https://ogma.newcastle.edu.au/vital/access/ /manager/Index ${session.getAttribute("locale")} 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:50479 72 hours with Injury Severity Score (ISS) of >15 were included. Patients were grouped based on number of repeat contrast studies received after initial imaging. Initial vital signs, resuscitation data, and laboratory parameters were collected. Primary outcome was AKI (Kidney Disease: Improving Global Outcomes criteria), and secondary outcomes included contrast-induced acute kidney injury (CI-AKI; >25% or >44 μmol/L increase in creatinine within 72 hours of contrast administration), multiple organ failure, length of stay, and mortality. Results: Six-hundred sixty-three multiple injury patients (age, 45.3 years [SD, 9.1 years]; males, 75%; ISS, 25 (interquartile range, 20–34); mortality, 5.4%) met the inclusion criteria. The incidence of AKI was 13.4%, and CI-AKI was 14.5%. Multivariate analysis revealed that receiving additional contrast doses within the first 72 hours was not associated with AKI (odds ratio, 1.33; confidence interval, 0.80–2.21; p = 0.273). Risk factors for AKI included higher ISS (p < 0.0007), older age (p = 0.0109), higher heart rate (p = 0.0327), lower systolic blood pressure (p = 0.0007), and deranged baseline blood results including base deficit (p = 0.0042), creatinine (p < 0.0001), lactate (p < 0.0001), and hemoglobin (p = 0.0085). Acute kidney injury was associated with worse outcomes (ICU length of stay: 8 vs. 3 days, p < 0.0001; mortality: 16% vs. 3.8%, p < 0.0001; MOF: 42% vs. 6.6%, p < 0.0001). Conclusion: There is a limited role of repeat contrast administration in AKI development in ICU-admitted multiple injury patients. The clinical significance of CI-AKI is likely overestimated, and it should not compromise essential secondary imaging from the ICU. Further prospective studies are needed to verify our results. Level of Evidence: Therapeutic/Care Management; Level III.]]> Wed 26 Jul 2023 18:08:25 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:33092 Wed 04 Sep 2019 09:56:32 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:54517 Tue 27 Feb 2024 15:46:04 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:18174 Tue 23 Jun 2015 18:29:53 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:23713 max reduction and increasing the K_M for the cofactor.]]> Tue 18 Oct 2016 16:59:59 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:54907  15, Abbreviated Injury Scale (AIS) Head < 3 and survived > 48 h. Demographics, physiological and shock resuscitation parameters were collected. The primary outcome was MOF defined by a Denver Score > 3. Secondary outcomes: intensive care unit length of stay (ICU LOS), ventilation days and mortality. Results: Three hundred and forty-seven patients met inclusion criteria (age 48 ± 20; ISS 30 ± 11, 248 (71%) were males and 23 (6.6%) patients died. The 74 (21%) MOF patients (maximum Denver Score: 5.5 ± 1.8; Duration; 5.6 ± 5.8 days) had higher ISS (32 ± 11 versus 29 ± 11) and were older (54 ± 19 versus 46 ± 20 years) than non-MOF patients. Mean daily Denver scores adjusted for age, sex, MOF and ISS did not change over time. Crystalloid usage decreased over the 10-year period (p value < 0.01) and PRBC increased (p value < 0.01). Baseline cumulative incidence of MOF at 28 days was 9% and competing risk analyses showed that incidence of MOF increased over time (subdistribution hazard ratio 1.14, 95% CI 1.04 to 1.23, p value < 0.01). Mortality risk showed no temporal change. ICU LOS increased over time (subdistribution hazard ratio 0.95, 95% CI 0.92 to 0.98, p value < 0.01). Ventilator days increased over time (subdistribution hazard ratio 0.94, 95% CI 0.9 to 0.97, p value < 0.01). Conclusion: The epidemiology of MOF continues to evolve. Our prospective cohort suggests an ageing population with increasing incidence of MOF, particularly in males, with little changes in injury or shock parameters, who are being resuscitated with less crystalloids, stay longer on ICU without improvement in survival.]]> Thu 21 Mar 2024 11:56:18 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:18322 Sat 24 Mar 2018 08:04:30 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:25252 Sat 24 Mar 2018 07:38:16 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:48680 Mon 27 Mar 2023 14:39:42 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:52701 Mon 23 Oct 2023 14:54:27 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:53032 95%) can be centrifuged/filtered from plasma in the size range of 0.45 to 5 μm, suggesting that there are larger forms of mtDNA-containing complexes in the plasma that could be considered cell-free. Whether this is true for trauma patients (and other relevant disease states) and the clinical relevance of the larger forms of mtDNA is unknown. These findings from healthy individuals also suggest that the centrifugation speeds used to generate cell-free plasma (which are rarely consistent among studies) could result in mixed populations of cell-free mtDNA that could confound associations with outcomes. We demonstrate in this study of 25 major trauma patients that the majority of the cell-free mtDNA in trauma patient plasma (>95%) is removed after centrifugation at 16,000g. Despite the larger forms of mtDNA being predominant, they do not correlate with outcomes or expected parameters such as injury/shock severity, multiple organ failure, and markers of inflammation, whereas low-molecular-weight cell-free mtDNA correlates strongly with these variables.]]> Mon 13 Nov 2023 08:46:11 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:50236 Mon 10 Jul 2023 14:50:01 AEST ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:49358 Fri 12 May 2023 12:35:29 AEST ]]>