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https://www.readbyqxmd.com/read/29313906/respiratory-complications-of-anaesthesia
#1
REVIEW
G H Mills
Postoperative pulmonary complications are a major determinant of outcome for patients and consume huge resources within hospital, particularly in critical care. Prediction and anticipation of postoperative pulmonary complications are vital for patient selection and, in some cases, for informed patient consent. Being able to assess the likelihood of postoperative pulmonary complications also allows research into methods to reduce them by allowing allocation of patients to the appropriate arms of research trials...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29286270/landmark-lecture-on-cardiac-intensive-care-and-anaesthesia-continuum-and-conundrums
#2
Peter C Laussen
Cardiac anesthesia and critical care provide an important continuum of care for patients with congenital heart disease. Clinicians in both areas work in complex environments in which the interactions between humans and technology is critical. Understanding our contributions to outcomes (modifiable risk) and our ability to perceive and predict an evolving clinical state (low failure-to-predict rate) are important performance metrics. Improved methods for capturing continuous physiologic signals will allow for new and interactive approaches to data visualization, and for sophisticated and iterative data modeling that will help define a patient's phenotype and response to treatment (precision physiology)...
December 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/29233755/postoperative-fasting-after-general-anaesthesia-a-survey-of-french-anaesthesiology-practices
#3
Sylvain Le Pape, Matthieu Boisson, Thibault Loupec, FabienVigneau, Bertrand Debaene, Denis Frasca
BACKGROUND: Preoperative fasting is well-codified worldwide. In contrast, the literature on the postoperative fasting (POF) is scarce leading to potentially wide discrepancies among anaesthesiology practices. This survey assessed French POF practices. METHODS: From March 2013 to January 2014, a survey was conducted among anaesthesiologists, members of the French Society of Anaesthesiology and Critical Care. The POF durations of either fluid or solid food intake was assessed according to airway management procedures (endotracheal intubation [EI] or laryngeal mask [LMA]) and age of the patients (adult or paediatric)...
December 9, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29222034/management-of-invasive-candidiasis-and-candidemia-in-critically-ill-adults-expert-opinion-of-the-european-society-of-anaesthesia-esa-intensive-care-scientific-subcommittee
#4
REVIEW
Ruth-Aoibheann OLeary, Sharon Einav, Marc Leone, Krisztina Madách, Claude Martin, Ignacio Martin-Loeches
OBJECTIVE: The global burden of invasive fungal disease is increasing. Candida albicans remains the leading cause of fungal blood stream infections although non-albicans Candidal infections are emerging. Areas of controversy regarding diagnosis and management are hampering our ability to respond effectively to this evolving threat. The purpose of this narrative review is to address current controversies and provide recommendations to supplement guidelines. DIAGNOSIS OF INVASIVE CANDIDIASIS: Diagnosis of invasive candidiasis requires a combination of diagnostic tests and patient risk factors...
December 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29210033/strategies-for-the-prevention-of-airway-complications-a-narrative-review
#5
REVIEW
T M Cook
Despite being infrequent, complications of airway management remain an important contributor to morbidity and mortality during anaesthesia and care of the critically ill. Developments in the last three decades have made anaesthesia safer, and this has been mirrored in the equipment and techniques available for airway management. Modern technology including novel oxygenation modalities, widespread availability of capnography, second-generation supraglottic airway devices and videolaryngoscopy provide the tools to make airway management safer still...
January 2018: Anaesthesia
https://www.readbyqxmd.com/read/29175318/effectiveness-of-a-blended-learning-course-including-e-learning-and-flipped-classroom-in-first-year-anaesthesia-training
#6
Antoine Marchalot, Bertrand Dureuil, Benoit Veber, Jean-Luc Fellahi, Jean-Luc Hanouz, Hervé Dupont, Emmanuel Lorne, Vincent Compère
BACKGROUND: Blended learning, which combines internet-based platform and lecturing, is used in anaesthesiology and critical care teaching. However, the benefits of this method remain unclear. METHODS: We conducted a prospective, multicentre, non-randomised work between 2007 and 2014 to study the effect of blended learning on the results of first year anaesthesia and critical care residents in comparison with traditional teaching. Blended learning was implemented in Rouen University Hospital in 2011 and residents affiliated to this university corresponded as the blended learning group...
