Search

Your search keyword '"Seppelt, Ian M."' showing total 196 results
Start Over Author "Seppelt, Ian M."
196 results on '"Seppelt, Ian M."'

2. Protocol summary and statistical analysis plan for the low oxygen intervention for cardiac arrest injury limitation (LOGICAL) trial

Author

Young, Paul J., Hodgson, Carol L., Mackle, Diane, Mather, Anne M., Beasley, Richard, Bellomo, Rinaldo, Bernard, Stephen, Brickell, Kathy, Deane, Adam M., Eastwood, Glenn, Finfer, Simon, Higgins, Alisa M., Hunt, Anna, Lawrence, Cassie, Linke, Natalie J., Litton, Edward, McDonald, Christine F., Moore, James, Nichol, Alistair D., Olatunji, Shaanti, Parke, Rachael L., Peake, Sandra, Secombe, Paul, Seppelt, Ian M., Turner, Anne, Trapani, Tony, Udy, Andrew, and Kasza, Jessica

Published
2023
Full Text
View/download PDF

5. Dexmedetomidine and Propofol Sedation in Critically Ill Patients and Dose-associated 90-Day Mortality: A Secondary Cohort Analysis of a Randomized Controlled Trial (SPICE III)

Author

Shehabi, Yahya, primary, Serpa Neto, Ary, additional, Bellomo, Rinaldo, additional, Howe, Belinda D., additional, Arabi, Yaseen M., additional, Bailey, Michael, additional, Bass, Frances E., additional, Bin Kadiman, Suhaini, additional, McArthur, Colin J., additional, Reade, Michael C., additional, Seppelt, Ian M., additional, Takala, Jukka, additional, Wise, Matt P., additional, Webb, Steve A., additional, Mashonganyika, C., additional, McKee, H., additional, Tonks, A., additional, Donnelly, A., additional, Hemmings, N., additional, O’Kane, S., additional, Blakemore, A., additional, Butler, M., additional, Cowdrey, K., additional, Dalton, J., additional, Gilder, E., additional, Long, S., additional, McCarthy, L., additional, McGuinness, S., additional, Parke, R., additional, Chen, Y., additional, McArthur, C., additional, McConnochie, R., additional, Newby, L., additional, Bellomo, R., additional, Eastwood, G., additional, Peck, L., additional, Young, H., additional, Boschert, C., additional, Edington, J., additional, Fletcher, J., additional, Smith, J., additional, Nand, K., additional, Raza, A., additional, Sara, T., additional, Bennett-Britton, J., additional, Bewley, J., additional, Bodenham, V., additional, Cole, L., additional, Driver, K., additional, Grimmer, L., additional, Howie, L., additional, Searles, C., additional, Sweet, K., additional, Webster, D., additional, van Berkel, A., additional, Connor, H., additional, Dennett, J., additional, van Der Graaff, M., additional, Henderson, S., additional, Mehrtens, J., additional, Miller, K., additional, Minto, E., additional, Morris, A., additional, Noble, S., additional, Parker, K., additional, Bulfin, L., additional, Hart, N., additional, Shepherd, K., additional, Vij, S., additional, Dickson, S., additional, Elloway, E., additional, Ferguson, C., additional, Jackson, R., additional, MacNaughton, P., additional, Marner, M., additional, Squire, R., additional, Waddy, S., additional, Wafer, P., additional, Welbourne, J., additional, Ashcroft, P., additional, Chambler, D., additional, Dukes, S., additional, Harris, A., additional, Horton, S., additional, Sharpe, S., additional, Williams, P., additional, Williams, S., additional, Bailey, M., additional, Blazquez, E., additional, France, D., additional, Hutchison, R., additional, O’Connor, A., additional, Comadira, G., additional, Gough, M., additional, Tallott, M., additional, Bastick, M., additional, Cameron, R., additional, Donovan, S., additional, Ellis, K., additional, Gaur, A., additional, Gregory, R., additional, Naumoff, J., additional, Turner, E., additional, White, M., additional, Au, K. F. J., additional, Fratzia, J., additional, Treloar, S., additional, Lim, C. H., additional, Maseeda, Y., additional, Tan, A. P., additional, Tang, C. L., additional, Yong, C. Y., additional, Akaltan, M., additional, Berger, S., additional, Blaser, D., additional, Fazlija, L., additional, Jong, M. L., additional, Lensch, M., additional, Ludwig, R., additional, Merz, T., additional, Nettelbeck, K., additional, Roth, M., additional, Schafer, M., additional, Takala, J., additional, Wehr, A., additional, Zacharias, D., additional, Amran, R., additional, Ashraf, H. N., additional, Azmi, N., additional, Basri, N., additional, Burhanuddin, H., additional, Hadinata, Y., additional, Hamdan, A., additional, Kadiman, S., additional, Rashid, A. I. Y. M., additional, Sabran, I. N., additional, Sulaiman, S., additional, Zabidi, I. N., additional, Al-Dawood, A., additional, Aljuaid, M., additional, Anizi, H. Al, additional, Saeedi, A. Al, additional, Arabi, Y., additional, Dbsawy, M., additional, Deeb, A., additional, Hegazy, M., additional, Magdi, I., additional, Clarey, E., additional, Corcoran, E., additional, Finney, C., additional, Harris, C., additional, Hopkins, P., additional, Noble, H., additional, Thompson, L., additional, Williams, T., additional, Dumlao, L. A., additional, Bassam, R., additional, Hassan, M. A., additional, Naseem, N., additional, Al-Kurdi, M. H., additional, Al-Harthy, A. M., additional, Bernard, S., additional, Sebafundi, L., additional, Serban, C., additional, Lim, S. K., additional, Mazidah, N., additional, Saidin, N., additional, Sjamsuddin, N., additional, Tan, I. T. A., additional, Zabidi, N., additional, Brain, M., additional, Mineall, S., additional, Kanhere, M., additional, Soar, N., additional, Kadir, N. Abd, additional, Abdullah, N. H., additional, Awang, R., additional, Emperan, Z., additional, Husin, N. S., additional, Ismail, N. I., additional, Ismail, S. Z., additional, Khadzali, F. N. A. Mohd, additional, Norddin, M. F., additional, Aguila, J., additional, Bold, C., additional, Clatworthy, B., additional, Dias, A., additional, Hogan, C., additional, Kazemi, A., additional, Lai, V., additional, Song, R., additional, Williams, A., additional, Bhatia, D., additional, Elliot, S., additional, Galt, P., additional, Lavrans, K., additional, Ritchie, P., additional, Wang, A., additional, Gresham, R., additional, Lowrey, J., additional, Masters, K., additional, Palejs, P., additional, Seppelt, I., additional, Symonds, F., additional, Weisbrodt, L., additional, Whitehead, C., additional, Babio-Galan, M., additional, Calder, V., additional, Clement, I., additional, Harrison, A., additional, McCullagh, I., additional, Scott, C., additional, Bevan, R., additional, Caniba, S., additional, Hacking, D., additional, Maher, L., additional, Azzolini, M. L., additional, Beccaria, P., additional, Colombo, S., additional, Landoni, G., additional, Leggieri, C., additional, Luca, C., additional, Mamo, D., additional, Moizo, E., additional, Monti, G., additional, Mucci, M., additional, Zangrillo, A., additional, Albania, M., additional, Arora, S., additional, Shi, Y., additional, Abudayah, A., additional, Almekhlafi, G., additional, Al Amodi, E., additional, Al Samarrai, S., additional, Badawi, M., additional, Caba, R. Cubio, additional, Elffaki, O., additional, Mandourah, Y., additional, Valerio, J., additional, Joyce, C., additional, Meyer, J., additional, Saylor, E., additional, Venkatesh, B., additional, Venz, E., additional, Walsham, J., additional, Wetzig, K., additional, Khoo, T. M., additional, Liew, J. E. S., additional, Sakthi, A. N., additional, Zulkurnain, A., additional, Bamford, A., additional, Bergin, C., additional, Carrera, R., additional, Cooper, L., additional, Despy, L., additional, Harkett, S., additional, Mee, L., additional, Reeves, E., additional, Snelson, C., additional, Spruce, E., additional, Cooper, G., additional, Hodgson, R., additional, Pearson, D., additional, Rosbergen, M., additional, Ali, M. N., additional, Bahar, N. I., additional, Ismail, A., additional, Ismail, W. N. W., additional, Samat, N. M., additional, Piah, N. S. M., additional, Rahman, R. Abd, additional, Duroux, M., additional, Ratcliffe, M., additional, Warhurst, T., additional, Buehner, U., additional, Williams, E., additional, Jacques, N., additional, Keating, L., additional, Macgill, S., additional, Tamang, K. L., additional, Tolan, N., additional, Walden, A., additional, Bower, R., additional, Cranshaw, J., additional, Molloy, K., additional, Pitts, S., additional, Butler, J., additional, Dunlop, R., additional, Fourie, C., additional, Jarrett, P., additional, Lassig-Smith, M., additional, Livermore, A., additional, O’Donoghue, S., additional, Reade, M., additional, Starr, T., additional, Stuart, J., additional, Campbell, L., additional, Phillips, M., additional, Stephens, D., additional, Thomas, J., additional, Cooper, D., additional, McAllister, R., additional, Andrew, G., additional, Barclay, L., additional, Dawson, H., additional, Griffith, D. M., additional, Hope, D., additional, Wojcik, G., additional, McCulloch, C., additional, Paterson, R., additional, Ascough, L., additional, Paisley, C., additional, Patrick-Heselton, J., additional, Shaw, D., additional, Waugh, V., additional, Williams, K., additional, Welters, I., additional, Barge, D., additional, Jordan, A., additional, MacIsaac, C., additional, Rechnitzer, T., additional, Bass, F., additional, Gatward, J., additional, Hammond, N., additional, Janin, P., additional, Stedman, W., additional, Yarad, E., additional, Razak, N. A., additional, Dzulkipli, N., additional, Jong, S. L., additional, Asen, K., additional, Voon, W. L., additional, Liew, S., additional, Ball, J., additional, Barnes, V., additional, Dalton, C., additional, Farnell-Ward, S., additional, Farrah, H., additional, Maher, K., additional, Mellinghoff, J., additional, Ryan, C., additional, Shirley, P., additional, Conlon, L., additional, Glover, A., additional, Martin-Loeches, I., additional, O’Toole, E., additional, Ewan, J., additional, Ferrier, J., additional, Litton, E., additional, Webb, S. A., additional, Berry, W., additional, Blanco Alonso, U., additional, Bociek, A., additional, Campos, S., additional, Jawara, S., additional, Hanks, F., additional, Kelly, A., additional, Lei, K., additional, McKenzie, C., additional, Ostermann, M., additional, Wan, R., additional, Al-Soufi, S., additional, Leow, S., additional, McCann, K., additional, Reynolds, C., additional, Brickell, K., additional, Fahey, C., additional, Hays, L., additional, Hyde, N., additional, Nichol, A., additional, Ryan, D., additional, Brailsford, J., additional, Buckley, A., additional, Forbes, L., additional, Maguire, T., additional, Moore, J., additional, Murray, L., additional, Ghosh, A., additional, Park, M., additional, Said, S., additional, Visser, A., additional, Abidin, H. Z., additional, Ali, S., additional, Hassan, M. H., additional, Omar, S. C., additional, Shukeri, W. F. W., additional, Brealey, D., additional, Bercades, G., additional, Blackburn, E., additional, Macallum, N., additional, Macklin, A., additional, Ryu, J. H., additional, Tam, K., additional, Smyth, D., additional, Arif, A., additional, Bassford, C., additional, Morgan, C., additional, Swann, C., additional, Ward, G., additional, Wild, L., additional, Bone, A., additional, Elderkin, T., additional, Green, D., additional, Sach, D., additional, Salerno, T., additional, Simpson, N., additional, Brohi, F., additional, Clark, M., additional, Williams, L., additional, Brooks, J., additional, Cocks, E., additional, Cole, J., additional, Curtin, J., additional, Davies, R., additional, Hill, H., additional, Morgan, M., additional, Palmer, N., additional, Whitton, C., additional, Wise, M., additional, Baskaran, P., additional, Hasan, M. S., additional, Tham, L. Y., additional, Sol Cruz, R., additional, Dinsdale, D., additional, Edney, S., additional, Firkin, C., additional, FitzJohn, F., additional, Hill, G., additional, Hunt, A., additional, Hurford, S., additional, Jones, G., additional, Judd, H., additional, Latimer-Bell, C., additional, Lawrence, C., additional, Lesona, E., additional, Navarra, L., additional, Robertson, Y., additional, Smellie, H., additional, Vucago, A. M., additional, Young, P., additional, Clark, P., additional, Kong, J., additional, Ho, J., additional, Nayyar, V., additional, and Skelly, C., additional

