Dean R. Chittock

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BACKGROUND Hyperglycemia is associated with increased mortality in critically ill patients. Randomized trials of intensive insulin therapy have reported inconsistent effects on mortality and increased rates of severe hypoglycemia. We conducted a meta-analysis to update the totality of evidence regarding the influence of intensive insulin therapy compared(More)
Assess the risk of complications during endotracheal intubation (ETI) and their association with the skill level of the intubating physician. Prospective cohort study of 136 patients intubated by the intensive care team during a 5-month period. Standardized data forms were used to collect detailed information on the intubating physicians, supervisors,(More)
INTRODUCTION The critical care management of traumatic brain injury focuses on preventing secondary ischemic injury. Cerebral oxygen delivery is dependent upon the cerebral perfusion pressure and the oxygen content of blood, which is principally determined by hemoglobin. Despite its importance to the cerebral oxygen delivery, the precise hemoglobin(More)
BACKGROUND Septic shock is associated with vasopressin deficiency and a hypersensitivity to its exogenous administration. The goal of the current study was to determine whether short-term vasopressin infusion in patients experiencing severe septic shock has a vasopressor sparing effect while maintaining hemodynamic stability and adequate end-organ(More)
Objective: To review all cases of septic shock treated with vasopressin to determine the effects on hemodynamic and renal function and to document any adverse effects. Setting: A 14-bed mixed medical-surgical ICU of St. Paul's Hospital, a 450-bed tertiary referral hospital affiliated with the University of British Columbia. Patients: All ICU patients who(More)
BACKGROUND Whether hypoglycemia leads to death in critically ill patients is unclear. METHODS We examined the associations between moderate and severe hypoglycemia (blood glucose, 41 to 70 mg per deciliter [2.3 to 3.9 mmol per liter] and ≤40 mg per deciliter [2.2 mmol per liter], respectively) and death among 6026 critically ill patients in intensive care(More)
Brain injury remains the leading cause of death in cases of trauma in North America and Europe. This article critically appraised and summarised all published and peer-reviewed, randomised, controlled trials of the use of hypothermia in traumatic brain injury. To be included, a study had to be a published, randomised, controlled trial of the use of(More)
There are no reliable, valid, and responsive scales to measure the quality of sedation in adult critically ill patients. Our objective was to develop a summated rating scale with these properties and to define the minimal clinically important difference (MCID). We developed and tested the scale in an 18-bed medical-surgical intensive care unit (ICU) (12-bed(More)
To compare the effect of intensive versus conventional blood glucose control in patients with traumatic brain injury. In a large international randomized trial patients were randomly assigned to a target blood glucose (BG) range of either 4.5–6.0 mmol/L (intensive control) or <10 mmol/L (conventional control). Patients with traumatic brain injury (TBI) were(More)
The approach to acute cognitive dysfunction varies among physicians, including intensivists. Physicians may differ in their labeling of cognitive abnormalities in critically ill patients. We aimed to survey: (a) what Canadian intensive care unit (ICU) physicians identify as “delirium”; (b) choices of non-pharmacological and pharmacological management; and(More)