Special considerations in paediatric intensive care
This article reviews critical therapies and techniques that define care in the PICU, and outlines the management of acute lung injury, traumatic brain injury and septic shock. Neonatal and cardiac intensive care medicine topics are outside the scope of this article. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 4, 2014 Category: Anesthesiology Source Type: research

Transporting critically ill children
Publication date: December 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 12 Author(s): Peter-Marc Fortune , Kate Parkins , Stephen Playfor Increasing centralization of paediatric intensive care services and a reduction in the numbers of children cared for in adult intensive care units over the last 15–20 years has led to an increase in the numbers of critically ill children being transferred between clinical centres throughout the UK. Eighty percent of these retrievals are conducted by a specialist paediatric intensive care unit (PICU) team, 13% by a specialist non-PICU team, and only ...
Source: Anaesthesia and intensive care medicine - December 4, 2014 Category: Anesthesiology Source Type: research

Trauma and burns in children
Publication date: December 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 12 Author(s): Mark J. Ross , Jon G. McCormack Trauma is the leading cause of death and disability in children, most often resulting from blunt trauma sustained in motor vehicle accidents and falls. An immediate coordinated resuscitation may contribute to improved morbidity and mortality outcomes. A multi-professional approach to the treatment of critically injured children should be adopted; where the primary survey aims to identify and manage immediately life-threatening injuries to airway, breathing and circulation. F...
Source: Anaesthesia and intensive care medicine - December 4, 2014 Category: Anesthesiology Source Type: research

Intraosseous cannulation in children
Publication date: December 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 12 Author(s): Pauline M. Cullen This review outlines the current recommendations for use of intraosseous access in children. It describes the technique of intraosseous cannulation, anatomy, physiology and possible complications. It also briefly describes currently available devices that allow for rapid and effective intraosseous access in infants, children and young adults. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 4, 2014 Category: Anesthesiology Source Type: research

Transfusion guidelines in children: II
This article presents ways of achieving this goal and introduces the process of the safe administration of blood products where indicated. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 4, 2014 Category: Anesthesiology Source Type: research

Transfusion guidelines in children: I
This article will present information concerning blood transfusion thresholds in children, calculations for maximal tolerated blood loss and the concept of massive transfusion protocols. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 4, 2014 Category: Anesthesiology Source Type: research

Fluid and electrolyte balance in children
Publication date: December 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 12 Author(s): Mark Terris , Peter Crean Safe intravenous fluid prescription in children requires an understanding of certain basic principles to avoid adverse events. Careful consideration needs to be given to both the appropriate rate and composition of the fluids to be administered with frequent re-assessment. In this review we examine the indications for parenteral fluid management: maintenance requirements, correction of any deficit and replacement of ongoing losses. The role of non-osmotic secretion of antidiuretic...
Source: Anaesthesia and intensive care medicine - December 4, 2014 Category: Anesthesiology Source Type: research

Aetiology and outcome of paediatric cardiopulmonary arrest
This article looks at the causes of arrests in children, the likely outcomes, and the ways in which this can be improved. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 4, 2014 Category: Anesthesiology Source Type: research

