Capnodynamic monitoring of lung volume and blood flow in response to increased positive end-expiratory pressure in moderate to severe COVID-19 pneumonia: an observational study.

Background: The optimal level of positive end-expiratory pressure (PEEP) during mechanical ventilation for COVID-19 pneumonia remains debated and should ideally be guided by responses in both lung volume and perfusion. Capnodynamic monitoring allows both end-expiratory lung volume ([Formula: see text]) and effective pulmonary blood flow (EPBF) to be determined at the bedside with ongoing ventilation.

Methods: Patients with COVID-19-related moderate to severe respiratory failure underwent capnodynamic monitoring of [Formula: see text] and EPBF during a step increase in PEEP by 50% above the baseline (PEEP to PEEP).

Post-operative renal failure management in mechanical circulatory support patients.

Acute kidney injury (AKI) occurs commonly in patients requiring mechanical circulatory support (MCS) after cardiothoracic surgery. The prognostic implications of AKI in this patient group relate closely to the pathophysiology and risk factors associated with the underlying disease; pre-operative, intra-operative, and post-operative variables; hemodynamic factors; and type of support device used. General approaches to AKI management, including prevention strategies, medical management, and hemodynamic support, are also applicable in patients requiring MCS.

Comparison of echocardiographic and invasive measures of volaemia and cardiac performance in critically ill patients.

Echocardiographic measurements are used in critical care to evaluate volume status and cardiac performance. Mean systemic filling pressure and global heart efficiency measures intravascular volume and global heart function. This prospective study conducted in fifty haemodynamically stabilized, mechanically ventilated patients investigated relationships between static echocardiographic variables and estimates of global heart efficiency and mean systemic filling pressure.

Long-term Outcome in Severe Left Ventricular Primary Graft Dysfunction Post Cardiac Transplantation Supported by Early Use of Extracorporeal Membrane Oxygenation.

Background: Severe primary graft dysfunction (PGD) is the leading cause of early death following cardiac transplantation. The early use of venoarterial extracorporeal membrane oxygenation (VA-ECMO) may facilitate graft rescue. However, the additional risks of its use are unknown.

Fluid Balance and Recovery of Native Lung Function in Adult Patients Supported by Venovenous Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy.

Fluid overload is associated with increased mortality in adult patients with acute respiratory distress syndrome. In patients requiring venovenous extracorporeal membrane oxygenation (VV-ECMO), the effects of fluid removal on survival and lung recovery remain undefined. We assessed the impact of early fluid removal in adult patients supported by VV-ECMO and concomitant continuous renal replacement therapy, in an 18-bed tertiary intensive care unit between 2010 and 2015.

Advances in critical care management of patients undergoing cardiac surgery.

Cardiac surgery has been evolving to include minimally invasive, hybrid and transcatheter techniques. Increasing patient age and medical complexity means that critical care management needs to adapt and evolve. Recent advances have occurred in several areas, including ventilation, haemodynamics and mechanical circulatory support, bleeding and coagulation, acute kidney injury, and neurological management.

Echocardiographic approach to cardiac tamponade in critically ill patients.

Cardiac tamponade should be considered in a critically ill patient in whom the cause of haemodynamic shock is unclear. When considering tamponade, transthoracic echocardiography plays an essential role and is the initial investigation of choice. Diagnostic sensitivity of transthoracic echocardiography is dependent on image quality, and in some cases a transoesophageal approach may be required to confirm the diagnosis.

Extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest: A multicentre experience.

Aim: To describe the ECPR experience of two Australian ECMO centres, with regards to survival and neurological outcome, their predictors and complications.

Methods: Retrospective observational study of prospectively collected data on all patients who underwent extracorporeal cardiopulmonary resuscitation (ECPR) at two academic ECMO referral centres in Sydney, Australia.

Measurements And Main Results: Thirty-seven patients underwent ECPR, 25 (68%) were for in-hospital cardiac arrests.

Implementation of an evidence based guideline reduces blood tests and length of stay for the limping child in a paediatric emergency department.

Introduction: Acute non-traumatic limp is a common reason for children to present to the emergency department (ED). There is a wide differential diagnosis for these patients, and there are certain serious conditions which cannot be missed. An evidence based guideline for the 'limping child' was designed and the impact of guideline implementation on a number of specific, predefined quantitative outcomes was assessed.

Venous vs arterial blood gases in the assessment of patients presenting with an exacerbation of chronic obstructive pulmonary disease.

Objective: The purpose of this study was to investigate the clinical correlation between arterial and venous blood gas (VBG) values in patients presenting to the emergency department (ED) with acute exacerbation of chronic obstructive pulmonary disease.

Methods: A prospective study of patients with chronic obstructive pulmonary disease presenting to the ED with acute ventilatory compromise was done. Patients were included if their attending physician considered arterial blood gas sampling important in their initial assessment.