Rinaldo Bellomo

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..However, the optimal duration of follow-up for the determination of mortality endpoint in such trials is uncertain. We aimed to determine the most logical and practical mortality end-point in clinical trials of critically ill patients...

..We conducted a study to evaluate the incidence, risk factors and outcomes associated with early acute kidney injury (AKI) in sepsis...

..We describe the incidence, clinical factors and outcomes associated with an early hypoglycemia and BG variability in critically ill patients...

..Urinary interleukin-18 (IL-18) measured during the immediate postoperative period could be a promising predictor of acute kidney injury following adult cardiac surgery...

..Accordingly, we systematically reviewed the literature to assess current knowledge on the histopathology of septic AKI...

..The majority of studies reporting improved patient outcome in association with the introduction of an RRT involve a MET, suggesting that inclusion of a physician in the team is an important determinant of its effectiveness...

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..There was no evidence of viral infiltration on kidney biopsy and the recipient did not develop H1N1 infection...

..That does not confer upon us a freedom to ignore the knowledge we already have, or to postpone the action that it appears to demand at a given time". (Sir Bradford Austin Hill 1)...

..The aim of this study is to evaluate the relationship between timing of renal replacement therapy (RRT) in severe acute kidney injury and clinical outcomes...

..Patients with septic AKI had an increased risk for death and longer duration of hospitalization yet showed trends toward greater renal recovery and independence from RRT...

..To assess the effect of a Medical Emergency Team (MET) service on patient mortality in the 4 years since its introduction into a teaching hospital...

..To compare the value of novel with conventional serum biomarkers in the prediction of acute kidney injury (AKI) in adult cardiac surgical patients according to preoperative renal function...

..The primary objective was to evaluate the rate, characteristics and outcomes of very old (age >or= 80 years) patients admitted to intensive care units (ICUs)...

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..To measure renal blood flow (RBF) and renal function during recovery from experimental septic acute kidney injury (AKI)...

..To describe the quality of postoperative documentation of vital signs and of medical and nursing review and to identify the patient and hospital factors associated with incomplete documentation...

..A large, multiple-center database might be needed to improve the discrimination and calibration of acute renal failure scoring system...

..In summary, this study identifies COMT LL homozygosity as an independent risk factor for shock, AKI, and hospital stay after cardiac surgery. (ClinicalTrials.gov number, NCT00334009)...

..To explore whether fluid resuscitation with normal saline or 4% albumin is associated with differential changes in routine clinical coagulation tests...

..However, standard hemodialysis membranes achieve only little diffusive removal of circulating cytokines. Modified membranes may enable both successful IHD treatment and simultaneous diffusive cytokine removal...

..There was little correlation between the changes in RSNA and renal blood flow, suggesting that the renal vasodilatation was mediated mainly by other mechanisms...

..To evaluate the impact of Rapid Response System (RRS) maturation on delayed Medical Emergency Team (MET) activation and patient characteristics and outcomes...

..Our findings show sustainability and suggest that, for every 17 MET calls, one cardiac arrest might be prevented...

..To assess the effect of high-dose N-acetylcysteine on renal function in cardiac surgery patients at higher risk of postoperative renal failure...

..The choice of vascular access catheter may affect filter life during continuous renal replacement therapy (CRRT); specifically, a new surface-modified catheter has been reported to possibly prevent thrombosis and catheter malfunction...

..However, it has been suggested that NAC may lower plasma creatinine levels independent of any effects on glomerular filtration rate (GFR)...

..Thus, accurate assessment of fluid status and careful definition of targets are needed to improve clinical outcomes. Controlled studies of conservative versus liberal fluid management in patients with AKI or CRS seem justified...

..CONCLUSIONS: Small solute SC and mass transfer during isovolaemic HVHF are significantly affected by the proportion of replacement fluid administered pre-filter. Isovolaemic HVHF is neither isonatraemic nor isochloraemic...

..To describe the characteristics and outcomes of patients receiving a medical emergency team (MET) review for the MET syndromes of respiratory distress or hypotension and to assess the effect of delayed MET activation on their outcomes...

..However, the effect of MD-NE was more pronounced. LDD did not affect other vital organ flows, but MD-NE increased coronary blood flow without any changes in mesenteric and sagittal sinus blood flow...

