Critical Care and Resuscitation最新文献

{"title":"Intensive care admissions for adults with treated kidney failure in Australia: A national retrospective cohort study","authors":"Dominic Keuskamp PhD ,&nbsp;Christopher E. Davies PhD ,&nbsp;Paul J. Secombe BMBS (Hons) MClinSc FCICM ,&nbsp;David V. Pilcher MBBS MRCP(UK) FRACP FCICM ,&nbsp;Shaila Chavan MSPH ,&nbsp;Sarah L. Jones MBChB (Hons) MRCP(UK) DICM(UK) FCICM FRACP ,&nbsp;Benjamin E. Reddi MA PhD FRCP(UK) FCICM ,&nbsp;Stephen P. McDonald MBBS (Hons) PhD FRACP","doi":"10.1016/j.ccrj.2025.100099","DOIUrl":"10.1016/j.ccrj.2025.100099","url":null,"abstract":"<div><h3>Objective</h3><div>Limited data are available on intensive care unit (ICU) admissions for adults receiving kidney replacement therapy (KRT – dialysis or transplantation) in Australia. Our aim is to characterise admissions for patients receiving long-term dialysis and kidney transplant recipients relative to the general intensive care population in Australia.</div></div><div><h3>Design</h3><div>Retrospective registry-based data linkage cohort study.</div></div><div><h3>Setting</h3><div>All ICUs in Australia that reported to the Australian and New Zealand Intensive Care Society Adult Patient Database, 1 January 2018–31 December 2020.</div></div><div><h3>Participants</h3><div>All admissions were included. Data were deterministically linked to the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry. Subgroups analysed were defined by sex, age, admission type, APACHE III-j diagnostic category, diabetes status, body mass index (BMI), dialysis modality, dialysis vintage, and kidney transplant vintage.</div></div><div><h3>Outcome measures</h3><div>Admission to ICU for patients receiving KRT at the time of admission (as reported to the ANZDATA Registry).</div></div><div><h3>Results</h3><div>Patients receiving long-term dialysis prior to admission and those with a kidney transplant numbered 2826 (0.6% of all admissions) and 1194 (0.3%), respectively. Age-sex standardised admission rates relative to the non-KRT cohort (n = 438,271 or 99.1%) were highest for long-term dialysis patients (relative rate 10.18 [95% CI: 9.46,10.93]) and associated with diabetes and sepsis, cardiovascular and respiratory diagnoses.</div></div><div><h3>Conclusions</h3><div>Rates of ICU admission for people receiving long-term dialysis or kidney transplantation were many times higher than the general population, with particularly increased relative risk among younger age groups and for key medical diagnoses. Given the burden on patients and health services, exploration of strategies to reduce this risk is important.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100099"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mean arterial pressure targets in intensive care unit patients receiving noradrenaline: An international survey","authors":"Paul J. Young MBChB, PhD ,&nbsp;Rinaldo Bellomo MBBS, MD, FCICM, FRACP ,&nbsp;Abdulrahman Al-Fares MBChB, FRCPC, ABIM, MRCP ,&nbsp;David GC. Antognini MBBS ,&nbsp;Yaseen M. Arabi MD ,&nbsp;Muhammad Sheharyar Ashraf MD ,&nbsp;Sean M. Bagshaw MD, MSc ,&nbsp;Alastair J. Brown MBChB ,&nbsp;Sarah Buabbas MD ,&nbsp;Lewis Campbell MBChB, MSc ,&nbsp;Jonathan M. Chen MBChB ,&nbsp;Ross C. Freebairn MBChB ,&nbsp;Tomoko Fujii MD, PhD ,&nbsp;Mohd Shahnaz Hasan MBBS, MAnes ,&nbsp;Aditi Jain DNB, FRCPC, FCCCM, AFIC ,&nbsp;Nai An Lai MBBS, MRCSEd, FRCP(Edin), FCICM ,&nbsp;Sanjay Lakhey MD ,&nbsp;Matthew Mac Partlin MBChB, FCICM, FACEM, MRCPI ,&nbsp;Sam Marment MBChB ,&nbsp;James P.A. McCullough MBChB, MMed ,&nbsp;François Lamontagne MD, MSc","doi":"10.1016/j.ccrj.2024.12.001","DOIUrl":"10.1016/j.ccrj.2024.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate intensive care doctors’ views about a large-scale pragmatic minimum mean arterial pressure (MAP) targets trial and their attitudes and beliefs about minimum MAP targets in different clinical scenarios.</div></div><div><h3>Design</h3><div>An online survey was conducted.