https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 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:29228 2) of 88-92% (n = 52) or a liberal oxygenation strategy with target SpO₂ of greater than or equal to 96% (n = 51). MeasurementsandMainResults:Themean area under the curve and 95% confidence interval (CI) for SpO₂ (93.4% [92.9-93.9%] vs. 97% [96.5-97.5%]), SaO₂ (93.5% [93.1-94%] vs. 96.8% [96.3-97.3%]), PaO₂ (70 [68-73] mm Hg vs. 92 [89-96] mm Hg), and FIO₂ (0.26 [0.25-0.28] vs. 0.36 [0.34-0.39) in the conservative versus liberal oxygenation arm were significantly different (P < 0.0001 for all). There were no significant between-group differences in any measures of new organ dysfunction, or ICU or 90-day mortality. The percentage time spent with SpO₂ less than 88% in conservative versus liberal arm was 1% versus 0.3% (P = 0.03), and percentage time spent with SpO₂ greater than 98% in conservative versus liberal arm was 4% versus 22% (P < 0.001). The adjusted hazard ratio for 90-day mortality in the conservative arm was 0.77 (95% CI, 0.40-1.50; P = 0.44) overall and 0.49 (95% CI, 0.20-1.17; P = 0.10) in the prespecified subgroup of patients with a baseline PaO₂/FIO₂ less than 300. Conclusions: Our study supports the feasibility of a conservative oxygenation strategy in patients receiving IMV. Larger randomized controlled trials of this intervention appear justified.]]> Sat 24 Mar 2018 07:36:48 AEDT ]]>