Predictors and outcomes of withholding and withdrawal of life-sustaining treatments in intensive care units in Singapore: a multicentre observational study.

Background: Clinical practice guidelines on limitation of life-sustaining treatments (LST) in the intensive care unit (ICU), in the form of withholding or withdrawal of LST, state that there is no ethical difference between the two. Such statements are not uniformly accepted worldwide, and there are few studies on LST limitation in Asia. This study aimed to evaluate the predictors and outcomes of withholding and withdrawal of LST in Singapore, focusing on the similarities and differences between the two approaches.

Regional citrate anti-coagulation dose titration: impact on dose of continuous renal replacement therapy.

Background: Regional citrate anti-coagulation (RCA) is the recommended anti-coagulation for continuous renal replacement therapy (CRRT). Citrated replacement fluids provide convenience but may compromise effluent delivery when adjusted to maintain circuit ionised calcium levels (circuit-iCa). This study aims to evaluate the effect of RCA titration on the delivered CRRT effluent dose.

Experiential learning in simulated parapharyngeal abscess in breathing cadavers.

Purpose: Education in airway management is a fundamental component of anesthesiology training programs. There has been a shift towards the use of simulation models of higher fidelity for education in airway management. The goal of this study was to create a novel cadaveric model of a simulated parapharyngeal abscess with features of a difficult airway such as distorted anatomy and narrow airway passages presenting as stridor.

Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy - A Safe and Effective Low-Dose Protocol.

Aims: Regional citrate anticoagulation (RCA) is the preferred mode of anticoagulation for continuous renal replacement therapy (CRRT). Conventional RCA-CRRT citrate dose ranges from 3 to 5 mmol/L of blood. This study explored the effectiveness of an RCA protocol with lower citrate dose and its impact on citrate-related complications.

National survey of outcomes and practices in acute respiratory distress syndrome in Singapore.

Introduction: In the past 20 years, our understanding of acute respiratory distress syndrome (ARDS) management has improved, but the worldwide incidence and current outcomes are unclear. The reported incidence is highly variable, and no studies specifically characterise ARDS epidemiology in Asia. This observation study aims to determine the incidence, mortality and management practices of ARDS in a high income South East Asian country.

Augmented renal clearance in the ICU: results of a multicenter observational study of renal function in critically ill patients with normal plasma creatinine concentrations*.

Objective: To describe the prevalence and natural history of augmented renal clearance in a cohort of recently admitted critically ill patients with normal plasma creatinine concentrations.

Design: Multicenter, prospective, observational study.

Setting: Four, tertiary-level, university-affiliated, ICUs in Australia, Singapore, Hong Kong, and Portugal.

Relation of ECG changes to neurological outcome in patients with aneurysmal subarachnoid hemorrhage.

Background: Electrocardiographic (ECG) alterations occurring during the course of subarachnoid hemorrhage (SAH) have been described frequently, but the incidence, patterns, and prognostic significance are not well defined. This study was designed to investigate these features.

Methods: All patients admitted to a 31-bed department of intensive care between 1993 and 2000 with acute aneurysmal SAH documented by cerebral angiography or autopsy were included.

Do all nonsurvivors of cardiogenic shock die with a low cardiac index?

Study Objectives: To characterize the hemodynamic course of cardiogenic shock and to relate the cause of death to ongoing cardiac failure or multiple organ dysfunction.

Design: Retrospective study.

Setting: A 31-bed department of intensive care in a university hospital.