</div></div><div><h3>Setting and participants</h3><div>An online survey was distributed to intensive care doctors in sites participating in a large-scale international randomised clinical trial evaluating oxygen therapy targets in 15 countries and to additional intensive care clinicians from Canada.</div></div><div><h3>Main outcome measures</h3><div>Outcomes included the expressed level of support for a large pragmatic trial to evaluate minimum MAP targets in critically ill adults and stated current practice and acceptability of minimum MAP for specific scenarios.</div></div><div><h3>Results</h3><div>The response rate to our survey for respondents who work in sites participating in the mega randomised registry trial research program was 265 out of 701 (37.8%), with an additional 56 out of 256 (21.8%) responses obtained from a direct email containing a link to the survey sent to intensive care clinicians in Canada. A total of 309 of 321 respondents (96.3%) were supportive, in principle, of conducting a very large pragmatic trial to evaluate MAP targets in intensive care unit patients receiving noradrenaline. The commonest response in all scenarios was to agree that the optimal minimum MAP target was uncertain. In all scenarios, except for active bleeding, the most common reported minimum MAP target was 65 mmHg; for patients who were actively bleeding, the most common reported target was 60 mmHg.</div></div><div><h3>Conclusions</h3><div>Our data suggest that intensive care clinicians are broadly supportive of a large-scale pragmatic minimum MAP targets in intensive care unit patients receiving noradrenaline.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100095"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In-hospital mortality in patients admitted to Australian intensive care units with COVID-19 between 2020 and 2024","authors":"Matthew T. Donnan MBBS ,&nbsp;Peinan Zhao PhD ,&nbsp;Allen C. Cheng MBBS PhD ,&nbsp;Aaliya Ibrahim MClinEpid ,&nbsp;Annamaria Palermo RN, BA ,&nbsp;Benjamin Reddi FCICM PhD ,&nbsp;Claire Reynolds MNurs ,&nbsp;Craig French MBBS ,&nbsp;Edward Litton MBChB PhD ,&nbsp;Hannah Rotherham MBBS ,&nbsp;Husna Begum PhD ,&nbsp;Jamie Cooper MD MBBS ,&nbsp;Jodi Dumbrell MPH ,&nbsp;Lewis Campbell FCICM MSc. ,&nbsp;Mark Plummer PhD ,&nbsp;Mahesh Ramanan FCICM MMed ,&nbsp;Patricia Alliegro MD ,&nbsp;Richard E. McAllister RN, BN ,&nbsp;Simon Erickson MBBS, CICM ,&nbsp;Shweta Priyadarshini FCICM MBBS ,&nbsp;Aidan Burrell MBBS PhD","doi":"10.1016/j.ccrj.2024.11.003","DOIUrl":"10.1016/j.ccrj.2024.11.003","url":null,"abstract":"<div><h3>Objective</h3><div>To describe and compare the demographics, management, and outcomes for patients with COVID-19 admitted to intensive care units (ICUs) in Australia across the various waves of the COVID pandemic.</div></div><div><h3>Design, setting, and participants</h3><div>People aged ≥16 years who were admitted to a participating ICU with confirmed COVID-19 in the Short Period Incidence Study of Severe Acute Respiratory Infection (SPRINT-SARI) Australia study between February 2020 and May 2024.</div></div><div><h3>Main outcome measures</h3><div>Primary outcome: In-hospital mortality. Secondary outcomes: ICU mortality; ICU and hospital lengths of stay; supportive and disease-specific therapies.</div></div><div><h3>Results</h3><div>From 27 February 2020 to 18 May 2024, 10171 people were admitted to 72 ICUs with confirmed COVID-19 disease. The <em>Wild Type w</em>ave included 518 (5.1%) patients, the <em>Delta</em> wave 2467 (24.3%) patients, and the <em>Omicron</em> wave 7186 (70.7%) patients. The median (IQR) age was 61 (49–70) years, 54 (41–66) years, and 65 (45–75) years, respectively (P &lt; 0.001). The proportion of vaccinated cases increased in successive waves (1% vs 23.9% vs 65.1%) but plateaued in the <em>Omicron</em> subvariant waves (range 60.0%–71.9%). Invasive mechanical ventilation use decreased across successive waves (52.5% vs 43.6% vs 31.7%, P &lt; 0.001). Use of extracorporeal membrane oxygenation was highest during the <em>Delta</em> wave (3.6%, 83 patients, median duration 18 days [IQR 9.8–35]). Multivariable analysis demonstrated an increased risk of in-hospital mortality among patients admitted during the D<em>elta</em> (adjusted HR 1.80, 95% CI: 1.38–2.35, <em>p</em> &lt; 0.001) and <em>Omicron</em> (adjusted HR 1.88, 95% CI: 1.46–2.42, <em>p</em> &lt; 0.001) waves when compared to the <em>Wild Type</em> wave.