17 results on '"Davies, Andrew R."'
Search Results
2. Nutrition Therapy in Australia and New Zealand Intensive Care Units: An International Comparison Study.
- Author
-
Ridley, Emma J., Peake, Sandra L., Jarvis, Matthew, Deane, Adam M., Lange, Kylie, Davies, Andrew R., Chapman, Marianne, and Heyland, Daren
- Subjects
NUTRITION ,INTENSIVE care units ,PATIENTS ,MEDICAL prescriptions ,PROKINETICINS ,GASTROINTESTINAL hormones ,CATASTROPHIC illness ,COMPARATIVE studies ,CRITICAL care medicine ,DIET therapy ,ENTERAL feeding ,GASTROINTESTINAL agents ,INGESTION ,SMALL intestine ,LONGITUDINAL method ,RESEARCH methodology ,MEDICAL cooperation ,PARENTERAL feeding ,DIETARY proteins ,RESEARCH ,SURVEYS ,ETHNOLOGY research ,EVALUATION research ,RETROSPECTIVE studies ,NUTRITIONAL status - Abstract
Background: The Augmented Versus Routine Approach to Giving Energy Trial (TARGET) is the largest blinded enteral nutrition (EN) intervention trial evaluating energy delivery to be conducted in the critically ill. To determine the external validity of TARGET results, nutrition practices in intensive care units (ICUs) in Australia and New Zealand (ANZ) are described and compared with international practices.Methods: This was a retrospective analysis of prospectively collected data for the International Nutrition Surveys, 2007-2013. Data are presented as mean (SD).Results: A total of 17,154 patients (ANZ: n = 2776 vs international n = 14,378) from 923 ICUs (146 and 777, respectively) were included. EN was the most common route of feeding (ANZ: 85%, n = 2365 patients vs international: 84%, n = 12,034; P = .258), and EN concentration was also similar (<1.25 kcal/mL ANZ: 70%, n = 12,396 vs international: 65%, n = 56,891 administrations; P < .001). Protein delivery was substantially below the estimated prescriptions but similar between the regions (0.6 [0.4] g/kg/day vs 0.6 [0.4] g/kg/day; P = .849). Patients in ANZ received slightly more energy (1133 [572] vs 948[536] kcal/day; P < .001), possibly because more energy was prescribed (1947 [348] vs 1747 [376] kcal/day; P < .001), nutrition protocols were more commonly used (98% vs 75%; P < .001) and included recommendations for therapies such as prokinetic agents (87% vs 51%, n = 399; P < .001) and small bowel feeding (62% vs 40%; P < .001) when compared with international ICUs.Conclusions: Key elements of nutrition practice are similar in ANZ and international ICUs. These data can be used to determine the external validity and relevance of TARGET results. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
3. Supplemental parenteral nutrition in critically ill patients: a study protocol for a phase II randomised controlled trial.
- Author
-
Ridley, Emma J., Davies, Andrew R., Parke, Rachael, Bailey, Michael, McArthur, Colin, Gillanders, Lyn, Cooper, David J., McGuinness, Shay, and Supplemental Parenteral Nutrition Clinical Investigators
- Subjects
- *
PARENTERAL feeding , *CRITICALLY ill , *RANDOMIZED controlled trials , *DIET therapy , *CRITICAL care medicine , *HEALTH outcome assessment , *SAMPLE size (Statistics) , *ANTIBIOTICS , *ARTIFICIAL respiration , *CATASTROPHIC illness , *ENTERAL feeding , *EXPERIMENTAL design , *HEALTH status indicators , *LENGTH of stay in hospitals , *INGESTION , *INTENSIVE care units , *RESEARCH protocols , *QUALITY of life , *TIME , *DISCHARGE planning , *TREATMENT effectiveness , *THERAPEUTICS - Abstract