Published
2023
Full Text
View/download PDF

14. SO YOU WANT TO HELP?

Author

Krin, Charles S, Giannou, Christos, Seppelt, Ian M, Walker, Steve, Mattox, Kenneth L, Wigle, Richard L, and Crippen, David

Published
2010

15. Effect of Selective Decontamination of the Digestive Tract on Hospital Mortality in Critically Ill Patients Receiving Mechanical Ventilation: A Randomized Clinical Trial.

Author

Myburgh, John A., Seppelt, Ian M., Goodman, Fiona, Billot, Laurent, Correa, Maryam, Davis, Joshua S., Gordon, Anthony C., Hammond, Naomi E., Iredell, Jon, Li, Qiang, Micallef, Sharon, Miller, Jennene, Mysore, Jayanthi, Taylor, Colman, Young, Paul J., Cuthbertson, Brian H., Finfer, Simon R., and SuDDICU Investigators for the Australian and New Zealand Intensive Care Society Clinical Trials Group

Subjects
*ANTIBIOTICS, *CROSS infection prevention, *DECONTAMINATION (From gases, chemicals, etc.), *EVALUATION research, *HOSPITAL mortality, *CATASTROPHIC illness, *GASTROINTESTINAL system, *RANDOMIZED controlled trials, *ARTIFICIAL respiration, *INTENSIVE care units, *RESEARCH, *RESEARCH methodology, *COMPARATIVE studies
Abstract

Importance: Whether selective decontamination of the digestive tract (SDD) reduces mortality in critically ill patients remains uncertain.Objective: To determine whether SDD reduces in-hospital mortality in critically ill adults.Design, Setting, and Participants: A cluster, crossover, randomized clinical trial that recruited 5982 mechanically ventilated adults from 19 intensive care units (ICUs) in Australia between April 2018 and May 2021 (final follow-up, August 2021). A contemporaneous ecological assessment recruited 8599 patients from participating ICUs between May 2017 and August 2021.Interventions: ICUs were randomly assigned to adopt or not adopt a SDD strategy for 2 alternating 12-month periods, separated by a 3-month interperiod gap. Patients in the SDD group (n = 2791) received a 6-hourly application of an oral paste and administration of a gastric suspension containing colistin, tobramycin, and nystatin for the duration of mechanical ventilation, plus a 4-day course of an intravenous antibiotic with a suitable antimicrobial spectrum. Patients in the control group (n = 3191) received standard care.Main Outcomes and Measures: The primary outcome was in-hospital mortality within 90 days. There were 8 secondary outcomes, including the proportion of patients with new positive blood cultures, antibiotic-resistant organisms (AROs), and Clostridioides difficile infections. For the ecological assessment, a noninferiority margin of 2% was prespecified for 3 outcomes including new cultures of AROs.Results: Of 5982 patients (mean age, 58.3 years; 36.8% women) enrolled from 19 ICUs, all patients completed the trial. There were 753/2791 (27.0%) and 928/3191 (29.1%) in-hospital deaths in the SDD and standard care groups, respectively (mean difference, -1.7% [95% CI, -4.8% to 1.3%]; odds ratio, 0.91 [95% CI, 0.82-1.02]; P = .12). Of 8 prespecified secondary outcomes, 6 showed no significant differences. In the SDD vs standard care groups, 23.1% vs 34.6% had new ARO cultures (absolute difference, -11.0%; 95% CI, -14.7% to -7.3%), 5.6% vs 8.1% had new positive blood cultures (absolute difference, -1.95%; 95% CI, -3.5% to -0.4%), and 0.5% vs 0.9% had new C difficile infections (absolute difference, -0.24%; 95% CI, -0.6% to 0.1%). In 8599 patients enrolled in the ecological assessment, use of SDD was not shown to be noninferior with regard to the change in the proportion of patients who developed new AROs (-3.3% vs -1.59%; mean difference, -1.71% [1-sided 97.5% CI, -∞ to 4.31%] and 0.88% vs 0.55%; mean difference, -0.32% [1-sided 97.5% CI, -∞ to 5.47%]) in the first and second periods, respectively.Conclusions and Relevance: Among critically ill patients receiving mechanical ventilation, SDD, compared with standard care without SDD, did not significantly reduce in-hospital mortality. However, the confidence interval around the effect estimate includes a clinically important benefit.Trial Registration: ClinicalTrials.gov Identifier: NCT02389036. [ABSTRACT FROM AUTHOR]