</div></div><div><h3>Conclusion</h3><div>COVID-19 continues to manifest significant morbidity and mortality in those requiring ICU admission. Despite a reduced need for ICU level supports, patients admitted during the <em>Omicron</em> wave demonstrated the highest in-hospital mortality.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100094"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sleep in the ICU – A complex challenge requiring multifactorial solutions","authors":"Oystein Tronstad BPhty ,&nbsp;John F. Fraser MBChB, PhD, FRCP Glas, FRCA, FFARCSI, FCICM","doi":"10.1016/j.ccrj.2025.100097","DOIUrl":"10.1016/j.ccrj.2025.100097","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100097"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protocol for the development of NHMRC-endorsed guidelines for extracorporeal membrane oxygenation using GRADE methodology","authors":"Sally F. Newman BN, PGCert ,&nbsp;Zachary Munn PhD, GradDip HlthSc, BMedRad ,&nbsp;Craig French FCICM ,&nbsp;Hergen Buscher DEAA, EDIC, FCICM ,&nbsp;Daniel Thomas Chung BMed MD ,&nbsp;Myles Smith MBBS, MBiostat, EDIC, FCICM ,&nbsp;Madeline Wilkinson MD, MN ,&nbsp;Priya Nair MBBS MD, FCICM, PhD","doi":"10.1016/j.ccrj.2024.11.002","DOIUrl":"10.1016/j.ccrj.2024.11.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The last 15 years have seen a rapid expansion in the use of extracorporeal life support. ECMO has evolved from a rescue treatment available in a few expert centres to an organ support modality for many forms of severe respiratory or cardiovascular failure. There is currently wide variation around the indications for, management of, and systems to support the practice of ECMO. There are few available guidelines on this topic; most have limitations and are not readily generalisable to the Australian or New Zealand healthcare systems.</div></div><div><h3>Methods and analysis</h3><div>This article aims to describe the processes that will be used to produce evidence-based guidelines on the use of ECMO in Australia and New Zealand. The protocol is informed by the National Health and Medical Research Council (NHMRC) Guidelines for Guidelines, and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework.</div><div>Analysis of available evidence on the identified questions follows a three-phase approach. Firstly, published guidelines will be identified and an assessment of their relevance, methodology and validity carried out. If there are no guidelines on the topic, the second step involves a search and evaluation of systematic reviews. Lastly, a de-novo systematic analysis of primary literature will be undertaken where no systematic reviews are available. The development process will be conducted using the GRADEpro and Covidence software for de novo systematic reviews.</div></div><div><h3>Dissemination</h3><div>The guideline will be published in peer-reviewed journals and summaries will be provided to end-users via the GRADEpro GDT application.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100093"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excessive vasopressors or excessive hypotension: Searching for the goldilocks zone in mean arterial pressure targets","authors":"Paul J. Young FCICM, PhD,&nbsp;Kyle C. White FCICM, MPH","doi":"10.1016/j.ccrj.2025.100101","DOIUrl":"10.1016/j.ccrj.2025.100101","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100101"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143535178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume–outcome relationships for tracheostomies in Australia and New Zealand Intensive Care Units: A registry-based retrospective study","authors":"Prashanti Marella MD ,&nbsp;Mahesh Ramanan MMed ,&nbsp;Alexis Tabah PhD ,&nbsp;Ed Litton PhD ,&nbsp;Felicity Edwards BHlthSc ,&nbsp;Kevin B. Laupland PhD","doi":"10.1016/j.ccrj.2024.12.002","DOIUrl":"10.1016/j.ccrj.2024.