November 22, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29171247/care-of-patients-undergoing-weaning-from-mechanical-ventilation-in-critical-care
#7
Susan Elliott, Nicola Morrell-Scott
There are several reasons why mechanical ventilation - the use of an artificial device to assist a patient to breathe - may be initiated, for example to enable general anaesthesia for patients undergoing surgery, and for those with a compromised airway or respiratory failure. It is important that critical care nurses have the skills and knowledge to care for patients who are undergoing weaning from mechanical ventilation. This is to ensure that patients are weaned safely and as soon as possible, to improve their outcomes and avoid an increase in patient mortality and morbidity through complications that can arise such as airway trauma and ventilator-associated pneumonia...
November 22, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29161399/global-lessons-developing-military-trauma-care-and-lessons-for-civilian-practice
#8
T Woolley, J A Round, M Ingram
The wars in Iraq and Afghanistan have helped to shape the modern Defence Medical Services. Many lessons were learnt including the need for rapid haemorrhage control, senior decision-making and the evolution of deployed transfusion support. These changes were implemented simultaneously with a coherent, end-to-end medical plan from point of wounding through to rehabilitation. Implementation of the medical plan is harmonious with the NHS trauma pathway, and is key to ensuring effective delivery. Military anaesthetists have a long pre-deployment training pathway starting with a Certificate of Completion of Training (CCT) in anaesthesia and/or critical care, and with an emphasis on military skills related to their specific role...
December 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29156486/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives
#9
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the society for Obstetric anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
November 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#10
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29147893/high-elective-surgery-cancellation-rate-in-malawi-primarily-due-to-infrastructural-limitations
#11
Meghan Prin, Jessica Eaton, Onias Mtalimanja, Anthony Charles
BACKGROUND: The provision of safe and timely surgical care is essential to global health care. Low- and middle-income countries have a disproportionate share of the global surgical disease burden and struggle to provide care with the given resources. Surgery cancellation worldwide occurs for many reasons, which are likely to differ between high-income and low-income settings. We sought to evaluate the proportion of elective surgery that is cancelled and the associated reasons for cancellation at a tertiary hospital in Malawi...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29125177/surgical-management-of-impalement-injuries-to-the-trunk-of-dogs-a-multicentre-retrospective-study
#12
M Matiasovic, Z J Halfacree, A Moores, P Nelissen, S Woods, B Dean, G Chanoit, D C Barnes
OBJECTIVES: To review a large series of dogs referred for treatment of traumatic impalement injuries to the thorax and/or abdomen and to report aetiologies, injury characteristics, management and long-term outcomes. MATERIALS AND METHODS: Previously collected data on dogs that were surgically treated for impalement injuries to the trunk at six veterinary specialist referral institutions in the UK over an 11-year period were reviewed. Data included patient signalment, physiological variables, injury-specific variables, diagnostic imaging reports, surgical procedures undertaken, duration of hospitalisation, antibiotic use, complications and outcomes...
November 10, 2017: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29095726/high-quality-of-evidence-is-uncommon-in-cochrane-systematic-reviews-in-anaesthesia-critical-care-and-emergency-medicine
#13
Aaron Conway, Zachary Conway, Kathleen Soalheira, Joanna Sutherland
BACKGROUND: The association between the quality of evidence in systematic reviews and authors' conclusions regarding the effectiveness of interventions relevant to anaesthesia has not been examined. OBJECTIVE: The objectives of this study were: to determine the proportion of systematic reviews in which the authors made a conclusive statement about the effect of an intervention; to describe the quality of evidence derived from outcomes in reviews that used the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) working group system for grading the quality of evidence; and to identify review characteristics associated with conclusiveness...
December 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29084236/derivation-and-validation-of-a-preoperative-risk-model-for-postoperative-mortality-sampe-model-an-approach-to-care-stratification
#14
Luciana Cadore Stefani, Claudia De Souza Gutierrez, Stela Maris de Jezus Castro, Rafael Leal Zimmer, Felipe Polgati Diehl, Leonardo Elman Meyer, Wolnei Caumo
Ascertaining which patients are at highest risk of poor postoperative outcomes could improve care and enhance safety. This study aimed to construct and validate a propensity index for 30-day postoperative mortality. A retrospective cohort study was conducted at Hospital de Clínicas de Porto Alegre, Brazil, over a period of 3 years. A dataset of 13524 patients was used to develop the model and another dataset of 7254 was used to validate it. The primary outcome was 30-day in-hospital mortality. Overall mortality in the development dataset was 2...