Background: Nutrition is one of the fundamentals of care provided to critically ill adults. The volume of enteral nutrition received, however, is often much less than prescribed due to multiple functional and process issues. To deliver the prescribed volume and correct the energy deficit associated with enteral nutrition alone, parenteral nutrition can be used in combination (termed "supplemental parenteral nutrition"), but benefits of this method have not been firmly established. A multi-centre, randomised, clinical trial is currently underway to determine if prescribed energy requirements can be provided to critically ill patients by using a supplemental parenteral nutrition strategy in the critically ill.Methods/design: This prospective, multi-centre, randomised, stratified, parallel-group, controlled, phase II trial aims to determine whether a supplemental parenteral nutrition strategy will reliably and safely increase energy intake when compared to usual care. The study will be conducted for 100 critically ill adults with at least one organ system failure and evidence of insufficient enteral intake from six intensive care units in Australia and New Zealand. Enrolled patients will be allocated to either a supplemental parenteral nutrition strategy for 7 days post randomisation or to usual care with enteral nutrition. The primary outcome will be the average energy amount delivered from nutrition therapy over the first 7 days of the study period. Secondary outcomes include protein delivery for 7 days post randomisation; total energy and protein delivery, antibiotic use and organ failure rates (up to 28 days); duration of ventilation, length of intensive care unit and hospital stay. At both intensive care unit and hospital discharge strength and health-related quality of life assessments will be undertaken. Study participants will be followed up for health-related quality of life, resource utilisation and survival at 90 and 180 days post randomisation (unless death occurs first).Discussion: This trial aims to determine if provision of a supplemental parenteral nutrition strategy to critically ill adults will increase energy intake compared to usual care in Australia and New Zealand. Trial outcomes will guide development of a subsequent larger randomised controlled trial.Trial Registration: NCT01847534 (First registered 5 February 2013, last updated 14 October 2015). [ABSTRACT FROM AUTHOR]- Published
- 2015
- Full Text
- View/download PDF
4. Use of a concentrated enteral nutrition solution to increase calorie delivery to critically ill patients: a randomized, double-blind, clinical trial.
- Author
-
Peake, Sandra L., Davies, Andrew R., Deane, Adam M., Lange, Kylie, Moran, John L., O'Connor, Stephanie N., Ridley, Emma J., Williams, Patricia J., and Chapman, Marianne J.
- Subjects
BLOOD sugar analysis ,MORTALITY prevention ,CATASTROPHIC illness ,ANTHROPOMETRY ,APACHE (Disease classification system) ,ARTIFICIAL respiration ,CHI-squared test ,CLOSTRIDIOIDES difficile ,CONFIDENCE intervals ,CRITICAL care medicine ,DIARRHEA ,ENTERAL feeding ,DIETARY fiber ,FISHER exact test ,LENGTH of stay in hospitals ,INGESTION ,INTENSIVE care units ,LONGITUDINAL method ,MATHEMATICS ,MEDICAL cooperation ,PARENTERAL feeding ,PROBABILITY theory ,DIETARY proteins ,RESEARCH ,RESEARCH funding ,STATISTICAL sampling ,STATISTICS ,SURVIVAL ,T-test (Statistics) ,PILOT projects ,STATISTICAL power analysis ,DATA analysis ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,BLIND experiment ,DATA analysis software ,DESCRIPTIVE statistics ,KAPLAN-Meier estimator ,LOG-rank test ,MANN Whitney U Test ,THERAPEUTICS - Abstract
Background: Critically ill patients typically receive ~60% of estimated calorie requirements. Objectives: We aimed to determine whether the substitution of a 1.5-kcal/mL enteral nutrition solution for a 1.0-kcal/mL solution resulted in greater calorie delivery to critically ill patients and establish the feasibility of conducting a multicenter, double-blind, randomized trial to evaluate the effect of an increased calorie delivery on clinical outcomes. Design: A prospective, randomized, double-blind, parallel-group, multicenter study was conducted in 5 Australian intensive care units. One hundred twelve mechanically ventilated patients expected to receive enteral nutrition for ≥2 d were randomly assigned to receive 1.5 (n = 57) or 1.0 (n = 55) kcal/mL enteral nutrition solution at a rate of 1 mL/kg ideal