Published
2022
Full Text
View/download PDF

26. Early Sedation with Dexmedetomidine in Critically Ill Patients

Author

Shehabi, Yahya, Howe, Belinda D, Bellomo, Rinaldo, Arabi, Yaseen M, Bailey, Michael, Bass, Frances E, Bin Kadiman, Suhaini, McArthur, Colin J, Murray, Lynnette, Reade, Michael C, Seppelt, Ian M, Takala, Jukka, Wise, Matt P, and Webb, Steven A

Subjects
610 Medicine & health
Abstract

BACKGROUND Dexmedetomidine produces sedation while maintaining a degree of arousability and may reduce the duration of mechanical ventilation and delirium among patients in the intensive care unit (ICU). The use of dexmedetomidine as the sole or primary sedative agent in patients undergoing mechanical ventilation has not been extensively studied. METHODS In an open-label, randomized trial, we enrolled critically ill adults who had been undergoing ventilation for less than 12 hours in the ICU and were expected to continue to receive ventilatory support for longer than the next calendar day to receive dexmedetomidine as the sole or primary sedative or to receive usual care (propofol, midazolam, or other sedatives). The target range of sedation-scores on the Richmond Agitation and Sedation Scale (which is scored from -5 [unresponsive] to +4 [combative]) was -2 to +1 (lightly sedated to restless). The primary outcome was the rate of death from any cause at 90 days. RESULTS We enrolled 4000 patients at a median interval of 4.6 hours between eligibility and randomization. In a modified intention-to-treat analysis involving 3904 patients, the primary outcome event occurred in 566 of 1948 (29.1%) in the dexmedetomidine group and in 569 of 1956 (29.1%) in the usual-care group (adjusted risk difference, 0.0 percentage points; 95% confidence interval, -2.9 to 2.8). An ancillary finding was that to achieve the prescribed level of sedation, patients in the dexmedetomidine group received supplemental propofol (64% of patients), midazolam (3%), or both (7%) during the first 2 days after randomization; in the usual-care group, these drugs were administered as primary sedatives in 60%, 12%, and 20% of the patients, respectively. Bradycardia and hypotension were more common in the dexmedetomidine group. CONCLUSIONS Among patients undergoing mechanical ventilation in the ICU, those who received early dexmedetomidine for sedation had a rate of death at 90 days similar to that in the usual-care group and required supplemental sedatives to achieve the prescribed level of sedation. More adverse events were reported in the dexmedetomidine group than in the usual-care group. (Funded by the National Health and Medical Research Council of Australia and others; SPICE III ClinicalTrials.gov number, NCT01728558.).

Published
2019
Full Text
View/download PDF

29. Early Sedation with Dexmedetomidine in Critically Ill Patients

Author

Shehabi, Yahya, primary, Howe, Belinda D., additional, Bellomo, Rinaldo, additional, Arabi, Yaseen M., additional, Bailey, Michael, additional, Bass, Frances E., additional, Bin Kadiman, Suhaini, additional, McArthur, Colin J., additional, Murray, Lynnette, additional, Reade, Michael C., additional, Seppelt, Ian M., additional, Takala, Jukka, additional, Wise, Matt P., additional, and Webb, Steven A., additional

Published
2019
Full Text
View/download PDF

31. Early sedation with dexmedetomidine in ventilated critically ill patients and heterogeneity of treatment effect in the SPICE III randomised controlled trial.

