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Anaesthesia and Intensive Care

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https://www.readbyqxmd.com/read/29137589/gastric-decompression-before-laparoscopic-entry-via-palmer-s-point
#1
P D Cook, R P Land
No abstract text is available yet for this article.
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137588/sodium-glucose-linked-transporter-2-inhibitor-associated-perioperative-euglycaemic-diabetic-ketoacidosis-a-case-for-a-perioperative-guideline
#2
C Hoffman, M Green, O Megafu
No abstract text is available yet for this article.
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137587/a-lung-model-to-demonstrate-dynamic-gas-trapping-and-intrinsic-positive-end-expiratory-pressure-at-realistic-ventilation-settings
#3
S H Freebairn, R Imlay, E Barrett, Maj Park, R C Freebairn
Intrinsic positive end-expiratory pressure (PEEP) and gas trapping are recognised hazards during ventilation of patients with airflow obstruction. Demonstration of these phenomena on conventional lung models using realistic ventilation settings is difficult. We describe an Intrinsic PEEP Model that is able to demonstrate dynamic gas trapping and intrinsic PEEP at realistic ventilation settings, and demonstrate its ability to develop intrinsic PEEP in a timeframe useful for teaching. The model uses a Heimlich valve to permit a lower resistance on inspiration than expiration...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137586/burnout-and-the-learning-environment-of-anaesthetic-trainees
#4
D J Castanelli, S A Wickramaarachchi, S Wallis
Burnout has a high prevalence among healthcare workers and is increasingly recognised as an environmental problem rather than reflecting a personal inability to cope with work stress. We distributed an electronic survey, which included the Maslach Burnout Inventory Health Services Survey and a previously validated learning environment instrument, to 281 Victorian anaesthetic trainees. The response rate was 50%. We found significantly raised rates of burnout in two of three subscales. Ninety-one respondents (67%) displayed evidence of burnout in at least one domain, with 67 (49%) reporting high emotional exhaustion and 57 (42%) reporting high depersonalisation...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137585/association-of-positive-fluid-balance-and-mortality-in-sepsis-and-septic-shock-in-an-australian-cohort
#5
M G Pittard, S J Huang, A S McLean, S R Orde
In patients with septic shock, a correlation between positive fluid balance and worsened outcomes has been reported in multiple observational studies worldwide. No published data exists in an Australasian cohort. We set out to explore this association in our institution. We conducted a retrospective audit of patient records from August 2012 to May 2015 in a single-centre, 24-bed surgical and medical intensive care unit (ICU) in Sydney, Australia. All patients with septic shock were included. Exclusion criteria included length of stay less than 24 hours or vasopressors needed for less than six hours...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137584/dexmedetomidine-associated-hyperthermia-a-retrospective-cohort-study-of-intensive-care-unit-admissions-between-2009-and-2016
#6
Ked Grayson, A E Tobin, T K Lim, D E Reid, M Ghani
Dexmedetomidine-associated hyperthermia has not been previously studied. Analysis is warranted to determine whether this potentially dangerous complication is more prevalent than previously realised. We aimed to examine the association between dexmedetomidine and temperature ≥39.5°C, including patient characteristics, temporality and potential risk factors. We conducted a retrospective cohort study of all intensive care unit (ICU) admissions between 1 July 2009 and 31 May 2016 in a tertiary ICU in Australia...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137583/the-effect-of-intensive-care-unit-admission-on-smokers-attitudes-and-their-likelihood-of-quitting-smoking
#7
C M Polmear, H Nathan, S Bates, C French, J Odisho, E Skinner, A Karahalios, F McGain
We sought to estimate the proportion of patients admitted to a metropolitan intensive care unit (ICU) who were current smokers, and the relationships between ICU survivors who smoked and smoking cessation and/or reduction six months post-ICU discharge. We conducted a prospective cohort study at a metropolitan level III ICU in Melbourne, Victoria. One hundred consecutive patients who met the inclusion criteria were included in the study. Inclusion criteria consisted of patients who were smokers at time of ICU admission, had an ICU length of stay greater than one day, survived to ICU discharge, and provided written informed consent...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137582/the-effectiveness-of-regional-anaesthesia-before-and-after-the-introduction-of-a-dedicated-regional-anaesthesia-service-incorporating-a-block-room
#8
A Chin, L Heywood, P Iu, A M Pelecanos, M J Barrington
Dedicated regional anaesthesia services incorporating block rooms and/or block teams may facilitate theatre efficiency and improve training in regional anaesthesia. Currently, it is unknown if a dedicated regional anaesthesia service improves the effectiveness of regional anaesthesia. In November 2013, the Royal Brisbane and Women's Hospital established a dedicated regional anaesthesia service comprising a block team and a block room. Pre-intervention (conventional model of care) registry data was retrospectively compared with post-intervention (dedicated regional anaesthesia service) audit data, with regard to pain and opioid requirement in the post-anaesthesia care unit (PACU)...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137581/evidence-of-malignant-hyperthermia-in-patients-administered-triggering-agents-before-malignant-hyperthermia-susceptibility-identified-missed-opportunities-prior-to-diagnosis
#9
T Y Chan, T F Bulger, K M Stowell, R L Gillies, E E Langton, N E Street, N A Pollock
