidine infusion at a mean (SD) rate of 0.9 ± 0.