body weight per hour for 10 d. Protein and fiber contents in the 2 solutions were equivalent. Results: The 2 groups had similar baseline characteristics (1.5 compared with 1.0 kcal/mL). The mean (±SD) age was 56.4 ± 16.8 compared with 56.5 ± 16.1 y, 74% compared with 75% were men, and the Acute Physiology and Chronic Health Evaluation II score was 23 ± 9.1 compared with 22 ± 8.9. The groups received similar volumes of enteral nutrition solution [1221 mL/d (95% CI: 1120, 1322 mL/d) compared with 1259 mL/d (95% CI: 1143, 1374 mL/d); P = 0.628], which led to a 46% increase in daily calories in the group given the 1.5-kcal/mL solution [1832 kcal/d (95% CI: 1681, 1984 kcal/d) compared with 1259 kcal/d (95% CI: 1143, 1374 kcal/d); P < 0.001]. The 1.5-kcal/mL solution was not associated with larger gastric residual volumes or diarrhea. In this feasibility study, there was a trend to a reduced 90-d mortality in patients given 1.5 kcal/mL [11 patients (20%) compared with 20 patients (37%); P = 0.057]. Conclusions: The substitution of a 1.0- with a 1.5-kcal/mL enteral nutrition solution administered at the same rate resulted in a 46% greater calorie delivery without adverse effects. The results support the conduct of a large-scale trial to evaluate the effect of increased calorie delivery on clinically important outcomes in the critically ill. This trial was registered at Australian New Zealand Clinical Trials (http://www.anzctr.org.au/) as ACTRN 12611000793910. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
5. Mean perfusion pressure deficit during the initial management of shock-an observational cohort study.
- Author
-
Panwar, Rakshit, Lanyon, Nicholas, Davies, Andrew R., Bailey, Michael, Pilcher, David, and Bellomo, Rinaldo
- Subjects
ARTERIAL physiology ,HOSPITAL admission & discharge ,HYPERTENSION ,CARDIOVASCULAR disease diagnosis ,PATIENTS ,SHOCK (Pathology) ,ACADEMIC medical centers ,ANESTHESIA ,APACHE (Disease classification system) ,BLOOD pressure ,BODY weight ,CONFIDENCE intervals ,CRITICAL care medicine ,LENGTH of stay in hospitals ,INTENSIVE care units ,LONGITUDINAL method ,MEDICAL protocols ,MULTIPLE organ failure ,PERFUSION ,VASOPRESSIN ,DATA analysis ,DATA analysis software ,THERAPEUTICS - Abstract
Purpose: It is unclear if blood pressure targets for patients with shock should be adjusted to pre-morbid levels. We aimed to investigate mean deficit between the achieved mean perfusion pressure (MPP) in vasopressor-treated patients and their estimated basal (resting) MPP, and assess whether MPP deficit has any association with subsequent acute kidney injury (AKI). Materials and Methods: Fifty-one consecutive, non-trauma patients, aged ⩾40 years, with ⩾2 organ dysfunction and requiring vasopressor ⩾4 hours were observed at an academic intensive care unit. Mean MPP deficit [=%(basal MPP - achieved MPP)/basal MPP] and % time spent with >20% MPP deficit were assessed during initial 72 vasopressor hours (T0-T72) for each patient. Results: Achieved MPP was unrelated to basal MPP (P = .99). Mean MPP deficit was 18%(95%CI 15-21). Patients spent 48% (95% CI 39-57) time with >20% MPP deficit. Despite similar risk scores at T0, subsequent AKI (⩾2 RIFLE class increase from T0) occurred more frequently in patients with higher (Nmedian) MPP deficit compared to patients with lower MPP deficit (56% vs 28%; P = .045). Incidence of subsequent AKI was also higher among patients who spent greater % time with >20% MPP deficit (P = .04). Conclusions: Achieved blood pressure during vasopressor therapy had no relationship to the pre-morbid basal level. This resulted in significant and varying degree of relative hypotension (MPP deficit), which could be a modifiable risk factor for AKI in patients with shock. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
6. Early Parenteral Nutrition in Critically III Patients With Short-term Relative Contraindications to Early Enteral Nutrition.
