Endobronchial cuff leak: case report of a temporising measure
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Abstracts of Papers
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
A survey of Australian and New Zealand anaesthetists ’ attitudes towards resuscitation orders in the perioperative setting
Not for resuscitation (NFR) orders are often suspended during anaesthesia, as perioperative care is believed to inherently involve the need for resuscitation including ventilation support. Recent legislative changes in Australia, New Zealand and the UK have enacted the binding nature of advance care directives (ACDs) in healthcare. National guidelines regarding codes of practice and government strategic plans for implementing advance care planning have reinforced the role for advance care planning in modern healthcare. We surveyed a random selection of Australian and New Zealand consultant and trainee anaesthetists to asse...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Patient and community attitudes toward perioperative biobanking and genomic research
We surveyed hospital patients and clinicians to ascertain their attitudes to the establishment of a perioperative biobank for future genomics research, and whether the requirements for an opt-out approach to consent can be met. We enrolled hospital patients (n=187), patient spouse/family members (n=64), ethics committee members (n=14), and clinical staff (doctors and nurses [n=67]), and unspecified community members (n=10). They were asked to rate and describe their views on medical research and biobanking, the need for individual consent, and the importance of confidentiality. Of 406 survey forms distributed, 342 (84%) we...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Effect of pre-hospital advanced airway management for out-of-hospital cardiac arrest caused by respiratory disease: a propensity score –matched study
In conclusion, pre-hospital AAM was associated with poor neurological outcome among patients with OHCA caused by intrinsic respiratory disease. (Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
The effect of Rapid Response System revision on standard and specific intensive care unit outcomes in a regional hospital
Hospital systems for the recognition (afferent limb) and management (efferent limb) of deteriorating patients, or Rapid Response Systems (RRSs), are being mandated worldwide, in spite of conflicting evidence regarding their efficacy. We have evaluated the impact of an Adult Deterioration Detection System (Q –ADDS)–based RRS specifically on illness severity at intensive care unit (ICU) admission and ICU length of stay (LOS), as well as previously studied endpoints. We undertook a retrospective, single-centre observational study comparing equivalent 18-month periods before the Q–ADDS–based RRS, a nd after implementat...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Severe hyperkalaemia complicating parathyroidectomy in patients with end-stage renal disease
We evaluated the incidence of perioperative hyperkalaemia in end-stage renal disease (ESRD) patients undergoing parathyroidectomy and investigated possible contributors to this phenomenon. This was a retrospective cohort study looking at patients who had undergone parathyroidectomy for chronic kidney disease –associated mineral bone disease (CKD-MBD) at The Alfred Hospital, Melbourne, since 2001. Baseline demographics including age, gender, aetiology of renal failure and mode of renal replacement therapy as well as anaesthetic technique and duration of surgery were studied as possible contributors. Pe rioperative potassi...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
A snapshot of the oxygenation of mechanically ventilated patients in one Australian intensive care unit
Hyperoxaemia in patients undergoing mechanical ventilation (MV) has been found to be an independent predictor of worse outcome and in-hospital mortality in some conditions. Data suggests that a fraction of inspired oxygen (FiO2) of 0.4 or lower may produce hyperoxaemia although it is commonly accepted without adjustment in ventilator settings. The primary aim of this study was to observe current practice at one Australian tertiary intensive care unit (ICU) with regard to prescription and titration of oxygen (O2) in patients undergoing MV, in particular whether they received higher FiO2 than required according to arterial b...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Relationship between functional status prior to onset of critical illness and mortality: a prospective multicentre cohort study
This prospective study aimed to assess the association between prior functional status and hospital mortality for patients admitted to four intensive care units in Spain between 2006 and 2012. Prior functional status was classified into three groups, using a modification of the Glasgow Outcome Scale (GOS), including group 1 with no limitations on activities of daily living; group 2 with some limitations but self-sufficient; and group 3 who were dependent on others for their activities of daily living. Of the 1,757 patients considered (mean Simplified Acute Physiology Score [SAPS] predicted mortality 14.8% and hospital mort...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Cardiopulmonary resuscitation —from the patient’s perspective
This study aims to understand the knowledge and perspectives of the local community regarding resuscitation options and end-of-life decision-making and to explore ways to improve the quality of end-of-life discussions. An interviewer-administered survey was conducted with a prospectively recruited group of surgical patients admitted postoperatively to the day surgery ward of a single tertiary institution in Singapore from April to May 2015. The survey, modelled after two validated questionnaires, measured patients ’ knowledge, attitudes and preferences regarding CPR in a series of 18 questions. Fifty-one out of 67 (76.1%...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Assessing contemporary intensive care unit outcome: development and validation of the Australian and New Zealand Risk of Death admission model
This study aimed to develop the Australian and New Zealand Risk of Death admission (ANZROD0) model to predict hospital mortality using data available at presentation to ICU and compare its performance with the ANZROD in Australian and New Zealand hospitals. Data pertaining to all ICU admissions between 1 January 2006 and 31 December 2015 were extracted from the Australian and New Zealand Intensive Care Society Adult Patient Database. Hospital mortality was modelled using logistic regression with development (two-thirds) and validation (one-third) datasets. All predictor variables available at ICU admission were considered ...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Efficacy and safety of ultra rapid iron polymaltose infusion during general anaesthesia
To assess the efficacy and safety of ultra rapid (15 minute) infusion of iron polymaltose to iron deficient patients during general anaesthesia, we performed a prospective, interventional non-randomised study on 99 adult patients with iron deficiency with or without anaemia presenting for surgery under general anaesthesia. Over 15 minutes during the maintenance phase of anaesthesia, patients were given iron polymaltose, 500 mg if not anaemic, or 1,000 mg if anaemic. Haemodynamic stability, immediate or delayed iron-related side-effects and efficacy at six weeks were assessed. The incidence of significant hypotension or the...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Coming full circle: thirty years of paediatric fluid resuscitation
Fluid bolus therapy (FBT) is a cornerstone of the management of the septic child, but clinical research in this field is challenging to perform, and hard to interpret. The evidence base for independent benefit from liberal FBT in the developed world is limited, and the Fluid Expansion as Supportive Therapy (FEAST) trial has led to conservative changes in the World Health Organization –recommended approach to FBT in resource-poor settings. Trials in the intensive care unit (ICU) and emergency department settings post-FEAST have continued to explore liberal FBT strategies as the norm, despite a strong signal associating fl...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Endothelial glycocalyx: basic science and clinical implications
This article aims to summarise the literature on the glycocalyx related to its basic science, clinical settings inciting injury, protective strategies and clinical perspectives. Perioperative damage to the glycocalyx structure can increase vascular permeability leading to interstitial fluid shifts, oedema, and increased surgical morbidity. Pathological shedding of the glycocalyx occurs in response to mechanical cellular stress, endotoxins, inflammatory mediators, atrial natriuretic peptide, ischaemia–reperfusion injury, free oxygen radicals and hyperglycaemia. Incr eased understanding of the endothelial glycocalyx may ch...
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
Incident reporting, aviation and anaesthesia
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - May 10, 2017 Category: Anesthesiology Source Type: research