SI units
This article summarizes the history and application of the Système Internationale (SI) of units. Non-SI units in common use in anaesthesia and standard units of digital information are also described. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Basic measurement concepts
Publication date: July 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 7 Author(s): Gary Thomas , Elana Owen Precise measurement of physiological parameters during anaesthesia is vital, and enables clinicians to deliver safe and appropriate care to patients. Monitoring devices are essential tools in the clinical environment, and accurate records of the measurements provided by these monitors must be kept. The physical parameter to be measured is known as a measurand. Examples of measurands in clinical practice include temperature, voltage and pressure. In the process of measurement, a measuran...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Mechanisms of action of general anaesthetic drugs
Publication date: July 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 7 Author(s): David G. Lambert Based on the diverse array of anaesthetic structures, a single anaesthetic target site seems unlikely. With the knowledge that anaesthesia likely results from central nervous system depression, it can be hypothesized that anaesthesia results from either enhanced inhibitory transmission or reduced excitatory transmission. Two main targets have been extensively described: GABAA receptors and N-methyl-d-aspartate (NMDA) glutamate receptors. On γ-aminobutyric acid (GABA) binding to GABAA rece...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Antidepressants and antipsychotics: anaesthetic implications
Publication date: July 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 7 Author(s): Faisal Rasool , Rahat Ghafoor , David G. Lambert According to the World Health Organization about 450 million people suffer from mental and behavioural disorder worldwide whereas depression has a lifetime prevalence of between 10 and 20%. Antidepressants are broadly divided into four main groups: tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), atypical agents and monoamine oxidase inhibitors (MAOIs). Lithium is also occasionally used as an adjunct to treat refractive depressio...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Factors affecting drug absorption and distribution
Publication date: July 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 7 Author(s): Shruti Chillistone , Jonathan G. Hardman The pharmacokinetic properties of a drug comprise the relationship between its absorption, distribution and inactivation. The passage of drugs across cell membranes is a key part of most pharmacokinetic processes. The most important means by which a drug crosses cell membranes is passive diffusion, the rate of which is determined by molecular size, the concentration gradient, lipid solubility, degree of ionization of the drug and protein binding. Pharmacokinetic processe...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Mechanisms of drug interactions: pharmacodynamics and pharmacokinetics
Publication date: July 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 7 Author(s): Kathryn Corrie , Jonathan G. Hardman The classification of drug interactions is first considered in this article, with an explanation of the terminology. Emphasis is placed on the importance of the topic in relation to the polypharmacy employed in anaesthesia and critical care. Pharmacodynamic interactions are then discussed. Further classification of these interactions is explained using examples of drugs in everyday use in anaesthesia and critical care medicine. Non-specific pharmacodynamic interactions are c...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Data quality and clinical audit
This article briefly defines the audit cycle and goes on to consider a typical data model. The various elements of the data model are defined, the understanding of which should enable individuals to avoid pitfalls in data collection and ensure that the data they collect for clinical audit are of the highest quality. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Modes of drug elimination and bioactive metabolites
Publication date: August 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 8 Author(s): Shruti Chillistone , Jonathan G. Hardman Drug elimination is the removal of active drug from the body. Metabolism takes place largely in the liver and produces water soluble metabolites which can be excreted in the bile or urine. Metabolism may also produce active or toxic metabolites or a pharmacologically active drug from an inactive prodrug. Most volatile anaesthetics are excreted unchanged via the lungs. Drug elimination can be affected by factors such as first-pass metabolism, genetic variants and variou...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Pharmacokinetic analysis
Publication date: August 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 8 Author(s): William J.D. Whiteley , Jonathan G. Hardman Pharmacokinetic analysis is an experimentally determined theory of how a drug behaves when in vivo. Volume of distribution, clearance and terminal half-life are defined. Compartmental modelling is introduced and some relevant graphs are described in this article. Applications of this theory in anaesthesia are considered. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Anaesthesia for maxillofacial surgery
Publication date: August 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 8 Author(s): Louisa Pavlakovic , Gene Lee Maxillofacial surgery covers a broad range of procedures on the head and neck, combining oral and facial procedures with the ear, nose and throat (ENT), plastics, neurosurgery and base of skull specialities. The main issues are that of managing a shared airway, providing good head, neck and oral access, the potential for difficult airways and measures to reduce tissue bleeding and oedema, both intraoperatively and postoperatively. Good communication between all members of the team...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Anaesthesia for facial trauma
This article considers the causes of facial trauma and the differing patterns of injury seen. The relative strengths of the facial bones and Le Fort fractures lines are described. The important airway and other management issues for the initial acute phase and the later second-stage management for surgical treatment of facial fractures are discussed. The concern regarding actual and potential cerebrospinal fluid leak from Le Fort 2- and 3-level fractures is reviewed, and different strategies for airway management put forward. Specific difficulties with endotracheal intubation of patients with facial trauma are examined. Th...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Dental damage in anaesthesia
Publication date: August 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 8 Author(s): Andrew Milne , Jane Lockie Damage to the teeth during general anaesthesia is a frequent cause of morbidity for patients and a source of litigation against anaesthetists. Most injuries occur as a result of laryngoscopy. To prevent damage during emergence from anaesthesia, bite blocks should be placed between molar teeth. However oropharyngeal airways may not prevent damage. Patients should be advised about the possibility of dental trauma during anaesthesia and should be advised to have preoperative dental tre...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