- Author
-
Doig, Gordon S., Simpson, Fiona, Sweetman, Elizabeth A., Finfer, Simon R., Cooper, D. Jamie, Heighes, Philippa T., Davies, Andrew R., O'Leary, Michael, Solano, Tom, and Peake, Sandra
- Subjects
CLINICAL trials ,PARENTERAL feeding ,ENTERAL feeding ,INTENSIVE care units ,QUALITY of life - Abstract
The article presents a study which determined whether providing early parenteral nutrition (PN) to critically ill adults with relative contraindications to early enteral nutrition (EN) alters outcomes and states that as part of the study a clinical trial was conducted between in intensive care units (ICUs) of 31 hospitals in Australia and New Zealand. As mentioned, the main study outcomes were measured for day-60 mortality, quality of life, infections and body composition. The study concluded that the provision of early PN to critically ill adults with relative contraindications to early EN did not result in a difference in day-60 mortality.
- Published
- 2013
- Full Text
- View/download PDF
7. Single-centre experience of donation after cardiac death.
- Author
-
Coulson, Tim G., Pilcher, David V., Graham, Shena M., Snell, Gregory I., Levvey, Bronwyn J., Philpot, Steve, Teo, Alvin, and Davies, Andrew R.
- Subjects
ORGAN donation ,TRANSPLANTATION of organs, tissues, etc. ,ORGAN donors ,BRAIN death - Abstract
The article focuses on a study which described the design, development and implementation of an organ and tissue donation following the cardiac death (DCD) program. Study authors evaluated the success of the DCD program and its impact on tissue and organ availability and the number of donors following brain death. They concluded that widespread implementation of DCD across Australia may reduce the deficiencies in organ transplantation.
- Published
- 2012
- Full Text
- View/download PDF
8. Nutritional therapy in patients with acute pancreatitis requiring critical care unit management: A prospective observational study in Australia and New Zealand.
- Author
-
Davies, Andrew R., Morrison, Siouxzy S., Ridley, Emma J., Bailey, Michael, Banks, Merrilyn D., Cooper, David J., Hardy, Gil, McIlroy, Kerry, and Thomson, Andrew
- Subjects
- *
PANCREATITIS , *CATASTROPHIC illness , *PARENTERAL feeding , *DIET therapy , *INTENSIVE care units - Abstract
The article examines the nutritional therapy practices of patients with severe acute pancreatitis in Australia and New Zealand. The study focuses on the patients' choice of enteral nutrition or parenteral nutrition. The results of the study revealed that enteral nutrition is most commonly used in intensive care unit patients, but parenteral nutrition is more often used as the initial route of nutritional therapy. It was also found out that there is a tendency toward higher mortality for patients who only received parenteral nutrition.
- Published
- 2011
- Full Text
- View/download PDF
9. Safer hours for doctors and improved safety for patients.
- Author
-
Kevat, Dev A. S., Cameron, Peter A., Davies, Andrew R., Landrigan, Chris P., and Rajaratnam, Shantha W.
- Subjects
MEDICAL care ,SLEEP deprivation ,SURGICAL complications ,MEDICAL personnel ,SAFETY - Abstract
The article presents information on the increasing concern over safety of medical care in Australia. According to a report, sleep deprivation of doctors were linked to increased risk of surgical complications. It is stated that with an increase in junior doctor workforce and the increasing concern over safety provides an opportunity for implementing best-practice workplace as well as roster reforms.
- Published
- 2014
- Full Text
- View/download PDF
10. Long-term quality of life in patients with acute respiratory distress syndrome requiring extracorporeal membrane oxygenation for refractory hypoxaemia.
