A Randomized Noninferiority Trial to Compare Enteral to Parenteral Phosphate Replacement on Biochemistry, Waste, and Environmental Impact and Healthcare Cost in Critically Ill Patients With Mild to Moderate Hypophosphatemia.

Objectives: Hypophosphatemia occurs frequently. Enteral, rather than IV, phosphate replacement may reduce fluid replacement, cost, and waste.

Design: Prospective, randomized, parallel group, noninferiority clinical trial.

Association between protocol change to a higher-protein formula with lower energy targets and nutrient delivery in critically ill patients with COVID-19: A retrospective cohort study.

Background: Guidelines recommend prioritizing protein provision while avoiding excessive energy delivery to critically ill patients with coronavirus disease 2019 (COVID-19), but there are no prospective studies evaluating such a targeted approach in this group. We aimed to evaluate the effect of a "higher-protein formula protocol" on protein, energy, and volume delivery when compared with standard nutrition protocol.

Methods: This was a retrospective cohort study of adult patients with COVID-19 who received mechanical ventilation for >72 h and enteral nutrition.

Clearance of Piperacillin-Tazobactam and Vancomycin During Continuous Renal Replacement With Regional Citrate Anticoagulation.

Background: The use of regional citrate anticoagulation during continuous venovenous hemodiafiltration (CVVHDF) has increased worldwide. However, data on its effect on the pharmacokinetics of antibiotics are limited. In this study, the authors aimed to measure the clearance of piperacillin-tazobactam and vancomycin in patients receiving CVVHDF with regional citrate anticoagulation.

Targeted Full Energy and Protein Delivery in Critically Ill Patients: A Pilot Randomized Controlled Trial (FEED Trial).

Background: International guidelines recommend greater protein delivery to critically ill patients than they currently receive. This pilot randomized clinical trial aimed to determine whether a volume-target enteral protocol with supplemental protein delivered greater amounts of protein and energy to critically ill patients compared with standard care.

Methods: Sixty participants received either the intervention (volume-based protocol, with protein supplementation) or standard nutrition care (hourly-rate-based protocol, without protein supplementation) in the intensive care unit (ICU).

Targeted full energy and protein delivery in critically ill patients: a study protocol for a pilot randomised control trial (FEED Trial).

Background: Current guidelines for the provision of protein for critically ill patients are based on incomplete evidence, due to limited data from randomised controlled trials. The present pilot randomised controlled trial is part of a program of work to expand knowledge about the clinical effects of protein delivery to critically ill patients. The primary aim of this pilot study is to determine whether an enteral feeding protocol using a volume target, with additional protein supplementation, delivers a greater amount of protein and energy to mechanically ventilated critically ill patients than a standard nutrition protocol.

Influence of changing endotracheal tube cuff management on antibiotic use for ventilator-associated pneumonia in a tertiary intensive care unit.

Background: Routine deflation of the endotracheal tube (ETT) cuff of critically ill patients receiving MV is common in Australia and New Zealand. Literature about ventilatorassociated pneumonia (VAP) and antibiotic use rates with different ETT cuff maintenance practices is lacking.

Objective: To determine the impact of a change in ETT cuff maintenance from a minimal leak technique to pressure manometry on the administration of antibiotics for VAP.

Measurement of physical activity levels in the Intensive Care Unit and functional outcomes: An observational study.

Purpose: Primary aims were: (1) objectively quantify levels of physical activity with the sensewear armband mini-fly motion sensor (SWA-MF), (2) evaluate the correlation of SWA-MF measurement of active and resting energy expenditure against the ICU Mobility scale (IMS) and indirect calorimetry respectively.

Materials And Methods: Adults mechanically ventilated ≥48h and anticipated to remain in ICU≥5days were included. Physical activity (PA) was measured using a SWA-MF (over the first five days); energy expenditure was measured with both the SWA-MF and the Deltatrac II metabolic cart on day three; highest level of mobility was assessed on the IMS.

Predicting short-term and long-term mortality in elderly emergency patients admitted for intensive care.

Objective: The long-term outcomes of intensive care for the growing elderly cohort are not well defined. We explored the predictive factors for 12-month mortality in elderly patients who were admitted to an intensive care unit within 24 hours of emergency department (ED) presentation.

Design, Setting And Participants: A retrospective cohort study of 506 patients aged 80 years and over who were admitted to the Royal Melbourne Hospital ICU within 24 hours of presentation to the ED, between 1 January 2005 and 1 December 2010.

The association of blood transfusion with mortality after cardiac surgery: cause or confounding? (CME).

Background: Bleeding into the chest is a life-threatening complication of cardiac surgery. Blood transfusion has been implicated as an important cause of harm associated with bleeding, based largely on studies demonstrating an independent association between transfusion and mortality. These studies did not, however, consider the possibility that bleeding may in itself be harmful, inasmuch as drains are inefficient at clearing blood from the chest and retained blood may compromise cardiac and lung function.