..However, NIV is sometimes used by the Medical Emergency Team (MET) as respiratory support for ward patients...

..To identify factors that predict outcome in patients receiving a Medical Emergency Team review...

..The choice of definition of acute kidney injury (AKI) might, at least in part, account for such variability...

..Further, we proposed that differences between indirect and direct chloride assays might be explained by interference from other plasma constituents, particularly bicarbonate, and possibly albumin...

..Decreasing the variability of blood glucose concentration might be an important aspect of glucose management...

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..We tested the hypothesis that relative hyperlactatemia is independently associated with an increased risk of hospital death...

..We conclude that cytokine dialysis is achievable through a membrane with a high cut-off point with negligible albumin loss. These findings support the technical feasibility of this new approach to blood purification in sepsis...

..To measure the extended renal hemodynamic changes induced by intravenous radiocontrast...

..Hyperoxia has recently been reported as an independent risk factor for mortality in patients resuscitated from cardiac arrest. We examined the independent relationship between hyperoxia and outcomes in such patients...

..We systematically reviewed the literature comparing loop diuretics with control in the management of ARF...

..Fluid resuscitation with saline in severe sepsis is controversial. Hypertonic (3%) saline (HTS) may be superior to normal (0.9%) saline (NS)...

..However, overall differences between the types of fluid are minor, whereas the volume of fluid administered is a much stronger predictor of such changes, which are also influenced by illness severity and the passage of time...

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..The purpose of the present study was to assess the effect of the MET and other variables on long-term mortality in this patient population...

..Severity scores could be used to predict the hospital outcome for these patients. Their mortality, when treated with CRRT, was similar to that of diagnosis- and severity-score-matched patients with acute renal failure...

..4 vs. 9.7%/ day, p = 0.78). CONCLUSIONS: Post-dilution was associated with reduced filter life without any beneficial effect on daily changes in urea and creatinine levels. Pre-dilution appears a preferable technical approach to CVVH...

..We have recently assessed the feasibility of measuring RBF by means of CPC-MRI in 2 critically ill patients with septic acute kidney injury and were able to compare such measurements to those obtained in a normal volunteer...

..A high cardiac output and the use of large animals predict a decreased RVR, while a decreased cardiac output and the use of small animals predict an increased RVR...

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..When unknown, current recommendations are to estimate a baseline SCr by the MDRD equation. However, the MDRD approach assumes a glomerular filtration rate of approximately 75 mL/min/1.73 m(2). This method has not been validated...

..This observation makes it possible to use Glu(1) as a surrogate of glucose control during ICU stay and opens the door to understanding ICU glucose control across the whole of Australia and New Zealand...

..In vasopressor-dependent patients, we evaluated the impact of a slow blood flow protocol on hypotension when starting continuous renal replacement therapy (CRRT)...

..We investigated if there is an association between choice of insertion side and body position and its changes and circuit life during CRRT with femoral vein access...

..It caused an epidemic of critical illness and some patients developed severe acute respiratory distress syndrome (ARDS) and were treated with extracorporeal membrane oxygenation (ECMO)...

..Accordingly, we studied the characteristics and outcome of patients receiving one MET call and compared them with those receiving multiple MET reviews...

..We speculate that global ischemia may not be the principal mechanism of vital organ dysfunction in hyperdynamic sepsis...

..Recently, extended intermittent dialytic techniques have been proposed for the treatment of ARF. The aim of this study was to compare these two approaches...

..87; 95% CI, 1.07-3.28; P = .03). CONCLUSION: In this multinational study, the period prevalence of ARF requiring RRT in the ICU was between 5% and 6% and was associated with a high hospital mortality rate...

..Isovolemic CVVH is not isonatremic and the use of bicarbonate-buffered fluid results in a significant accumulation of chloride and a loss of magnesium...

..Spironolactone is an aldosterone antagonist that promotes natriuresis and may attenuate such hypernatraemia, but its effect in this setting has not been previously studied...

..We aim to evaluate the incidence and outcome of acute kidney injury (AKI) among critically ill adult patients with H1N1 2009 infection...