- Author
-
Hodgson CL, Hayes K, Everard T, Nichol A, Davies AR, Bailey MJ, Tuxen DV, Cooper DJ, and Pellegrino V
- Subjects
- Adult, Australia epidemiology, Disabled Persons, Female, Follow-Up Studies, Humans, Influenza A Virus, H1N1 Subtype, Intensive Care Units, Length of Stay, Male, Mental Health, Pneumonia, Viral epidemiology, Respiratory Distress Syndrome etiology, Retrospective Studies, Return to Work statistics & numerical data, Extracorporeal Membrane Oxygenation, Hypoxia therapy, Quality of Life, Respiratory Distress Syndrome therapy
- Abstract
Introduction: The purpose of the study was to assess the long term outcome and quality of life of patients with acute respiratory distress syndrome (ARDS) receiving extracorporeal membrane oxygenation (ECMO) for refractory hypoxemia., Methods: A retrospective observational study with prospective health related quality of life (HRQoL) assessment was conducted in ARDS patients who had ECMO as a rescue therapy for reversible refractory hypoxemia from January 2009 until April 2011 in a tertiary Australian centre. Survival and long-term quality of life assessment, using the Short-Form 36 (SF-36) and the EuroQol health related quality of life questionnaire (EQ5D) were assessed and compared to international data from other research groups., Results: Twenty-one patients (mean age 36.3 years) with ARDS receiving ECMO for refractory hypoxemia were studied. Eighteen (86%) patients were retrieved from external intensive care units (ICUs) by a dedicated ECMO retrieval team. Eleven (55%) had H1N1 influenza A-associated pneumonitis. Eighteen (86%) patients survived to hospital discharge. Of the 18 survivors, ten (56%) were discharged to other hospitals and 8 (44%) were discharged directly home. Sequelae and health related quality of life were evaluated for 15 of the 18 (71%) long-term survivors (assessment at median 8 months). Mean SF-36 scores were significantly lower across all domains compared to age and sex matched Australian norms. Mean SF-36 scores were lower (minimum important difference at least 5 points) than previously described ARDS survivors in the domains of general health, mental health, vitality and social function. One patient had long-term disability as a result of ICU acquired weakness. Only 26% of survivors had returned to previous work levels at the time of follow-up., Conclusions: This ARDS cohort had a high survival rate (86%) after use of ECMO support for reversible refractory hypoxemia. Long term survivors had similar physical health but decreased mental health, general health, vitality and social function compared to other ARDS survivors and an unexpectedly poor return to work.
- Published
- 2012
- Full Text
- View/download PDF
11. Enteral nutrition in Australian and New Zealand intensive care units: a point-prevalence study of prescription practices.
- Author
-
Peake SL, Chapman MJ, Davies AR, Moran JL, O'Connor S, Ridley E, and Williams P
- Subjects
- APACHE, Adult, Aged, Australia, Cross-Sectional Studies, Energy Intake, Female, Humans, Length of Stay, Male, Middle Aged, New Zealand, Critical Care, Enteral Nutrition, Practice Patterns, Physicians'
- Abstract
Background: Enteral nutrition (EN) is widely accepted as the preferred method for providing nutrition therapy to critically ill patients. However, optimal energy goals and the best way to achieve those goals are ill defined., Objective: To determine the type and energy concentration of commonly prescribed EN formulations and whether energy-dense formulations (> 1 kcal/mL) are used., Design: Prospective, observational, multicentre, single-day, point-prevalence study., Participants and Setting: All patients present in 38 Australian and New Zealand intensive care units at 10:00 on 17 November 2010., Main Outcome Measures: Demographic data, admission diagnosis and information on EN administration were collected., Results: 522 patients were enrolled. Mean age was 58.7 (SD, 17.3) years, 65% were male and 79% were mechanically ventilated. On study day, 220/522 patients received EN (43%; 95% CI, 39%-48%). ICU admission source, Acute Physiology and Chronic Health Evaluation (APACHE) III diagnostic category, APACHE II score and ventilation on study day predicted receipt of EN. Of those receiving EN, 111/220 (51%; 95% CI, 44%-57%) received a 1 kcal/mL formulation and the remainder received an energy-dense formulation - 2 kcal/mL, 39/220 (18%; 95% CI, 13%-23%); and 1.5 kcal/mL, 32/220 (15%; 95% CI, 10%-20%). There were no significant predictors for receipt of energy-dense versus 1 kcal/mL EN., Conclusions: 1 kcal/mL and energy-dense formulations are administered with about equal frequency in Australian and New Zealand ICUs. This finding supports future research into the evaluation of optimal nutritional delivery amounts using EN formulations with differing energy concentrations.