Malignant hyperthermia (MH) is a hypermetabolic disorder of skeletal muscle triggered almost exclusively by potent inhalational agents and suxamethonium. Signs of an MH reaction are non-specific and may be confused with the presentation of other problems such as sepsis and overheating of a patient. A high index of suspicion is needed to be aware of an early presentation of MH. Nine patients are presented who showed abnormal signs with an earlier anaesthetic where the possible diagnosis of an MH reaction was missed...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137580/prevalence-and-predictors-of-persistent-post-surgical-opioid-use-a-prospective-observational-cohort-study
#10
N Stark, S Kerr, J Stevens
Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137579/assessment-of-the-reliability-of-intubation-and-ease-of-use-of-the-cook-staged-extubation-set-an-observational-study
#11
C Furyk, M L Walsh, I Kaliaperumal, S Bentley, C Hattingh
The Staged Extubation Set has recently been introduced by Cook Medical for the management of difficult airway patients who potentially require reintubation; however, its reliability for intubation and ease of use is not reported in the literature. The set contains a wire and reintubation catheter with a central lumen for the wire and oxygenation if required. Reintubation is by a two-stage Seldinger-like technique. After induction of general anaesthesia, 23 low-risk elective surgical patients had the Staged Extubation Wire from the Cook set inserted into their trachea under direct laryngoscopy...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137578/predictive-value-of-quick-sepsis-related-organ-failure-scores-following-sepsis-related-medical-emergency-team-calls-a-retrospective-cohort-study
#12
D Boulos, Y Shehabi, J A Moghaddas, M Birrell, A Choy, V Giang, J Nguyen, T Hall, S Le
We conducted a cohort study of adult ward patients who had a Medical Emergency Team (MET) call triggered by confirmed or suspected sepsis in an Australian tertiary centre to assess the predictive utility of systemic inflammatory response syndrome (SIRS) and quick Sepsis-Related Organ Failure Assessment (qSOFA) scores for 28-day mortality over a 12-month period. Sepsis was the causative aetiology in 970 MET calls for 646 patients with a mean age of 68 years and median Charlson Comorbidity score (CCS) of 3.0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137577/postoperative-troponin-measurement-as-a-screening-tool-for-adverse-cardiac-events-in-adult-patients-undergoing-moderate-or-major-non-cardiac-surgery
#13
D Coric, N A Smith
Elevated troponin levels within three days of surgery are strongly linked to major adverse cardiac events (MACE). However, the value of screening with troponin measurements is controversial. The extent to which this is done in routine practice is uncertain. We examined the medical records of all patients ≥45 years of age undergoing moderate or major non-cardiac surgery in our tertiary referral hospital over a six-month period. We determined how many patients had a troponin (TnT) measurement recorded in the first three days postoperatively, how many of these were abnormal, and the occurrence of MACE within 30 days...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137576/perioperative-assessment-of-older-surgical-patients-using-a-frailty-index-feasibility-and-association-with-adverse-post-operative-outcomes
#14
H Lin, N M Peel, I A Scott, D L Vardesh, P Sivalingam, R L McBride, J J Morong, M J Nelson, R E Hubbard
This study aimed to examine the feasibility of using a frailty index (FI) based on comprehensive geriatric assessment (CGA), to assess the level of frailty in older surgical patients preoperatively and to evaluate the association of FI-CGA with poorer postoperative outcomes. Two hundred and forty-six patients aged ≥70 years undergoing intermediate- to high-risk surgery in a tertiary hospital were recruited. Frailty was assessed using a 57-item FI-CGA form, with fit, intermediate frail, and frail patients defined as FI ≤0...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137575/effect-of-hypocaloric-normoprotein-or-trophic-feeding-versus-target-full-enteral-feeding-on-patient-outcomes-in-critically-ill-adults-a-systematic-review
#15
K A Phan, C M Dux, E J Osland, M C Reade
Uncertainty surrounds the optimal approach to feeding the critically ill, with increasing interest in the concept of intentional underfeeding to reduce metabolic stress while maintaining gut integrity. Conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, this systematic review evaluates clinical outcomes reported in studies comparing hypocaloric normonitrogenous or trophic feeding (collectively 'intentional underfeeding') targeted full energy feeding administered via enteral nutrition to adult critically ill patients...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137574/understanding-the-lives-of-anaesthesia-trainees
#16
L J Roberts
No abstract text is available yet for this article.
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137573/can-we-reduce-the-prevalence-of-persistent-opioid-use-after-surgery-by-predicting-the-future
#17
N L Pratt, E E Roughead
No abstract text is available yet for this article.
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29137572/intravenous-crystalloids-in-the-late-19th-and-early-20th-century
#18
P J Featherstone, C M Ball
No abstract text is available yet for this article.
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28911298/veno-arterial-extracorporeal-membrane-oxygenation-for-severe-cardiogenic-shock-secondary-to-phaeochromocytoma-crisis
#19
R K Fung, D Arumugam, A Tjokrowidjaja, P Forrest, E L Chua, T Southwood
No abstract text is available yet for this article.
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28911297/fungal-coronary-embolus-while-on-extracorporeal-membrane-oxygenation
#20
LETTER
F E Martinez, L Ryden, R Leaver, J Mendoza, K Havill
No abstract text is available yet for this article.
September 2017: Anaesthesia and Intensive Care
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