https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:32716 Wed 18 Jul 2018 16:33:36 AEST ]]> https://ogma.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://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:38898 2 ≥ 97% (23.5 h [interquartile range (IQR) 8–70] vs. 47 h [IQR 11–93], absolute difference, 23 h; 95% CI 8–38), and more time receiving an FiO₂ of 0.21 than patients allocated to usual oxygen therapy (20.5 h [IQR 1–79] vs. 0 h [IQR 0–10], absolute difference, 20 h; 95% CI 14–26). At 90-days, 47 of 130 patients (36.2%) assigned to conservative oxygen and 35 of 120 patients (29.2%) assigned to usual oxygen had died (absolute difference, 7 percentage points; 95% CI − 4.6 to 18.6% points; P = 0.24; interaction P = 0.35 for sepsis vs. non-sepsis). There were no statistically significant differences between groups for secondary outcomes but point estimates of treatment effects consistently favored usual oxygen therapy. Conclusions: Point estimates for the treatment effect of conservative oxygen therapy on 90-day mortality raise the possibility of clinically important harm with this intervention in patients with sepsis; however, our post hoc analysis was not powered to detect the effects suggested and our data do not exclude clinically important benefit or harm from conservative oxygen therapy in this patient group. Clinical Trials Registry: ICU-ROX Australian and New Zealand Clinical Trials Registry number ACTRN12615000957594.]]> Tue 01 Mar 2022 15:43:40 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:38897 Tue 01 Mar 2022 15:34:13 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:27614 Sat 24 Mar 2018 07:39:40 AEDT ]]> https://ogma.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 ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:24441 Sat 24 Mar 2018 07:17:27 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:31005 Mon 23 Sep 2019 10:08:51 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:47387 Mon 16 Jan 2023 15:31:37 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:43365 P = 0.1 adjusted odds ratio 0.54; 95% CI 0.23–1.26; P = 0.15. A total of 37 of 86 patients (43%) assigned to conservative oxygen and 46 of 78 (59%) assigned to usual oxygen had died by day 180; odds ratio 0.53; 95% CI 0.28–0.98; P = 0.04; adjusted odds ratio 0.56; 95% CI 0.25–1.23; P = 0.15. Cause-specific mortality was similar by treatment group. Conclusions: Conservative oxygen therapy was not associated with a statistically significant reduction in death or unfavourable neurological outcomes at day 180. The potential for important benefit or harm from conservative oxygen therapy in HIE patients is not excluded by these data.]]> Fri 16 Sep 2022 08:41:21 AEST ]]>