Diabetes and hyperglycaemia among hospitalised patients with COVID-19 in Western Sydney: a retrospective cohort study.

Background: Diabetes has been recognised as a major risk factor for COVID-19 mortality and hospital complications in earlier studies.

Aims: To examine the characteristics of hospitalised COVID-19 patients with diabetes and the impact of diabetes and hyperglycaemia on hospital outcomes.

Methods: This was a retrospective cohort study.

Short research paper: Personal protective equipment for the care of suspected and confirmed COVID-19 patients - Modelling requirements and burn rate.

Background: The COVID-19 pandemic has caused unprecedented global demand for personal protective equipment (PPE). A paucity of data on PPE burn rate (PPE consumption over time) in pandemic situations exacerbated these issues as there was little historic research to indicate volumes of PPE required to care for surges in infective patients and thus plan procurement requirements.

Methods: To better understand PPE requirements for care of suspected or confirmed COVID-19 patients in our Australian quaternary referral hospital, the number of staff-to-patient interactions in a 24-h period for three patient groups (ward-based COVID suspect, ward-based COVID confirmed, intensive care COVID confirmed) was audited prospectively from 1st to 30th April 2020.

Third generation cephalosporins and piperacillin/tazobactam have distinct impacts on the microbiota of critically ill patients.

Effective implementation of antibiotic stewardship, especially in critical care, is limited by a lack of direct comparative investigations on how different antibiotics impact the microbiota and antibiotic resistance rates. We investigated the impact of two commonly used antibiotics, third-generation cephalosporins (3GC) and piperacillin/tazobactam (TZP) on the endotracheal, perineal and faecal microbiota of intensive care patients in Australia. Patients exposed to either 3GC, TZP, or no β-lactams (control group) were sampled over time and 16S rRNA amplicon sequencing was performed to examine microbiota diversity and composition.

Introducing 1,3-beta-d-glucan for screening and diagnosis of invasive fungal diseases in Australian high-risk haematology patients: is there a clinical benefit?

Background: Early, accurate diagnosis of invasive fungal disease (IFD) improves clinical outcomes. 1,3-beta-d-glucan (BDG) (Fungitell, Associates of Cape Cod, Inc., Falmouth, MA, USA) detection can improve IFD diagnosis but has been unavailable in Australia.

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.

Ethical considerations in the management of Ebola virus disease.

Is it ethically appropriate in some circumstances for HCWs to decline to care for patients with EVD? How should treatment decisions be made regarding limitation of therapy for patients with EVD? There are two main ethical questions regarding the critical care of patients with EVD in an Australian setting: Is it ethically appropriate in some circumstances for HCWs to decline to care for patients with EVD? How should treatment decisions be made regarding limitation of therapy for patients with EVD? The key concern is ensuring that no patient is denied therapy that should be provided, while preventing unnecessary risk to HCWs. It is imperative to develop an approach that facilitates rigorous, evidence-based and ethically justifiable decision making, which should include a predetermined, institutionally endorsed process for assessing difficult clinical scenarios as they arise.

Evaluation of point-of-care testing in critically unwell patients: comparison with clinical laboratory analysers and applicability to patients with Ebolavirus infection.

Data on the performance of point-of-care (POC) or near-patient devices in the management of critically unwell patients are limited, meaning that there are demands for confirming POC test results in the routine clinical laboratory and so potentially leading to delay in treatment provision. We evaluated the performance of the i-STAT CHEM 8+ and CG4+, Hemochron Signature Elite, HemoCue Hb 201+ and WBC Diff Systems on whole blood collected from medical and surgical patients admitted to the intensive care unit at an Australian tertiary care hospital. Measurements obtained for haematology, coagulation, biochemistry and arterial blood gas parameters using POC devices were compared against clinical laboratory analysers (XE-5000, STA-R Evolution, Dimension Vista 1500 and ABL800 FLEX).

Immediate coronary angiogram in comatose survivors of out-of-hospital cardiac arrest--an Australian study.

Introduction: The role of immediate coronary angiography and percutaneous coronary intervention (angio±PCI), amongst comatose survivors of out-of-hospital cardiac arrest is unclear. This study was undertaken to evaluate if immediate angio±PCI compared to no initial intervention improves neurological outcome at hospital discharge amongst comatose survivors of out-of-hospital pulseless ventricular tachycardia (pVT) or ventricular fibrillation (VF).

Methods: All patients admitted to Intensive Care Unit (ICU) following an out-of-hospital VF/pVT arrest from 1/1/2003 to 31/12/2008 were included.

Rapid response systems: a prospective study of response times.

Purpose: The purpose of the study was to evaluate the time taken for delivery of each component of care following patient deterioration and to assess the effect on response times of strategies implemented to improve the system.

Methods: A model identifying the sequence of organizational responses following a patient's unexpected clinical deterioration was developed. The time to key events and interventions from initial deterioration was measured for 3 months in 2005 and again in 2006 at a tertiary care hospital with a rapid response team (RRT) in place.

Does after-hours discharge of ICU patients influence outcome?

Objective: To assess the frequency of after-hours discharges of patients from the intensive care unit and its effect on in-hospital mortality.

Design, Setting And Participants: Observational cohort study conducted in the ICU of Westmead Hospital, a tertiary care teaching hospital in Sydney. All adult patients admitted to the ICU between 1 January 2004 and 31 December 2006 were included in the study cohort.

Do men and women differ in their course following traumatic brain injury? A preliminary prospective investigation of early outcome.

Primary Objective: To examine the effect of a patient's sex on measures of outcome in a matched sample of patients admitted for acute traumatic brain injury (TBI).

Research Design: A prospective multi-centred group comparison study based in metropolitan Sydney, Australia.

Methods And Procedures: Data was collected on 25 women admitted for treatment following non-penetrating TBI.

The incidence of dysautonomia and its relationship with autonomic arousal following traumatic brain injury.

Primary Objective: To determine the incidence of autonomic arousal vs. Dysautonomia following traumatic brain injury (TBI) in an Intensive Care Unit (ICU) setting and to prospectively evaluate these groups against injury severity and outcome variables.

Research Design: Prospective observational group comparison (cohort) study of consecutive ICU admissions to a major trauma hospital over a 2-year period.