The Effect of Renal Replacement Therapy and Antibiotic Dose on Antibiotic Concentrations in Critically Ill Patients: Data From the Multinational Sampling Antibiotics in Renal Replacement Therapy Study.

Background: The optimal dosing of antibiotics in critically ill patients receiving renal replacement therapy (RRT) remains unclear. In this study, we describe the variability in RRT techniques and antibiotic dosing in critically ill patients receiving RRT and relate observed trough antibiotic concentrations to optimal targets.

Methods: We performed a prospective, observational, multinational, pharmacokinetic study in 29 intensive care units from 14 countries.

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.

Prospective observational study of levosimendan and weaning of difficult-to-wean ventilator dependent intensive care patients.

Objective: To evaluate the role of levosimendan in improving cardiac performance and the success rate of weaning from mechanical ventilation in ventilatordependent, difficult-to-wean patients with impaired cardiac function in the intensive care unit.

Design And Setting: Prospective, observational study in the ICU of Westmead Hospital, a university-affiliated tertiary referral hospital in Sydney, NSW, between January 2003 and October 2004.

Patients And Interventions: 47 ICU patients who were ventilator-dependent for > or =10 days and had failed a weaning or extubation attempt due to respiratory insufficiency were identified as difficult to wean from mechanical ventilation.

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.

Direct cerebral oxygenation monitoring--a systematic review of recent publications.

This review has been compiled to assess publications related to the clinical application of direct cerebral tissue oxygenation (PtiO2) monitoring published in international, peer-reviewed scientific journals. Its goal was to extract relevant, i.e.

Cerebrovascular autoregulation as a neuroimaging tool.

Functional transcranial Doppler (fTCD) sonography provides a high temporal resolution measure of blood flow and has over the years proved to be a valuable tool in the clinical evaluation of patients with cerebrovascular disorders. More recently, due to advances in physics and computing, it has become possible to derive indices of cerebrovascular autoregulation (CA) as well as cerebrovascular pressure reactivity (CR), using non-invasive techniques. These indices provide a dynamic representation of the brain's regulatory blood flow mechanisms not only in pathological states but also in health.

Multimodality monitoring in severe traumatic brain injury: the role of brain tissue oxygenation monitoring.

Traumatic brain injury (TBI) is a major cause of morbidity and mortality with widespread social, personal, and financial implications for those who survive. TBI is caused by four main events: motor vehicle accidents, sporting injuries, falls, and assaults. Similarly to international statistics, annual incidence reports for TBI in Australia are between 100 and 288 per 100,000.

Cerebral autoregulation and ageing.

Little is known about the effects of ageing on cerebral autoregulation (CA). To examine the relationship between age and CA in adults, we conducted a prospective study using a non-invasive protocol without external stimuli. We studied 32 subjects, aged 23-68 years.

Examining discharge outcomes and health status of critically ill patients: some practical considerations.

This prospective observational study examined the outcomes of 200 consecutive admissions to an adult tertiary level Intensive Care Unit (ICU). Eligible and consenting participants were also involved in a sub-study that examined health status at four measurement points from pre-illness to 6 months post-discharge. Of the 189 individual patients admitted, 23% died in ICU and 57% were discharged home.

Improving the quality of information on pathology request forms.

Background: We have investigated the causes of incomplete pathology request forms received at our clinical chemistry laboratory. Based on a request form audit we found that the data most frequently missing from a pathology request form was the doctor's name, unique identification provider number, or signature.

Methods: We examined the effect of issuing the requesting doctors with self-inking stamps personalized with their name and a unique provider number.

Hemispheric asymmetry and temporal profiles of cerebral pressure autoregulation in head injury.

A moving correlation index (Mx-ABP) between arterial blood pressure (ABP) and mean middle cerebral artery blood flow velocity (CBFV) can be used to monitor dynamic cerebrovascular autoregulation (CA) after traumatic brain injury (TBI). In this study we examined hemispheric CA asymmetry and temporal CA profiles, their relationship with ABP and CBFV, and their prognostic relevance. Mx-ABP was calculated for each hemisphere in 25 TBI patients second-daily for as long as they were receiving sedation and analgesia.

Noninvasive cerebrovascular autoregulation assessment in traumatic brain injury: validation and utility.

A moving correlation index (Mx-CPP) of cerebral perfusion pressure (CPP) and mean middle cerebral artery blood flow velocity (CBFV) allows continuous monitoring of dynamic cerebral autoregulation (CA) in patients with severe traumatic brain injury (TBI). In this study we validated Mx-CPP for TBI, examined its prognostic relevance, and assessed its relationship with arterial blood pressure (ABP), CPP, intracranial pressure (ICP), and CBFV. We tested whether using ABP instead of CPP for Mx calculation (Mx-ABP) produces similar results.