https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:39453 Wed 13 Mar 2024 13:53:21 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:44383 Wed 12 Oct 2022 11:13:30 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:41656 Wed 10 Aug 2022 10:49:25 AEST ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:33890 Tue 22 Jan 2019 14:21:58 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:42296  20% as key exposure variables. New significant AKI was defined as an AKI-stage increase of two or more (Kidney Disease: Improving Global Outcome creatinine-based criteria). Measurements and Main Results: The median MPP deficit was 19% (interquartile range, 13–25), and 54% (interquartile range, 19–82) of time points were spent with an MPP deficit > 20%. Seventy-three (24%) patients developed new significant AKI; 86 (29%) patients developed MAKE. For every percentage increase in the time-weighted average MPP deficit, multivariable-adjusted odds of developing new significant AKI and MAKE increased by 5.6% (95% confidence interval, 2.2–9.1; P = 0.001) and 5.9% (95% confidence interval, 2.2–9.8; P = 0.002), respectively. Likewise, for every one-unit increase in the percentage of time points with an MPP deficit > 20%, multivariable-adjusted odds of developing new significant AKI and MAKE increased by 1.2% (0.3–2.2; P = 0.008) and 1.4% (0.4–2.4; P = 0.004), respectively. Conclusions: Vasopressor-treated patients with shock are often exposed to a significant degree and duration of relative hypotension, which is associated with new-onset, adverse kidney-related outcomes.Study registered with Australian New Zealand Clinical Trial Registry (ACTRN 12613001368729).]]> Tue 21 Mar 2023 18:30:16 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:36119 Tue 11 Feb 2020 11:47:06 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:7097 Sat 24 Mar 2018 08:37:59 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:14338 18 years presenting to John Hunter Hospital (JHH), Newcastle, Australia, from January 2007 until July 2007 requiring arterial blood gas sampling had a peripheral venous blood gas performed simultaneously. A survey of JHH trauma clinicians and members of the American Association for the Surgery of Trauma was performed to determine a clinically relevant difference between two serial base deficit measurements. Pearson correlation and Bland-Altman tests were performed. During the 7-month period, 127 patients (79% men, mean age, 46.3 [±18.4 years] and median injury severity score of 15 [interquartile range, 8–23; range, 1–75]) were included into the study. The average peripheral ABD (pABD) and pVBD were −2.2 mmol/L ± 3.8 mmol/L and −1.3 mmol/L ± 3.8 mmol/L, respectively. The average difference between measurements was 0.9 (range, −1.7 to +3.5; 95% confidence interval, 0.7–1.0) with pVBD > pABD. The Pearson test showed highly significant correlation (r = 0.97, p < 0.0001). The survey of 11 JHH and 56 American Association for the Surgery of Trauma clinicians determined 2 mmol/L as clinically relevant difference between two base deficit measurements. All individual paired sample's difference sat within the clinically relevant limits and >95% (121 of 127) of samples sat within the 1.96 standard deviation acceptable by the Bland-Altman plot. There is near perfect correlation and clinically acceptable agreement between pABD and pVBD values on simultaneous testing. pVBD is an acceptable test to assess trauma patients' initial metabolic status when occult blood loss suspected.]]> Sat 24 Mar 2018 08:21:25 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:18141 Sat 24 Mar 2018 08:04:44 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:20346 Sat 24 Mar 2018 08:02:57 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:21784 Sat 24 Mar 2018 08:00:40 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:19102 =10 units of PRBC. Average PRBC use was 7.2 ± 6.6 units and fresh frozen plasma use 4.3 ± 5.2 units. Thirty-nine percent (25/64) had a pelvic ring injury or acetabular fracture. Thirty-seven percent (24/64) had at least one femoral shaft fracture. Twenty patients had a total of 23 tibia fractures. Conclusions: Orthopaedic trauma patients consume the majority of the blood products <24 hours among blunt trauma patients. This resource-intensive group requires frequent urgent surgical interventions and intensive care unit admission.]]> Sat 24 Mar 2018 07:55:50 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:19238 Sat 24 Mar 2018 07:54:55 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:19721 15; age > 18 years, head Abbreviated Injury Scale [AIS] score < 3; and survival for >48 hours). Demographics, injury severity (ISS), physiologic parameters, MOF status based on the Denver score, and outcome data were prospectively collected. Univariate analysis and multivariate logistic modeling were performed; p < 0.05 was considered significant. Data are presented as percentage or mean (SD). RESULTS: A total of 140 patients met the inclusion criteria (age, 47 [21] years; ISS, 30 [11]; male, 69%), 21 patients (15%) developed MOF, and MOF associated mortality was 24% versus non-MOF mortality rate of 3%. Patients who developed MOF had longer ICU stays (19 [7] vs. 7 [5], p < 0.01) and had more ventilator days (18 [9] vs. 4 [4], p < 0.01). Prediction models were generated at two time points as follows: admission and 24 hours after injury. At admission, age (>65 years) and admission platelet count (<150 ✕ 10(9)/L) were significant predictors of MOF; at 24 hours after injury, MOF was predicted by age more than 65 years, admission platelet count less than 150 ✕ 10(9)/L, maximum creatinine of greater than 150 ✕ 10(9)/L and minimum bilirubin of greater than 10 ✕ 10(9)/L. Shock parameters and injury severity did not predict MOF. CONCLUSION: The incidence of MOF (15%) is lower than reported 15 years ago; MOF remains a major cause of ICU resource use and late mortality after injury. The independent predictors of MOF have fundamentally changed, likely owing to improvements in resuscitation and critical care. Current predictors are universally available at admission and 24 hours. LEVEL OF EVIDENCE: Epidemiologic/prognostic study, level III.]]> Sat 24 Mar 2018 07:53:43 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:20178 110 g/l). Conclusion: The prospective evaluation of acutely transfused trauma patients showed a distinct pattern of transfusion triggers as the patient passes from ED to the OT and arrives to the ICU. The conventional transfusion trigger (haemoglobin level) is not appropriate in ET as early transfusion triggers are based on vital signs, blood gas results, injury patterns and anticipated major bleeding.]]> Sat 24 Mar 2018 07:51:40 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:46976 Mon 12 Dec 2022 16:54:26 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:33969 Fri 25 Jan 2019 14:42:24 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:52615 3, 12.7% (95% CI, 9.3-16.1%) in Denver score >3 with blunt injuries only, 28.6% (95% CI, 12-45.1%) in Denver score >8, 25.6% (95% CI, 10.4-40.7%) in Goris score >4, 29.9% (95% CI, 14.9-45%) in Marshall score >5, 20.3% (95% CI, 9.4-31.2%) in Marshall score >5 with blunt injuries only, 38.6% (95% CI, 33-44.3%) in SOFA score >3, 55.1% (95% CI, 49.7-60.5%) in SOFA score >3 with blunt injuries only, and 34.8% (95% CI, 28.7-40.8%) in SOFA score >5. Conclusion: The incidence of postinjury MOF varies largely because of lack of a consensus definition and study population. Until an international consensus is reached, further research will be hindered. Level of Evidence: Systematic Review and Meta-analysis; Level III.]]> Fri 10 Nov 2023 07:10:04 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:39971 Fri 01 Jul 2022 09:16:31 AEST ]]>