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Anaesthesia and Intensive Care

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https://www.readbyqxmd.com/read/30447682/postoperative-residual-curarisation-is-still-an-issue-when-weaning-patients-in-intensive-care-following-cardiac-surgery
#1
G Cammu, E Neyens, J Coddens, F Van Praet, K De Decker
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447681/in-reply
#2
Gtc Wong, M G Irwin
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447680/a-cost-comparison-between-total-intravenous-and-volatile-based-anaesthesia
#3
D H Lam, M D Ng
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447679/use-of-the-lma%C3%A2-gastro%C3%A2-airway-a-novel-dual-channel-laryngeal-mask-airway-for-endoscopic-retrograde-cholangiopancreatography-a-report-of-two-cases
#4
M W Skinner, P S Galloway, D J McGlone, C Middleton
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447678/primum-non-nocere-greening-anaesthesia
#5
R H Burrell
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447677/persistent-opioid-use-after-arthroplasty
#6
M J Lennon, F J Torlot, J Micallef, R J Khan, P Vasantharao
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447676/in-reply
#7
R Kerridge, J Luu, I Whyte, F Prior, D A Story
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447675/it-s-hard-to-kill-off-an-old-paradigm-starvation-in-the-midst-of-plenty
#8
P D McLoughlin
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447674/functional-assessment-tools-in-the-intensive-care-unit-are-we-comparing-apples-and-oranges
#9
A Taylor, V Sarode, D J Brewster
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447673/an-audit-of-the-diagnostic-accuracy-of-rotational-thromboelastometry-for-the-identification-of-hypofibrinogenaemia-and-thrombocytopenia-during-cardiopulmonary-bypass
#10
S A Matzelle, W M Weightman, N M Gibbs
We audited the diagnostic accuracy of ROTEM® (TEM Innovations, GmbH, Munich, Germany) measurements of hypofibrinogenaemia (fibrinogen <1.5 g/l) and thrombocytopenia (platelet count <100 x 10<sup>9</sup>/l) in 200 adult non-transplant patients during cardiopulmonary bypass (CPB). Blood samples were obtained for FIBTEM (assay for the fibrin part of the clot), PLTEM (calculated platelet-specific component), and laboratory measurements simultaneously. Our thresholds for FIBTEM and PLTEM were A10 (clot firmness 10 minutes after clotting time) ≤8 mm, and <35 mm respectively...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447672/the-effect-of-preload-on-electromyographic-train-of-four-ratio-at-the-first-dorsal-interosseous-muscle-during-spontaneous-recovery-from-neuromuscular-blockade
#11
A Bansal, P A Stewart, S Phillips, S Liang, X Wang
Accurate and reliable quantitative neuromuscular function monitoring is desirable for the optimal management of neuromuscular blockade, selection of the most appropriate reversal agent and dosage, and assessing the completeness of reversal to exclude residual neuromuscular blockade. Applying preload to the thumb may affect the precision of electromyography. This study compared the precision and agreement of electromyography with and without preload during recovery from non-depolarising neuromuscular blockade...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447671/preoperative-gastric-residual-volumes-in-fasted-patients-measured-by-bedside-ultrasound-a-prospective-observational-study
#12
Y Ohashi, J C Walker, F Zhang, F E Prindiville, J P Hanrahan, R Mendelson, T Corcoran
The purpose of this prospective observational study was to measure gastric volumes in fasted patients using bedside gastric ultrasound. Patients presenting for non-emergency surgery underwent a gastric antrum assessment, using the two-diameter and free-trace methods to determine antral cross-sectional area (CSA). Gastric residual volume (GRV) was calculated using a validated formula. Univariate and multivariable analyses were performed to examine any potential relationships between 'at risk' GRVs (>100 ml) and patient factors...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447670/peripheral-tissue-oxygenation-and-the-number-of-organs-transplanted-per-donor
#13
S E Perez-Protto, J D Reynolds, R Nazemian, J You, J S Hata, S Q Latifi, D J Lebovitz
Current donor management practices target macrohaemodynamic parameters, but it is unclear if this leads to improvements in microvascular perfusion and tissue oxygenation; the latter may have more impact on organ status. In a recent preclinical study we determined that brain death impaired tissue perfusion and oxygen utilisation in swine while pharmacologic correction of these deficits improved organ function and reduced markers of tissue injury. As a first step in translating the preclinical findings, we conducted a prospective observational study to determine if there was an association between peripheral tissue oxygenation (measured by near-infrared spectroscopy) in deceased by neurological criteria human donors and the number of organs transplanted...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447669/postoperative-cognitive-dysfunction-after-sevoflurane-or-propofol-general-anaesthesia-in-combination-with-spinal-anaesthesia-for-hip-arthroplasty
#14
Y Konishi, L A Evered, D A Scott, B S Silbert
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...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447668/vitamin-d-status-and-supplementation-in-adult-patients-receiving-extracorporeal-membrane-oxygenation
#15
P Nair, B Venkatesh, D J Hoechter, H Buscher, S Kerr, J R Center, J A Myburgh
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 unit (ICU) patients not receiving ECMO, two prospective studies were performed sequentially: an observational study of 100 consecutive ICU patients and an interventional study assessing effects of intramuscular cholecalciferol in 50 ICU patients...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447667/retrieval-of-critically-ill-adults-using-extracorporeal-membrane-oxygenation-the-nine-year-experience-in-new-south-wales
#16
D E Austin, B Burns, D Lowe, B Cartwright, A Clarke, M Dennis, M D'Souza, R Nathan, P G Bannon, D Gattas, M Connellan, P Forrest
In New South Wales, a coordinated extracorporeal membrane oxygenation (ECMO) retrieval program has been in operation since 2007. 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...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447666/hyperinsulinaemic-euglycaemic-therapy-use-in-neurogenic-stunned-myocardium-following-subarachnoid-haemorrhage
#17
B T Chandler, P Pernu
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.
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447665/adhesive-arachnoiditis-following-inadvertent-epidural-injection-of-2-chlorhexidine-in-70-alcohol-partial-recovery-over-the-ensuing-eight-years
#18
I Mohamed Iqbal, R Morris, M Hersch
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...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447664/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
#19
Phm Sadleir, R C Clarke, Bsl Lim, P R Platt
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 anaphylactic shock...
November 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/30447663/mostly-harmless
#20
J Sleigh
No abstract text is available yet for this article.
November 2018: Anaesthesia and Intensive Care
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