..It appears likely that the accumulation of evidence from different settings and situations, though methodologically imperfect, will increase the rationale and logic of RRS. A conclusive randomised controlled trial is unlikely to occur...

..Until such studies are completed, basing international treatment guidelines on a single centre study performed in what may turn out to be a highly atypical environment would seem premature...

..This editorial aims to summarize and interpret recent findings concerning the application of the RIFLE criteria to the assessment of the epidemiology and the prediction of the outcome of ARF...

..Accordingly, we sought to review the available evidence, make recommendations and delineate key questions for future studies...

..More research is required to describe their accuracy, pattern, and time course in patients with septic ARF...

..Whether it is superior to noradrenaline in this setting remains uncertain, and more studies are needed before recommendations can be made...

..001) and higher APACHE III scores (p = 0.016). AKI is relatively common even in patients with TBI. Its association with age and APACHE III scores helps identify patients at higher risk of AKI...

..Nevertheless the high morbidity and mortality associated with severe traumatic brain injury (TBI) demands that we investigate the safety and efficacy of these promising potential therapies as a matter of urgency...

..Here, we outline the rationale for conducting economic evaluations in the critical care setting and argue that these evaluations need to be routinely incorporated into all large-scale clinical trials...

..TIPS FOR RESEARCHERS: The RCTs most likely to be funded and/or be of high quality always address these issues...

..Data from the mid 1970s relating to the clinical features, pathogenesis, treatment and outcome of patients affected by acute renal failure were compared with data reported in the literature in 2005...

..The hospital's medical emergency team expedited involvement of all required services when it was called in twice for episodes of bleeding...

..The hospital's medical emergency team expedited involvement of all required services when it was called in twice for episodes of bleeding...

..The hospital's medical emergency team expedited involvement of all required services when it was called in twice for episodes of bleeding...

..To assess the characteristics of patients who died in a teaching hospital and the role of the medical emergency team (MET) in their end-of-life care...

..Finally, we describe the establishment and objectives of the Australian and New Zealand Intensive Care Research Centre (ANZIC-RC) and outline the Centre's current projects in the context of an integrated research framework...

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..CONCLUSIONS: Blood flow during CRRT can be monitored by an ultrasound Doppler probe and displayed graphically. Preliminary data using this technique suggest potentially serious and undetected problems with blood flow during routine CRRT...

..To determine the incidence and appropriateness of use of allogenic packed red blood cell (RBC) transfusion in Australian and New Zealand intensive care practice...

..Similar developments may be both possible and desirable in other countries...

..To determine the effect on cardiac arrests and overall hospital mortality of an intensive care-based medical emergency team...

..To assess outcomes in patients with spinal cord injury (SCI) and a tracheostomy tube (TT), before and after the introduction of a tracheostomy review and management service (TRAMS) for ward-based patients...

..The Acute Kidney Injury Network (AKIN) group has recently proposed modifications to this system. It is currently unknown whether there are advantages between these criteria...

..The aim of this article is to assess the data on clinical outcomes for critically ill patients admitted to Australian and New Zealand intensive care units in comparison to information available for similar patients in other counties..

..006). Long-term follow-up revealed no complications in either group. CONCLUSIONS: Both percutaneous tracheostomies and surgical tracheostomies can be safely performed at the bedside by experienced, skilled practitioners...

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..Accordingly, the second Acute Dialysis Quality Initiative conference in Vicenza, Italy, was organized, and its goals and rationale are presented in this report...

..CONCLUSIONS: SHF hemofiltration achieved a much greater clearance of myoglobin than conventional hemofiltration, and it may provide a potential modality for the treatment of myoglobinuric acute renal failure...

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..To assess the incidence and nature of postoperative serious adverse events (SAEs) among inpatients having surgery in a tertiary hospital, and to determine which subgroups of patients might be at greatest risk...

..Furthermore, they have allowed improved analysis and characterization of 'at-risk' patients and their needs. Four years later, we remain glad we MET...

..Down-time adversely affects azotaemic control. Physicians prescribing CRRT should be aware of the consequences of such down-time on the quality and quantity of renal replacement therapy delivered...

..If this were to happen, our therapeutic approaches would also be profoundly altered...

..We sought to evaluate the RIFLE criteria on the day of ICU admission in a large heterogenous population of critically ill patients...