General anaesthesia for dentistry
Publication date: August 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 8 Author(s): Susan Hutchinson Dental anaesthesia developed down a different pathway from the rest of anaesthesia. Techniques such as nasal mask anaesthesia in the sitting position were specific to dental surgery, which took place largely outside hospital in dental clinics. Now dental anaesthesia is confined to locations within the aegis of a hospital and anaesthetic techniques are similar to those in other surgical specialities. Dental surgery consists of extractions and conservation. Short procedures for the extraction o...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Sedation for dental and other procedures
Publication date: August 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 8 Author(s): Carol J. Peden , Sara-Catrin Cook While sedation can improve the patient experience of unpleasant procedures, if performed poorly it has the potential to cause harm. Some authorities believe that patients’ protective reflexes are impaired at any level of sedation, and sedation merges into anaesthesia in a continuum of loss of consciousness. All anaesthetists should understand the definition of ‘conscious sedation’, and be aware of the concepts of ‘deep sedation’ and ‘monito...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Flexible fibre-optic intubation
Publication date: August 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 8 Author(s): Sandi Wylie , Ian Calder Flexible fibre-optic intubation has been practised for 40 years. It is an enormously useful skill, but it is not always the most appropriate tactic to deploy. The great advantage of flexible endoscopy is that the passage of an endoscope is acceptable to conscious patients, so that a tracheal tube can be placed easily when face-mask ventilation or direct laryngoscopy is likely to be difficult. The best position for the endoscopist is by the patient’s side (whether the patient is ...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Identification of the difficult airway
Publication date: August 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 8 Author(s): Ian Calder Nearly all patients who are seriously difficult to manage are easily identified because they have grossly obvious abnormalities. Conversely, it is difficult to identify the few normal-looking patients that are difficult to manage. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Pharmacology of plasma expanders
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): Robert McCahon , Jonathan Hardman Plasma expanders are used to restore the circulating volume of a hypovolaemic patient. Typically, colloids are used to expand the plasma volume, although combinations of hypertonic crystalloid and colloid have recently been used. The currently available colloids vary in their physicochemical, pharmacodynamics and pharmacokinetic properties. In particular, they differ in molecular weight, which partly determines their duration of action, and in their ability to expand the p...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

