Postoperative cognitive dysfunction after sevoflurane or propofol general anaesthesia in combination with spinal anaesthesia for hip arthroplasty
It is unknown if the type of general anaesthetic used for maintenance of anaesthesia affects the incidence of postoperative cognitive dysfunction (POCD). The aim of this study was to compare the incidence of POCD in patients administered either sevoflurane or propofol for maintenance of anaesthesia during total hip replacement surgery. Following administration of a spinal anaesthetic, patients received either sevoflurane (n=121) or propofol (n=171) at the discretion of the anaesthetist for maintenance of general anaesthesia to maintain the processed electroencephalogram (bispectral index, BIS) under 60. POCD was assessed p...
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
Vitamin D status and supplementation in adult patients receiving extracorporeal membrane oxygenation
The prevalence of vitamin D deficiency in critical illness is known to be high and associated with adverse clinical outcomes. Patients receiving extracorporeal membrane oxygenation (ECMO) may be at increased risk of vitamin D deficiency due to high severity of acute illness. Challenges with drug dosing in ECMO patients are recognised due to increased volume of distribution and drug absorption to circuit components. To describe the prevalence of vitamin D deficiency in ECMO patients and the effect of intramuscular dosing of cholecalciferol on levels of vitamin D metabolites, and to compare these data with intensive care uni...
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
Retrieval of critically ill adults using extracorporeal membrane oxygenation: the nine-year experience in New South Wales
This study describes the characteristics and outcomes of patients transported by this service. We performed a retrospective observational study and included patients who were transported on ECMO to either of two adult tertiary referral hospitals in Sydney, New South Wales, between February 28, 2007 and February 29, 2016. One hundred and sixty-four ECMO-facilitated transports occurred, involving 160 patients. Of these, 118 patients (74%) were treated with veno-venous (VV) ECMO and 42 patients (26%) were treated with veno-arterial ECMO. The mean (standard deviation, SD) age was 40.4 (15.0) years. Seventy-seven transports (47...
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
Hyperinsulinaemic euglycaemic therapy use in neurogenic stunned myocardium following subarachnoid haemorrhage
We present a 62-year-old female who collapsed with a subarachnoid haemorrhage. This was complicated by profound shock secondary to neurogenic stunned myocardium. As the patient demonstrated life-threatening catecholamine-resistant shock that was unresponsive to conventional treatment measures, hyperinsulinaemic euglycaemic therapy was utilised as a rescue therapy. To our knowledge this has not previously been described in the literature. The patient proceeded to stabilise and made a good recovery. (Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
Adhesive arachnoiditis following inadvertent epidural injection of 2% chlorhexidine in 70% alcohol —partial recovery over the ensuing eight years
We report a case of serious neurologic injury due to inadvertent epidural injection of 8 ml of the antiseptic 2% chlorhexidine in 70% alcohol during a procedure aimed to relieve the pain of labour. This resulted in immediate severe back pain, progressive tetraparesis and sphincter dysfunction caused by damage to the spinal cord and nerve roots. Subacute hydrocephalus necessitated drainage, but cranial nerve and cognitive function were spared. Magnetic resonance imaging documented marked abnormality of the spinal cord and surrounding leptomeninges. In the ensuing eight years, there has been clinical and electrophysiological...
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
Epinephrine (adrenaline) preventing recovery from intraoperative anaphylactic shock complicated by systolic anterior motion of the mitral valve with left ventricular outflow tract obstruction on transoesophageal echocardiography
We describe a case of severe left ventricular outflow tract obstruction (LVOTO) with severe mitral incompetence due to systolic anterior motion of the anterior mitral leaflet (SAM) that was recognised thanks to the immediate availability of transoesophageal echocardiography during the resuscitation of anaphylactic shock. The patient rapidly responded to cessation of the epinephrine (adrenaline) infusion and intravascular volume expansion with intravenous crystalloid. The absence of risk factors for developing SAM/LVOTO serve as a warning to clinicians to consider this diagnosis in all cases of epinephrine non-responsive an...
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
Mostly harmless?
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
The < i > Anaesthesia and Intensive Care < /i > Jeanette Thirlwell Best Paper Award turns 21, and our first Junior Investigator Award
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
A data sharing policy for Anaesthesia and Intensive Care
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
The early history of extracorporeal membrane oxygenation
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - November 7, 2018 Category: Anesthesiology Source Type: research
Anaesthesia —the Gift of Oblivion and the Mystery of Consciousness. Kate Cole-Adams. Published by Text Publishing Company, 2017. ISBN: 9781925498202 (paperback), ISBN: 9781925410525 (e-book); pp. 416. A$32.99
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - September 7, 2018 Category: Anesthesiology Source Type: research
Anaesthesia: The Gift of Oblivion and the Mystery of Consciousness. Kate Cole-Adams. Published by Text Publishing, 2017. ISBN 9781925498202; pp. 416. A$32.99.
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - September 7, 2018 Category: Anesthesiology Source Type: research
Parasitic infections in the intensive care unit
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - September 7, 2018 Category: Anesthesiology Source Type: research
Time for a collaborative approach to airway training
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - September 7, 2018 Category: Anesthesiology Source Type: research
Evaluation of a new bougie design for the difficult airway: a manikin crossover trial
(Source: Anaesthesia and Intensive Care)
Source: Anaesthesia and Intensive Care - September 7, 2018 Category: Anesthesiology Source Type: research
