The three-dimensional (3D) printing of a flexible trachea
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
SWAPNET: Ethically bankrupt or ethically blinded?
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Introduction of a simple algorithm improves thromboelastography-guided blood product use during cardiac surgery
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Abstracts of the Australian Society of Anaesthetists National Scientific Congress, Melbourne, Victoria, 17 to 20 September 2016
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
The expanding role of extracorporeal membrane oxygenation retrieval services in Australia
Herein we detail the cases of three patients transferred on veno-arterial extracorporeal membrane oxygenation (VA ECMO) from a tertiary referral hospital to an ECMO centre. We highlight the benefits of such a transfer and offer this as a model of care for unwell patients likely to require a prolonged period of ECMO support. (Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Elective use of veno-venous extracorporeal membrane oxygenation and high-flow nasal oxygen for resection of subtotal malignant distal airway obstruction
We describe the use of peripheral veno-venous extracorporeal membrane oxygenation (VV ECMO) and high-flow nasal oxygen as procedural support in a patient undergoing debulking of a malignant tumour of the lower airway. Due to the significant risk of complete airway obstruction upon induction of anaesthesia, ECMO was established while the patient was awake, and was maintained without systemic anticoagulation to minimise the risk of intraoperative bleeding. This case illustrates that ECMO support with high-flow nasal oxygen can be considered as part of the algorithm for airway management during surgery for subtotal lower airw...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Evaluating team-based inter-professional advanced life support training in intensive care —a prospective observational study
Recent focus on national standards within Australian hospitals has prompted a focus on the training of our staff in advanced life support (ALS). Research in critical care nursing has questioned the traditional annual certification of ALS competence as the best method of delivering this training. Simulation and team-based training may provide better ALS education to intensive care unit (ICU) staff. Our new inter-professional team-based advanced life support program involved ICU staff in a large private metropolitan ICU. A prospective observational study using three standardised questionnaires and two multiple choice questio...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Welfare of anaesthesia trainees survey
This study was designed to investigate levels of stress, anxiety or depression and to identify factors compounding or relieving stress in anaesthesia trainees within the Australian and New Zealand College of Anaesthetists (ANZCA) training scheme. An electronic survey was sent to 999 randomly selected trainees and 428 responses were received. In addition to demographics, psychological wellbeing was assessed using the Kessler Psychological Distress Scale (K10) and questions were asked about depression and anxiety, exacerbating factors, personal healthcare and strategies used to manage stress. The majority of respondents (73%...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Prognosis of patients with rheumatic diseases admitted to intensive care
In conclusion, patients with a rheumatic condition admitted to intensive care do not do significantly worse than patients without such a disease. (Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Haptoglobin and free haemoglobin during cardiac surgery —is there a link to acute kidney injury?
The objective of this study was to investigate the influence of perioperative changes in frHb and Hp levels on the incidence of CS-associated (CSA) AKI. After receiving local ethics committee approval and obtaining informed consent from our patients, we analysed the data pertaining to 154 patients undergoing CPB surgery. We recorded frHb and Hp concentrations pre-, intra- and postoperatively and defined AKI using the Kidney Disease Improving Global Outcomes (KDIGO) classification. We observed that frHb levels increased significantly during surgery and then decreased at ten hours thereafter and that Hp levels decreased duri...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
The addition of tick-boxes related to tobacco cessation improves smoking-related documentation in the anaesthesia chart
In this study we evaluated the effect of adding ti ck-boxes for ‘quit advice given’ and ‘referral to GP/Quitline’ to anaesthesia charts of elective surgical patients to assess whether this intervention changed documentation of compliance with the ANZCA guideline. The anaesthesia charts of all smokers were reviewed for evidence of asking, adv ising and referring, over two three-month periods (n=999) separated by the intervention of placing a sticker to modify the preoperative charts of all elective patients which added tick-box prompts of advice and referral. No educational campaigns occurred to encourage tick-box u...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Aetiology of preoperative anaemia in patients undergoing elective cardiac surgery —the challenge of pillar one of Patient Blood Management
Preoperative anaemia is common in patients undergoing cardiac surgery. Whilst there is a strong association with increased morbidity and mortality, it is currently unclear whether treatment of anaemia leads to patient benefit. This retrospective study aimed to determine the aetiology of preoperative anaemia in a cohort of patients undergoing elective cardiac surgery over two years at a tertiary hospital. Laboratory data obtained at the preoperative assessment clinic visit were assessed to stratify patients into four groups —iron deficiency anaemia (IDA), possible IDA, anaemia of chronic disease (ACD) and non-anaemic pati...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Altered blood levels of vitamin D, cathelicidin and parathyroid hormone in patients with sepsis —a pilot study
It has been recognised that vitamin D (VitD) has a potential role in the regulation of inflammation and protection from infection. In a prospective clinical observational pilot study, we investigated the serum levels of 25-hydroxyvitamin-D3 (25(OH)D3), 1,25-hydroxyvitamin-D3 (1,25(OH)2D3), parathyroid hormone (PTH), and cathelicidin in intensive care unit (ICU) patients with or without systemic inflammatory response syndrome (SIRS). We included 32 patients with SIRS (septic patients), 16 ICU patients without SIRS, and 16 healthy controls. To substantiate the findings of the clinical study, we stimulated monocyte-derived ma...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
A cross-sectional overview of the first 4,000 incidents reported to webAIRS, a de-identified web-based anaesthesia incident reporting system in Australia and New Zealand
webAIRS is a web-based de-identified anaesthesia incident reporting system, which was introduced in Australia and New Zealand in September 2009. By July 2016, 4,000 incident reports had been received. The incidents covered a wide range of patient age (90 years), American Society of Anesthesiologists physical status, and body mass index (50 kg/m2). They occurred across a wide range of anaesthesia techniques and grade of anaesthesia provider, and over a wide range of anaesthetising locations and times of day. In a high proportion the outcome was not benign; about 26% of incidents were associated with patient harm and a furth...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
Apnoeic oxygenation during intubation: a systematic review and meta-analysis
Apnoeic oxygenation during intubation is used to prevent desaturation during intubation. The aim of this review was to assess whether apnoeic oxygenation during endotracheal intubation reduced the incidence of hypoxaemia. Five major databases were systematically searched for all relevant studies published up to May 2016. All study designs with a control group and a group receiving apnoeic oxygenation were included in this review. These studies were then assessed for level of evidence and risk of bias. The data were then analysed using a meta-analysis. Eleven studies (six high quality randomised controlled trials, four low ...
Source: Anaesthesia and Intensive Care - January 11, 2017 Category: Anesthesiology Source Type: research