Author

Shehabi, Yahya, Serpa Neto, Ary, Howe, Belinda D., Bellomo, Rinaldo, Arabi, Yaseen M., Bailey, Michael, Bass, Frances E., Kadiman, Suhaini Bin, McArthur, Colin J., Reade, Michael C., Seppelt, Ian M., Takala, Jukka, Wise, Matt P., Webb, Steve A., The SPICE III Study Investigators, Mashonganyika, C., McKee, H., Tonks, A., Donnelly, A., and Hemmings, N.

Subjects
CRITICALLY ill, DEXMEDETOMIDINE, OLDER patients, BAYESIAN analysis, TREATMENT effectiveness, INTENSIVE care units, RESEARCH, RESEARCH methodology, MEDICAL cooperation, EVALUATION research, CATASTROPHIC illness, IMIDAZOLES, ARTIFICIAL respiration, COMPARATIVE studies, RANDOMIZED controlled trials, PROBABILITY theory
Abstract

Purpose: To quantify potential heterogeneity of treatment effect (HTE), of early sedation with dexmedetomidine (DEX) compared with usual care, and identify patients who have a high probability of lower or higher 90-day mortality according to age, and other identified clusters.Methods: Bayesian analysis of 3904 critically ill adult patients expected to receive invasive ventilation > 24 h and enrolled in a multinational randomized controlled trial comparing early DEX with usual care sedation.Results: HTE was assessed according to age and clusters (based on 12 baseline characteristics) using a Bayesian hierarchical models. DEX was associated with lower 90-day mortality compared to usual care in patients > 65 years (odds ratio [OR], 0.83 [95% credible interval [CrI] 0.68-1.00], with 97.7% probability of reduced mortality across broad categories of illness severity. Conversely, the probability of increased mortality in patients ≤ 65 years was 98.5% (OR 1.26 [95% CrI 1.02-1.56]. Two clusters were identified: cluster 1 (976 patients) mostly operative, and cluster 2 (2346 patients), predominantly non-operative. There was a greater probability of benefit with DEX in cluster 1 (OR 0.86 [95% CrI 0.65-1.14]) across broad categories of age, with 86.4% probability that DEX is more beneficial in cluster 1 than cluster 2.Conclusion: In critically ill mechanically ventilated patients, early sedation with dexmedetomidine exhibited a high probability of reduced 90-day mortality in older patients regardless of operative or non-operative cluster status. Conversely, a high probability of increased 90-day mortality was observed in younger patients of non-operative status. Further studies are needed to confirm these findings. [ABSTRACT FROM AUTHOR]

Published
2021
Full Text
View/download PDF

33. Selective Decontamination of the Digestive Tract and Hospital Mortality in Critically Ill Patients Receiving Mechanical Ventilation—Reply.

Author

Myburgh, John A., Seppelt, Ian M., and Finfer, Simon R.

Subjects
*HOSPITAL mortality, *ALIMENTARY canal, *ARTIFICIAL respiration, *CRITICALLY ill
Abstract

Both Dr Massart and colleagues and Dr Determann and colleagues question the SDD protocol adherence rates and the adequacy of microbiological surveillance in the SuDDICU trial. Comment & Response B In Reply b The SuDDICU trial[1] was designed to determine whether the administration of SDD as a preventive infection control strategy improved patient-centered outcomes, specifically hospital mortality, in intensive care unit patients receiving mechanical ventilation. Selective Decontamination of the Digestive Tract and Hospital Mortality in Critically Ill Patients Receiving Mechanical Ventilation - Reply. [Extracted from the article]

Published
2023
Full Text
View/download PDF

35. End points for phase II trials in intensive care: recommendations from the Australian and New Zealand Clinical Trials Group consensus panel meeting