The metabolic and endocrine response to trauma
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): Jennifer Hastings , Amy Krepska , Owen Roodenburg Metabolic and endocrine pathways are central to the body's compensatory response to trauma. They drive mobilization of energy substrates, volume conservation and haemostasis via activation of the hypothalamic pituitary adrenal axis, the sympathetic nervous system and an inflammatory response. As clinicians, we can intervene in these pathways, however optimal management of anaesthesia, fluids, transfusion, nutrition and the use of steroids remain controversi...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Anaesthesia outside the theatre environment
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): Jan M. Dieleman , David J. Daly Remote anaesthesia is the provision of anaesthesia and sedation outside the theatre environment. The diverse range of locations, procedures and patient groups can provide a challenge to the anaesthesia team. Anaesthetists must maintain the same high standards as in the operating room, which requires appropriate facilities and staff, as well as suitable pre- and post-anaesthesia care. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Spinal cord injury
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): Bob Winter , Hina Pattani , Emma Temple With an annual incidence of 13 per million, around 40,000 people in the UK live with spinal cord injury (SCI). The extent of morbidity and mortality and thus quality of life, is highly dependent on meticulous management from the first point of contact with medical services. Treatment is focussed on reducing the risk of further cord injury and prevention of secondary (penumbral) damage through avoidable complications. As key members of trauma, theatre, intensive care ...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Drowning and immersion injury
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): F. Eduardo Martinez , Andrew J. Hooper Drowning is a process resulting in primary respiratory impairment from submersion/immersion in a liquid medium. It is a frequent cause of unintentional injury deaths and public health initiatives to prevent drowning are important as there are no specific interventions proven to improve outcomes in drowning victims. Risk factors for drowning include inadequate supervision, recreational or occupational access to water, risk-taking behaviour and underlying medical condit...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Critical care management of inhalational injury and severe burns
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): Dominic Trainor , Jason McClure Inhalational injury and severe burns are common. Most will present to district general hospitals and thus an understanding of how to assess and manage these patients is vital for all practising anaesthetists with on-call commitments. In this article we emphasize the requirement for a highly functioning multidisciplinary approach with excellent communication both within and between treating teams. We will challenge the dogmatic approach to airway management and discuss the in...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Chest trauma
This article summarises major life-threatening injuries in thoracic trauma. Timing, clinical features, necessary investigations and interventions are described within the clinical approach of primary and secondary surveys. Emphasis is on immediate resuscitation with some discussion on further management. Injuries included are tension pneumothorax, open pneumothorax, massive haemothorax, pericardial tamponade, aortic injuries, cardiac injuries, lung contusion, flail chest, diaphragmatic injury, airway injury and oesophageal rupture. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Management of shock in trauma
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): Jonathan D. Pearson , Jonathan A. Round , Michael Ingram Shock is failure of the circulatory system to provide the organ perfusion and tissue oxygenation required to meet cellular metabolic demands. Traumatic shock is most commonly associated with haemorrhage, although it is recognized the trauma patient may present with non-haemorrhagic shock. The ‘lethal triad’ of metabolic acidosis, hypothermia, and acute coagulopathy seen in trauma patients has been fundamental to the development of the cur...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Management of major trauma
This article will review these reports, discuss the changes that have occurred in recent years in the organization of the care of major trauma and describe the anaesthetic management of this important group of patients. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Pain priorities in pre-hospital care
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): Charlotte Small , Dominic Aldington Pain management in the pre-hospital environment is a priority following life- and limb-saving manoeuvres. Pain should be assessed and documented then managed according to a multimodal model. Even in the context of environmental challenges and limited resources, pharmacological, physical and psychological interventions can all be used to provide effective analgesia and relieve suffering prior to and during transfer to hospital. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Anaesthetic priorities in pre-hospital trauma care
Publication date: September 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 9 Author(s): Phil Docherty , Adrian Mellor The approach to pre-hospital trauma care has undergone some changes in recent years. Some of the lessons have been learnt from the military as a direct result from experiences in recent conflicts. Personnel involved in pre-hospital care need to be aware of the dangers at the scene and have the ability to work with and liaise with other emergency services. Control of any massive haemorrhage needs to be gained as a priority before moving on to the more familiar Airway, Breathing...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

MCQs
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 Author(s): Vijayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