2017: PloS One
https://www.readbyqxmd.com/read/29050063/-update-in-obstetric-anesthesia-tried-and-trusted-methods-controversies-and-new-perspectives-part-1
#15
Peter Kranke, Thorsten Annecke, Dorothee H Bremerich, Daniel Chappell, Thierry Girard, Wiebke Gogarten, Robert Hanß, Lutz Kaufner, Sophie Neuhaus, Tobias Ninke, Thomas Standl, Stefan Weber, Yvonne Jelting, Thomas Volk
Since 1975, a plethora of lectures within the context of annual meetings relevant for the clinical care has been summarized in "what's new in obstetric anesthesia" by the Society for Obstetric Anesthesia and Perinatology which can be recommended to everyone interested in anaesthesiology in the delivery room. After the death of Gerard W. Ostheimer, Professor of Anaesthesiology at Brigham and Women's Hospital in Boston, Massachusetts, it became renamed the Gerard W. Ostheimer "what's new in obstetric anesthesia" lecture to honor his contributions to regional anesthesia and obstetric anaesthesia...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28922339/incidence-and-risk-factors-of-anaesthesia-related-perioperative-cardiac-arrest-a-6-year-observational-study-from-a-tertiary-care-university-hospital
#16
Andreas Hohn, Jan-Nicolas Machatschek, Jeremy Franklin, Stephan A Padosch
BACKGROUND: In recent decades, the incidences of anaesthesia-related perioperative mortality and adverse outcomes have decreased drastically. However, to date, data on perioperative cardiac arrest and risk factors of perioperative cardiac arrest from European countries are scarce. OBJECTIVES: To determine the incidences of perioperative cardiac arrest and rates of anaesthesia-related and anaesthesia-contributory cardiac arrest. Identification of pre-existing risk factors leading to perioperative cardiac arrest...
September 15, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28893748/effect-of-individual-patient-risk-centre-surgeon-and-anaesthetist-on-length-of-stay-in-hospital-after-cardiac-surgery-association-of-cardiothoracic-anaesthesia-and-critical-care-actacc-consecutive-cases-series-study-of-10-uk-specialist-centres
#17
Olympia Papachristofi, Andrew A Klein, John Mackay, Samer Nashef, Nick Fletcher, Linda D Sharples
OBJECTIVES: To determine the relative contributions of patient risk profile, local and individual clinical practice on length of hospital stay after cardiac surgery. DESIGN: Ten-year audit of prospectively collected consecutive cardiac surgical cases. Case-mix adjusted outcomes were analysed in models that included random effects for centre, surgeon and anaesthetist. SETTING: UK centres providing adult cardiac surgery. PARTICIPANTS: 10 of 36 UK specialist centres agreed to provide outcomes for all major cardiac operations over 10 years...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28882925/snap-2-epiccs-the-second-sprint-national-anaesthesia-project-epidemiology-of-critical-care-after-surgery-protocol-for-an-international-observational-cohort-study
#18
S Ramani Moonesinghe, Danny J N Wong, Laura Farmer, Richard Shawyer, Paul S Myles, Steve K Harris
INTRODUCTION: The admission of high-risk patients to critical care after surgery is a recommended standard of care. Nevertheless, poor compliance against this recommendation has been repeatedly demonstrated in large epidemiological studies. It is unclear whether this is due to reasons of capacity, equipoise, poor quality clinical care or because hospitals are working creatively to create capacity for augmented care on normal surgical wards. The EPIdemiology of Critical Care after Surgery study aims to address these uncertainties...
September 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28764268/comparison-between-two-endotracheal-tube-cuff-inflation-methods-just-seal-vs-stethoscope-guided
#19
Rishiraj Borhazowal, Minal Harde, Rakesh Bhadade, Sona Dave, Swapnil Ganeshrao Aswar
INTRODUCTION: The Endotracheal Tube (ETT) cuff performs a critical function of sealing the airway during positive pressure ventilation. There is a narrow range of cuff pressure required to maintain a functionally safe seal without exceeding capillary blood pressure. AIM: We aimed to compare Just-Seal (JS) and Stethoscope-Guided (SG) method of ETT cuff inflation with respect to the volume of air required to inflate the cuff, the manometric cuff pressure achieved and also to assess for the occurrence of postoperative sore throat after extubation in both the groups...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28758187/differences-between-patients-and-clinicians-research-priorities-from-the-anaesthesia-and-peri-operative-care-priority-setting-partnership
#20
O Boney, M H Nathanson, M P W Grocott, L Metcalf
The James Lind Alliance Anaesthesia and Peri-operative Care Priority Setting Partnership was a recent collaborative venture bringing approximately 2000 patients, carers and clinicians together to agree priorities for future research into anaesthesia and critical care. This secondary analysis compares the research priorities of 303 service users, 1068 clinicians and 325 clinicians with experience as service users. All three groups prioritised research to improve patient safety. Service users prioritised research about improving patient experience, whereas clinicians prioritised research about clinical effectiveness...
September 2017: Anaesthesia
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