Author

Paul Young, Carol Hodgson, Joel Dulhunty, Manoj Saxena, Michael John Bailey, Rinaldo Bellomo, Andrew Davies, Simon Finfer, Peter Kruger, Jeffrey Lipman, John Myburgh, Peake, Sandra L., Seppelt, Ian M., Stephen Streat, Rhiannaon Tate, and Steve Webb

Subjects
Clinical Trials, Phase II as Topic, Endpoint Determination, Critical Illness, Sample Size, Outcome Assessment, Health Care, Australia, Humans, New Zealand
Abstract

There is uncertainty about which end points should be used for Phase II trials in critically ill patients.To systematically evaluate potential end points for Phase II trials in critically ill patients.A report outlining a process of literature review and recommendations from a consensus meeting conducted on behalf of the Australian and New Zealand Intensive Care Society Clinical Trials Group (ANZICS CTG) in October 2011.The consensus panel concluded that there are no adequately validated end points for Phase II trials in critically ill patients. However, the following were identified as potential Phase II end points: hospital-free days to Day 90, ICU-free days to Day 28, ventilator-free days to Day 28, cardiovascular support-free days to Day 28, and renal replacement therapy-free days to Day 28. We recommend that these end points be evaluated further.

Published
2012

38. COMmunication with Families regarding ORgan and Tissue donation after death in intensive care (COMFORT): protocol for an intervention study.

Author

Potter, Julie E., Herkes, Robert G., Perry, Lin, Elliott, Rosalind M., Aneman, Anders, Brieva, Jorge L., Cavazzoni, Elena, Cheng, Andrew T. H., O'Leary, Michael J., Seppelt, Ian M., Gebski, Val, and COMFORT study investigators

Subjects
ORGAN donation, CRITICAL care medicine, MEDICAL personnel, TERMINAL care, DECISION making in clinical medicine, COMMUNICATION, COMPARATIVE studies, DEATH, DECISION making, EMOTIONS, FAMILIES, INTENSIVE care units, RESEARCH methodology, MEDICAL cooperation, MOTIVATION (Psychology), RESEARCH, EVALUATION research, ACQUISITION of data
Abstract

Background: Discussing deceased organ donation can be difficult not only for families but for health professionals who initiate and manage the conversations. It is well recognised that the methods of communication and communication skills of health professionals are key influences on decisions made by families regarding organ donation.Methods: This multicentre study is being performed in nine intensive care units with follow-up conducted by the Organ and Tissue Donation Service in New South Wales (NSW) Australia. The control condition is pre-intervention usual practice for at least six months before each site implements the intervention. The COMFORT intervention consists of six elements: family conversations regarding offers for organ donation to be led by a "designated requester"; family offers for donation are deferred to the designated requester; the offer of donation is separated from the end-of-life discussion that death is inevitable; it takes place within a structured family donation conversation using a "balanced" approach. Designated requesters may be intensivists, critical care nurses or social workers prepared by attending the three-day national "Family Donation Conversation" workshops, and the half-day NSW Simulation Program. The design is pre-post intervention to compare rates of family consent for organ donation six months before and under the intervention. Each ICU crosses from using the control to intervention condition after the site initiation visit. The primary endpoint is the consent rate for deceased organ donation calculated from 140 eligible next of kin families. Secondary endpoints are health professionals' adherence rates to core elements of the intervention; identification of predictors of family donation decision; and the proportion of families who regret their final donation decision at 90 days.Discussion: The pragmatic design of this study may identify 'what works' in usual clinical settings when requesting organ donation in critical care areas, both in terms of changes in practice healthcare professionals are willing and able to adopt, and the effect this may have on desired outcomes. The findings of this study will be indicative of the potential benefits of the intervention and be relevant and transferrable to clinical settings in other states and countries.Trial Registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12613000815763 (24 July 2013). ClinicalTrials.gov: NCT01922310 (14 August 2013) (retrospectively registered). [ABSTRACT FROM AUTHOR]

Published
2017
Full Text
View/download PDF

43. Clinical stakeholders’ opinions on the use of selective decontamination of the digestive tract in critically ill patients in intensive care units: an international Delphi study