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>It is unknown whether a volume–outcome relationship exists for patients who receive tracheostomy in the intensive care unit (ICU) as has been observed in other healthcare settings. This study aimed to determine the average number of tracheostomies performed per intensivist per ICU in Australia and New Zealand and associations with case fatality.</div></div><div><h3>Design</h3><div>A retrospective cohort study of adult ICU admissions was conducted.</div></div><div><h3>Setting</h3><div>Data from the Australia and New Zealand Intensive Care Society Adult Patient Database and Critical care resources registry were linked and analysed over the time period extending from 01 January 2018 to 31 March 2023.</div></div><div><h3>Participants</h3><div>The study population included adults (aged ≥18 years) admitted to Australia and New Zealand ICUs who received tracheostomy.</div></div><div><h3>Intervention</h3><div>No intervention was reported.</div></div><div><h3>Main outcome measures</h3><div>The primary exposure variable was tracheostomies per intensivist (TPIs), which was calculated as (the number of patients who had tracheostomy inserted during their ICU admission)/(the total number of intensivists), for each site for each financial year.</div></div><div><h3>Results</h3><div>There were 9318 patients from 172 ICUs over a 5-year period, from January 2018 to March 2023, who received tracheostomies and were included in this analysis. The median TPI value was 3.1 (interquartile range: 1.9–4.3). Raw case fatality in the total cohort was 13.7% (1280/9318). The lowest adjusted risk of death (8.5%, 95% confidence interval: 3.63%–13.36%) was observed when the TPI value was equal to 10.3, with higher risk of death observed at lower values of TPI.</div></div><div><h3>Conclusions</h3><div>A volume–outcome relationship was observed between TPI value and hospital case fatality, with lower case fatality at higher TPI values across the entire range of TPI.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"27 1","pages":"Article 100096"},"PeriodicalIF":1.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is hypernatremia worth its salt?","authors":"Balasubramanian Venkatesh MD, FCICM","doi":"10.1016/j.ccrj.2024.11.001","DOIUrl":"10.1016/j.ccrj.2024.11.001","url":null,"abstract":"","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 4","pages":"Pages 225-226"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of early intravenous amino acid supplementation in critically ill patients without acute kidney injury: Protocol for a multicentre, randomised, parallel-controlled trial (the ESSENTIAL trial)","authors":"Lingliang Zhou MD ,&nbsp;Gordon S. Doig PhD ,&nbsp;Cheng Lv PhD ,&nbsp;Lu Ke PhD ,&nbsp;Weiqin Li PhD ,&nbsp;for the Chinese Critical Care Nutrition Trials Group (CCCNTG)","doi":"10.1016/j.ccrj.2024.10.002","DOIUrl":"10.1016/j.ccrj.2024.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>There is uncertainty about whether early infusion of intravenous amino acids confers clinical benefits in critically ill patients. In this study, we aimed to test the hypothesis that intravenous amino acids could improve 90-day mortality in critically ill patients with normal kidney function.</div></div><div><h3>Design</h3><div>This is a multicentre, open-label, randomised, parallel-controlled trial.</div></div><div><h3>Setting</h3><div>20 ICUs across China.</div></div><div><h3>Participants</h3><div>1928 eligible critically ill patients with normal kidney function.</div></div><div><h3>Interventions</h3><div>In addition to standard care, patients assigned to the intervention group will receive a continuous infusion of amino acids at a rate to achieve a total daily protein intake of approximately 2.0 g/kg/day.