- Published
- 2012
12. Deep vein thrombosis and pulmonary embolus in patients with traumatic brain injury: a prospective observational study.
- Author
-
Praeger AJ, Westbrook AJ, Nichol AD, Wijemunige R, Davies AR, Lyon SM, Wills JL, Bailey M, Rosenfeld JV, and Cooper DJ
- Subjects
- Adult, Aged, Aged, 80 and over, Anticoagulants therapeutic use, Australia, Humans, Intensive Care Units statistics & numerical data, Leg blood supply, Male, Middle Aged, Pilot Projects, Prospective Studies, Pulmonary Embolism therapy, Venous Thrombosis therapy, Young Adult, Brain Injuries complications, Pulmonary Embolism etiology, Venous Thrombosis etiology
- Abstract
Background: Intensive care patients with traumatic brain injury (TBI) are at high risk of developing deep vein thrombosis (DVT). A high rate of DVT was reported before routine thromboprophylaxis, but the current DVT rate in TBI patients receiving best-practice mechanical and pharmacological prophylaxis is unknown., Objectives: To determine the prevalence of DVT among TBI patients., Design, Participants and Setting: A prospective observational pilot study of adult patients admitted to the intensive care unit of a level 1 trauma centre within 72 hours of sustaining a TBI (Glasgow Coma Scale score _14)., Main Outcome Measures: Rate of DVT determined using twice-weekly compression ultrasound; rate of pulmonary embolism (PE) and length of stay., Results: 36 patients (28 men; mean age, 40.3 years) were included. Six had moderate and 21 had severe TBI. Two patients (6%) developed a DVT and two patients (6%) developed a PE. The proximal leg DVT rate was 3%, but the overall venous thromboembolism rate was 11% (4 patients)., Conclusions: Mechanical and pharmacological prophylaxis appeared to be effective. The incidence of clinically identified PE is of concern and suggests that thromboembolic sources other than large leg veins may not be being adequately controlled by modern thromboprophylaxis regimens.
- Published
- 2012
13. Extracorporeal membrane oxygenation for severe ARDS in pregnant and postpartum women during the 2009 H1N1 pandemic.
- Author
-
Nair P, Davies AR, Beca J, Bellomo R, Ellwood D, Forrest P, Jackson A, Pye R, Seppelt I, Sullivan E, and Webb S
- Subjects
- Adult, Australia epidemiology, Female, Humans, Intensive Care Units, New Zealand epidemiology, Postpartum Period, Pregnancy, Pregnancy Complications blood, Pregnancy Complications epidemiology, Retrospective Studies, Severity of Illness Index, Young Adult, Extracorporeal Membrane Oxygenation, Influenza A Virus, H1N1 Subtype, Influenza, Human epidemiology, Respiratory Distress Syndrome therapy
- Abstract
Purpose: To describe the technical challenges, efficacy, complications and maternal and infant outcomes associated with extracorporeal membrane oxygenation (ECMO) for severe adult respiratory distress syndrome (ARDS) in pregnant or postpartum patients during the 2009 H1N1 pandemic., Methods: Twelve critically ill pregnant and postpartum women were included in this retrospective observational study on the application of ECMO for the treatment of severe ARDS refractory to standard treatment. The study was conducted at seven tertiary hospitals in Australia and New Zealand., Results: Of the 12 patients treated with ECMO, 7 (58%) were pregnant and 5 (42%) were postpartum. Their median (interquartile range [IQR]) age was 29 (26-33) years, 6 (50%) were obese. Two patients were initially treated with veno-arterial (VA) ECMO. All others received veno-venous (VV) ECMO with one or two drainage cannulae. ECMO circuit-related complications were rare, circuit change was needed in only two cases and there was no sudden circuit failure. On the other hand, bleeding was common, leading to relatively large volumes of packed red blood cell transfusion (median [IQR] volume transfused was 3,499 [1,451-4,874] ml) and was the main cause of death (three cases). Eight (66%) patients survived to discharge and seven were ambulant, with normal oxygen saturations. The survival rate of infants whose mothers received ECMO was 71% and surviving infants were discharged home with no sequelae., Conclusions: The use of ECMO for severe ARDS in pregnant and postpartum women was associated with a 66% survival rate. The most common cause of death was bleeding. Infants delivered of mothers who had received ECMO had a 71% survival rate and, like their mothers, had no permanent sequelae at hospital discharge.