The pancreas
This article looks at the physiology of each of the hormones and enzymes released by the pancreas, the factors influencing their secretion, and how their secretion is coordinated. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Thyroid and parathyroid hormones and calcium homeostasis
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 Author(s): Iain Campbell The thyroid gland is under the control of thyroid-stimulating hormone (TSH) from the pituitary. It secretes thyroxine (T4) and triiodothyronine (T3). Iodine is essential for the synthesis of thyroid hormones. T4 is probably converted to T3 in peripheral tissues. Thyroid hormones have a role in growth and development, but their principal effect is the control of basal metabolic rate. Deficiency or excess affects all the tissues of the body, reducing or increasing the metabolic rate, resulting i...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Adrenocortical hormones
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 Author(s): Iain Campbell The adrenal glands lie on top of the kidneys. The adrenal medulla produces catecholamines and the adrenal cortex produces three types of steroid hormone (mineralocorticoids (aldosterone), glucocorticoids (cortisol) and androgens (dehydroepiandrosterone, DHEA)). All are synthesized from cholesterol. Cortisol secretion is controlled by adrenocorticotrophic hormone from the pituitary. It rises in response to stress and is essential for life. It stimulates gluconeogenesis, breaking down lean tissu...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Hypothalamic–pituitary–adrenal function: anaesthetic implications
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 Author(s): Grainne Nicholson , George M. Hall Surgery, trauma and critical illness evoke a series of hormonal and metabolic changes commonly referred to as the stress response. Activation of the hypothalamic–pituitary–adrenal axis results in increased secretion of hormones such as cortisol. Anaesthesia can suppress adrenocortical secretion either by an effect at the hypothalamus, for example by a decrease in neural input with regional anaesthesia, or by a direct effect on the adrenal cortex, for example by...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Pharmacological control of blood sugar
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 Author(s): Giridhar Tarigopula , Melanie J. Davies Diabetes is a chronic and progressive metabolic disorder characterized by hyperglycaemia. The two main types of diabetes are type 1 diabetes (T1DM) where there is complete lack of insulin and type 2 diabetes (T2DM) which may be due to a combination of insulin resistance and relative insulin deficiency due to impaired β-cell function. Good control of blood glucose near physiological limits is vital to reduce long-term microvascular and macrovascular complications ...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Recognition and management of phaeochromocytoma
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 Author(s): Inas Ahmed , Chandran Jepegnanam Phaeochromocytomas are catecholamine-secreting neuroendocrine tumours arising from the chromaffin cells in the adrenal medulla. These tumours may be identified incidentally, as part of a workup for multiple endocrine neoplasia or during unrelated surgery. Better understanding of catecholamine physiology and advances in preoperative preparation has significantly reduced surgical mortality from around 40% to less than 3%. Surgery is the definitive treatment in most cases and l...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Thyroid disease and thyroid surgery
This article focuses on disorders of thyroid function and their management, thyroid malignancy, surgery of the thyroid gland and the perioperative anaesthetic management of patients undergoing thyroidectomy. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Anaesthetic management of diabetes
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 Author(s): Inas Ahmed , Swamy Mruthunjaya Diabetes is a complex metabolic disorder that is increasing in incidence globally. It is the most common non-communicable disease worldwide. Diabetic patients pose a challenge to anaesthesia and surgery due to the organs and systems affected by the disease. Good glycaemic control perioperatively is essential to minimize complications. There is an increasing number of therapies to control diabetes, and this is rapidly evolving, so a multidisciplinary approach to the management ...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Anaesthesia for obesity surgery
This article will discuss the different types of obesity surgery commonly performed, and the practical aspects of how to manage these patients both perioperatively and postoperatively. The principles described can be utilised in the management of obese patients attending for other types of surgery. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Anaesthesia in the obese patient
This article will present important aspects related to pathophysiology and pharmacology. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Clinical aspects of endocrinology: parathyroid and adrenal gland disorders
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 Author(s): Inese Kutovaja , Kailash Bhatia The parathyroid glands are responsible for calcium homeostasis, which is necessary for appropriate functioning of the musculoskeletal and nervous system. Parathyroid adenoma remains the most common indication for surgery. The adrenal cortex is mainly responsible for secretion of mineralocorticoids, glucocorticoids and androgens whereas the medulla consists of pre-ganglionic sympathetic ganglion, which secretes epinephrine, nor-epinephrine and dopamine. Adrenocortical dis...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Contents
Publication date: October 2014 Source:Anaesthesia & Intensive Care Medicine, Volume 15, Issue 10 (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Anaesthesia for surgery of the trachea and main bronchi
Publication date: Available online 8 October 2014 Source:Anaesthesia & Intensive Care Medicine Author(s): Alistair Macfie , Philip McCall Major surgery on the trachea and airway is an anaesthetic challenge, which necessitates the simultaneous control of the airway, maintenance of gas exchange and good surgical exposure. Advance planning, good communication and teamwork among surgeon, anaesthetist and theatre staff are never more important. A major indication for laryngeal and tracheal surgery is laryngotracheal stenosis, a rare condition, which can cause significant morbidity and life-threatening airway obstructi...
Source: Anaesthesia and intensive care medicine - October 12, 2014 Category: Anesthesiology Source Type: research

Contents
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - September 1, 2014 Category: Anesthesiology Source Type: research