</div></div><div><h3>Main outcome measures</h3><div>The primary endpoint is all-cause mortality at day 90 after randomisation. Secondary endpoints and process measures will also be reported. The primary conclusions will be based on a modified intention-to-treat analysis for efficacy.</div></div><div><h3>Ethics and dissemination</h3><div>This study was approved by the ethics committee of the Jinling Hospital, Nanjing University (2020-NZKY-014-02 for the original version and 2020-NZKY-014-06 for the revised version) and all the participating sites. Results will be disseminated through journal publications and conference presentations.</div></div><div><h3>Registration</h3><div>This study protocol was registered with the Chinese Clinical Trial Registry, and the identifier is ChiCTR2100053359 (<span><span>https://www.chictr.org.cn/hvshowprojectEN.html?id=257327&amp;v=1.7</span><svg><path></path></svg></span>).</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 4","pages":"Pages 326-331"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provision of continuous renal replacement therapy in children in intensive care in Australia and New Zealand","authors":"Caroline J. Killick MBBS, LLM, FCICM ,&nbsp;Felix Oberender MBBS, PhD, FCICM ,&nbsp;Subodh Ganu MBBS, MD, MClinEpi ,&nbsp;Kristen Gibbons PhD","doi":"10.1016/j.ccrj.2024.08.007","DOIUrl":"10.1016/j.ccrj.2024.08.007","url":null,"abstract":"<div><h3>Objectives</h3><div>The objective of this study was to describe current use, clinical practice, and outcomes of continuous renal replacement therapy (CRRT) in children in the intensive care unit (ICU) in Australia and New Zealand.</div></div><div><h3>Design</h3><div>retrospective, binational registry-based cohort study and electronic survey of clinical practice.</div></div><div><h3>Setting</h3><div>ICUs that contribute to the Australian and New Zealand Paediatric Intensive Care Registry and a survey conducted in November 2021 including ICUs accredited for paediatric intensive care training that provide CRRT for children were part of this study.</div></div><div><h3>Participants</h3><div>Patients aged &lt;18 years who received renal replacement therapy (RRT) in the ICU were included. Analysis of Australian and New Zealand Paediatric Intensive Care Registry data encompassed admissions from 1 January 2016 to 31 December 2020.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main outcome measures</h3><div>.</div></div><div><h3>Results</h3><div>1378 of 58,736 (2.4%) ICU admissions received RRT (CRRT or peritoneal dialysis [PD]), of which 592 (1.0%) received CRRT. Patients receiving CRRT were older and had a median age of 43 months (interquartile range: 7–130 months) compared to 0.3 months (interquartile range: 0.1–2.6 months) for PD. CRRT was used more commonly in all patient groups (523/626, 84%), except those with congenital heart disease (CHD). The number of admissions receiving CRRT varied between units from 1 to 160 admissions for the 5-year period. Overall ICU mortality for CRRT was 30% (175/592). ICU mortality was the highest in neonates ([51/108] 47%) and in those with CHD ([40/69] 58%). ICU mortality for CRRT decreased over the 5-year study period (35%–22%, <em>p</em> = 0.025). The survey showed consistency in CRRT equipment used between units, but there were differences in choice of dialytic modality and anticoagulation regimen.</div></div><div><h3>Conclusion</h3><div>CRRT is used less frequently than PD in smaller children and in those with CHD. In all other cohorts, it is the predominant mode of RRT. ICU mortality rates were higher for CRRT than for PD, with a large variation in mortality rates across age and diagnostic groups. The CRRT mortality in ICU decreased over the 5 years of the study.</div></div>","PeriodicalId":49215,"journal":{"name":"Critical Care and Resuscitation","volume":"26 4","pages":"Pages 271-278"},"PeriodicalIF":1.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11704422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142957644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}