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dc.contributor.authorMoore, John PR
dc.contributor.authorAnstey, Chris
dc.contributor.authorMurray, Lauren
dc.contributor.authorFraser, John F
dc.contributor.authorSinger, Mervyn
dc.date.accessioned2019-09-20T01:15:38Z
dc.date.available2019-09-20T01:15:38Z
dc.date.issued2018
dc.identifier.issn2197-425X
dc.identifier.doi10.1186/s40635-018-0179-0
dc.identifier.urihttp://hdl.handle.net/10072/387556
dc.description.abstractBACKGROUND: A dysregulated stress response has been implicated in the pathogenesis of critical illness. Sedative agents utilised in the critically unwell patient may impact upon the stress response with a downstream negative effect on multiple organ systems. This study was designed to assess the feasibility of investigating components of the stress response as a sub-study of the current SPICE-III study (NCT01728558). METHODS: This pilot observational cohort study was conducted in a single intensive care unit in Queensland, Australia. Enrolled patients were over 18 years who had been commenced on mechanical ventilation requiring sedation for less than 12 h but expected to remain ventilated for > 24 h. Blood samples were taken at 12 h intervals over a 5-day period commencing at the time of enrolment, and subsequently tested for various markers of key efferent limbs of the stress axis. RESULTS: The 12 patients recruited closely mirrored the population within the pilot study used to design SPICE-III. Eighty-nine percent (107/120) of all planned blood samples were obtained and drawn within 0 h (0-0.3) of the planned sampling time point. Time from eligibility to enrolment was a median (IQR) 1.4 h (0.36-9.19), and time from eligibility to the first blood sample was 4.79 h (2.0-10.61). Physiological, hormonal, metabolic and cardiac biomarkers were consistent with an elevated stress response at baseline which mostly normalised over the 5-day study period. Plasma noradrenaline levels correlated with the dose of norepinephrine used. CONCLUSIONS: A larger sub-study of the SPICE-III study is feasible. The study has demonstrated a predictable trend of variation of the components of the blood panel during the evolution of critical illness and supports multiple sampling time points for the follow-up study. TRIAL REGISTRATION: ANZCTR.org.au , ACTRN12616001200471, Registered on 22 January 2016.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherSpringer Open
dc.relation.ispartofpagefrom13:1
dc.relation.ispartofpageto13:11
dc.relation.ispartofissue1
dc.relation.ispartofjournalIntensive Care Medicine Experimental
dc.relation.ispartofvolume6
dc.subject.fieldofresearchClinical Sciences
dc.subject.fieldofresearchcode1103
dc.subject.keywordsScience & Technology
dc.subject.keywordsLife Sciences & Biomedicine
dc.subject.keywordsCritical Care Medicine
dc.subject.keywordsGeneral & Internal Medicine
dc.subject.keywordsSedatives
dc.titleAllostasis and sedation practices in intensive care evaluation: an observational pilot study
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationMoore, JPR; Anstey, C; Murray, L; Fraser, JF; Singer, M, Allostasis and sedation practices in intensive care evaluation: an observational pilot study, Intensive Care Medicine Experimental, 2018, 6 (1), pp. 13:1-13:11
dcterms.dateAccepted2018-05-22
dcterms.licensehttp://creativecommons.org/licenses/by/4.0/
dc.date.updated2019-09-20T01:11:51Z
dc.description.versionVersion of Record (VoR)
gro.rights.copyright© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
gro.hasfulltextFull Text
gro.griffith.authorAnstey, Christopher
gro.griffith.authorFraser, John F.


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