- Published
- 2011
- Full Text
- View/download PDF
14. Extracorporeal life support. ECMO patients overestimated.
- Author
-
Davies AR, McArthur C, Seppelt IM, and Webb SA
- Subjects
- Australia epidemiology, Humans, Influenza A Virus, H1N1 Subtype, Influenza, Human epidemiology, New Zealand epidemiology, Extracorporeal Membrane Oxygenation, Respiratory Insufficiency therapy
- Published
- 2010
- Full Text
- View/download PDF
15. The practical experience of managing the H1N1 2009 influenza pandemic in Australian and New Zealand intensive care units.
- Author
-
Harrigan PW, Webb SA, Seppelt IM, O'Leary M, Totaro R, Patterson D, Davies AR, and Streat S
- Subjects
- Australia epidemiology, Comorbidity, Cross Infection epidemiology, Cross Infection prevention & control, Disease Outbreaks prevention & control, Humans, Infection Control, Influenza, Human epidemiology, Influenza, Human prevention & control, New Zealand epidemiology, Pneumonia epidemiology, Pneumonia virology, Polymerase Chain Reaction, Respiration, Artificial, Respiratory Distress Syndrome epidemiology, Cross Infection therapy, Disease Outbreaks statistics & numerical data, Influenza A Virus, H1N1 Subtype, Influenza, Human therapy, Intensive Care Units
- Published
- 2010
16. Comparison of adult patients hospitalised with pandemic (H1N1) 2009 influenza and seasonal influenza during the "PROTECT" phase of the pandemic response.
- Author
-
Davies AR, Webb SA, Seppelt IM, and Bellomo R
- Subjects
- Adult, Australia epidemiology, Humans, Influenza, Human epidemiology, Influenza, Human virology, Retrospective Studies, Disease Outbreaks, Hospitalization statistics & numerical data, Influenza A Virus, H1N1 Subtype, Influenza, Human therapy, Seasons
- Published
- 2010
- Full Text
- View/download PDF
17. Establishment of enteral nutrition: prokinetic agents and small bowel feeding tubes.
- Author
-
Davies AR and Bellomo R
- Subjects
- Australia, Critical Care, Humans, Intestine, Small, Cisapride administration & dosage, Enteral Nutrition, Erythromycin administration & dosage, Metoclopramide administration & dosage
- Abstract
Purpose of Review: Nutritional support is vital to improving the clinical outcomes in patients in the intensive care unit. Enteral nutrition should be administered early and aggressively, thereby reducing the need for parenteral nutrition. Because nasogastric feeding is often associated with gastrointestinal intolerance, recent research has focused on the use of prokinetic agents or small bowel feeding tubes to enhance the successful establishment and maintenance of enteral nutrition., Recent Findings: Prokinetic agents (such as metoclopramide and erythromycin) improve markers of gastric emptying and appear to improve tolerance of enteral nutrition, although their effects on clinical outcomes are not as well established. In comparison with nasogastric feeding, small bowel feeding allows the dysfunctional stomach of the critically ill to be bypassed, thereby reducing the rate of gastrointestinal complications and probably the risk of pneumonia. Small bowel tubes are more difficult to place than nasogastric tubes, although the new Tiger tube appears very promising., Summary: Nasogastric feeding is preferred for almost all patients in the intensive care unit. Metoclopramide is the preferred prokinetic agent, although whether it or erythromycin should be administered to all patients in the intensive care unit or only those with gastrointestinal intolerance remains unknown. Small bowel feeding is not currently recommended for all patients in the intensive care unit because the benefits do not appear to outweigh the logistic and cost considerations. Nevertheless, when gastrointestinal intolerance develops in a nasogastrically fed patient, a small bowel feeding tube should be inserted at the earliest opportunity.
- Published
- 2004
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.