Author

Cuthbertson, Brian H, primary, Campbell, Marion K, additional, MacLennan, Graeme, additional, Duncan, Eilidh M, additional, Marshall, Andrea P, additional, Wells, Elisabeth C, additional, Prior, Maria E, additional, Todd, Laura, additional, Rose, Louise, additional, Seppelt, Ian M, additional, Bellingan, Geoff, additional, and Francis, Jill J, additional

Published
2013
Full Text
View/download PDF

44. A multicentre evaluation of two intensive care unit triage protocols for use in an influenza pandemic

Author

Cheung, Winston K, primary, Myburgh, John, additional, Seppelt, Ian M, additional, Parr, Michael J, additional, Blackwell, Nikki, additional, DeMonte, Shannon, additional, Gandhi, Kalpesh, additional, Hoyling, Larissa, additional, Nair, Priya, additional, Passer, Melissa, additional, Reynolds, Claire, additional, Saunders, Nicholas M, additional, Saxena, Manoj K, additional, and Thanakrishnan, Govindasamy, additional

Published
2012
Full Text
View/download PDF

49. Comparison of four methods for assessing the importance of attitudinal beliefs: An international Delphi study in intensive care settings.

Author

Francis, Jill J., Duncan, Eilidh M., Prior, Maria E., MacLennan, Graeme, Marshall, Andrea P., Wells, Elisabeth C., Todd, Laura, Rose, Louise, Campbell, Marion K., Webster, Fiona, Eccles, Martin P., Bellingan, Geoff, Seppelt, Ian M., Grimshaw, Jeremy M., and Cuthbertson, Brian H.

Subjects
ATTITUDE (Psychology), DELPHI method, CRITICAL care medicine, BELIEF & doubt, PREDICTION (Psychology)
Abstract

Objectives Behaviour change interventions often target 'important' beliefs. The literature proposes four methods for assessing importance of attitudinal beliefs: elicitation frequency, importance ratings, and strength of prediction (bivariate and multivariate). We tested congruence between these methods in a Delphi study about selective decontamination of the digestive tract ( SDD). SDD improves infection rates among critically ill patients, yet uptake in intensive care units is low internationally. Methods A Delphi study involved three iterations ('rounds'). Participants were 105 intensive care clinicians in the United Kingdom, Canada, and Australia/ New Zealand. In Round 1, semi-structured interviews were conducted to elicit beliefs about delivering SDD. In Rounds 2 and 3, participants completed questionnaires, rating agreement and importance for each belief-statement (9-point Likert scales). Belief importance was assessed using elicitation frequency, mean importance ratings, and prediction of global attitude ( Pearson's correlations; beta-weights). Correlations between indices were computed. Results Participants generated 14 attitudinal beliefs. Indices had adequate variation (frequencies: 4-94, mean importance ratings: 4.93-8.00, Pearson's correlations: ±0.09 to ±0.54, beta-weights: ±0.01 to ±0.30). SDD increases antibiotic resistance was the most important belief according to three methods and was ranked second by beta-weights (behind Overall, SDD benefits patients to whom it is delivered). Spearman's correlations were significant for importance ratings with frequencies and correlations. However, other indices were unrelated. The top four beliefs differed according to the measure used. Conclusions Results provided evidence of congruence across three methods for assessing belief importance. Beta-weights were unrelated to other indices, suggesting that they may not be appropriate as the sole method. Statement of contribution What is already known on this subject? Attitudinal beliefs (specific beliefs about the consequences of performing an action) are key to designing interventions to change intentions and behaviour., The literature reports four methods for assessing the importance of attitudinal beliefs: frequency of elicitation in interviews, importance ratings in questionnaires, and strength of prediction (bivariate and multivariate) of global attitude scores., The congruence between these measures of importance is not known., What does this study add? Four indices of importance were examined in a multi-professional, international study about the use of selective digestive decontamination to prevent infection in intensive care settings., Three indices were correlated with one another., Each method used to assess importance produced a different subset of the most important beliefs. Selection of the most important beliefs should use multiple assessment methods., This evidence suggests that multiple regression approaches may not be appropriate as the sole method for assessing belief importance. [ABSTRACT FROM AUTHOR]

Published
2014
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results