Adverse drug reactions
Abstract: Adverse drug reactions (ADRs) are a common and important cause of morbidity and mortality. They occur frequently in patients undergoing anaesthesia or in intensive care. ADRs occur by a number of mechanisms, some of which remain unclear, but several risk factors have been identified. It is increasingly recognized that pharmacogenetic factors are important in determining susceptibility to ADRs. Medical practitioners should be aware of their responsibility to report ADRs and know how to report them. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 18, 2014 Category: Anesthesiology Authors: Simon Scott, Jonathan Thompson Tags: Pharmacology Source Type: research

Airway trauma
Abstract: Airway trauma can be considered according to the mechanism of injury, which may guide further management. Trauma may be mechanical, either blunt or penetrating, be due to burns or be iatrogenic as a result of instrumentation of the airway. Immediate airway intervention will be required for obvious airway compromise. Such patients may be difficult to manage, and may be complicated by polytrauma. It is important to appreciate the potential for rapid deterioration in patients with an injury to the aerodigestive tract. Delayed diagnosis can result in poor outcomes from airway and neck trauma, and a structured approac...
Source: Anaesthesia and intensive care medicine - April 18, 2014 Category: Anesthesiology Authors: Alexander Sell, Anil Patel Tags: ENT/Head and neck Source Type: research

Anaesthesia for endoscopic surgery
Abstract: Shared airway procedures are unique in that both anaesthetist and surgeon are working in the same anatomical field. Close cooperation between anaesthetist and surgeon, an understanding of each other’s problems and knowledge of specialist equipment are often required. There is no ideal anaesthetic technique for all endoscopy procedures and the technique chosen depends on the patient’s general condition, the size, mobility and location of the lesion, the use of a laser, and surgical requirements. Smooth emergence and recovery from anaesthesia are essential. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 18, 2014 Category: Anesthesiology Authors: Edward Burdett, Anil Patel Tags: ENT/Head and neck Source Type: research

Obstructive sleep apnoea and anaesthesia
Abstract: Obstructive sleep apnoea (OSA) is a common condition affecting approximately 4% of middle-aged individuals. The condition is more common in men with a history of snoring. Patients experience fragmented sleep caused by repetitive obstruction of the upper airway during sleep. There is mounting evidence that OSA is associated with metabolic syndrome. Metabolic syndrome comprises hypertension and type 2 diabetes, with associated disturbances of lipid metabolism and central obesity that predisposes to cardiovascular disease. Sleep disruption causes excessive daytime sleepiness and patients may be a danger to themselve...
Source: Anaesthesia and intensive care medicine - April 18, 2014 Category: Anesthesiology Authors: Peter J.H. Venn Tags: ENT/Head and neck Source Type: research

Gas, tubes and flow
Abstract: Gases behave as ‘fluids’ under flow conditions. There are two main flow patterns: laminar and turbulent. Here, we review the flow characteristics of gases and how they relate to the airway and endotracheal tubes. An understanding of these characteristics can be manipulated to improve flow in clinical situations; for example, using a gas with a lower density than air such as heliox reduces turbulent flow and may be helpful in patients with airway obstruction. The Bernoulli principle and Venturi effect have been used to develop fixed-performance masks, jet ventilators and suction devices. (Source: Anaes...
Source: Anaesthesia and intensive care medicine - April 18, 2014 Category: Anesthesiology Authors: Viki Mitchell, Kate Cheesman Tags: ENT/Head and neck Source Type: research

Transtracheal jet ventilation
This article outlines the indications, equipment required, insertion technique and complications of transtracheal jet ventilation. It can be used electively to aid management of the difficult airway and for laryngeal surgery. It also has a vital role in the management of the ‘can't intubate – can't ventilate’ scenario. Death and hypoxic brain damage under anaesthesia are fortunately rare, but most commonly occur as a result of problems with tracheal intubation. No patient should suffer hypoxic brain damage without an attempt at transtracheal ventilation being made. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 18, 2014 Category: Anesthesiology Authors: Catriona Ferguson, Fauzia Mir Tags: ENT/Head and neck Source Type: research

Alternative techniques for tracheal intubation
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 17, 2014 Category: Anesthesiology Authors: Seema Charters, Peter Charters Tags: ENT/Head and neck Source Type: research

Anaesthesia for endoscopic surgery
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 16, 2014 Category: Anesthesiology Authors: Edward Burdett, Anil Patel Tags: ENT/Head and neck Source Type: research

Gas, tubes and flow
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 16, 2014 Category: Anesthesiology Authors: Viki Mitchell, Kate Cheesman Tags: ENT/Head and neck Source Type: research

Histamine and antihistamines
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 16, 2014 Category: Anesthesiology Authors: Amr M. Mahdy, Nigel R. Webster Tags: Pharmacology Source Type: research

Transtracheal jet ventilation
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 15, 2014 Category: Anesthesiology Authors: Catriona Ferguson, Fauzia Mir Tags: ENT/Head and neck Source Type: research

Airway trauma
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 15, 2014 Category: Anesthesiology Authors: Alexander Sell, Anil Patel Tags: ENT/Head and neck Source Type: research

Adverse drug reactions
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 15, 2014 Category: Anesthesiology Authors: Simon Scott, Jonathan Thompson Tags: Pharmacology Source Type: research

Obstructive sleep apnoea and anaesthesia
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 15, 2014 Category: Anesthesiology Authors: Peter J.H. Venn Tags: ENT/Head and neck Source Type: research

MCQs
Questions Which of the following are the signs of a complete palsy of the oculomotor nerve? (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Vijayanand Nadella, Henry G.W. Paw Tags: Test yourself Source Type: research

Reflexes: principles and properties
Abstract: The body responds to changing circumstances and environmental threats both consciously and subconsciously. The cognitive response to a physical threat normally involves movement mediated by skeletal muscle. There are a number of control mechanisms ‘hardwired’ into the nervous system that enable muscle systems to respond in an integrated fashion without involving a conscious decision, although the subject is usually conscious of what has happened. These include the stretch reflex, the withdrawal reflex and the crossed extensor reflexes. Muscle spindles, Golgi tendon organs and cutaneous nociceptors pro...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: James Waterhouse, Iain Campbell Tags: Physiology Source Type: research

Essential_Anasthetic_Equipment
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Tags: Physiology Source Type: research

The brain: functional divisions
Abstract: The incompletely separated cerebral hemispheres consist of a thin outer folded cortex of grey matter containing organized neuronal cell bodies and interneurons. Some of the surface convolutions subserve particular sensory or motor functions. Incoming afferent and projected efferent fibres constitute the underlying white matter, which connects different parts of each hemisphere, the hemispheres to each other and (as the corona radiata) to subcortical nuclei, especially components of the deeply-embedded diencephalon and the basal ganglia, and continuing between the latter as the internal capsule to and from the cer...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Leo Donnelly Tags: Physiology Source Type: research

Intracranial pressure and cerebral blood flow
Abstract: Intracranial pressure (ICP) is determined by the volumes of brain, blood and cerebrospinal fluid within the skull, which is of course of fixed volume. The Monro–Kellie hypothesis states that an increase in volume of one of these components must be compensated for by a reduction in volume of one or both of the others. If this compensation is insufficient, then potentially fatal increases in ICP can occur. Maintenance of relatively constant ICP is essential for normal perfusion of the brain. Cerebral blood flow is regulated both globally, in order to prevent hypo- or hyper-perfusion resulting from changes in ...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Tomas Partington, Andrew Farmery Tags: Physiology Source Type: research

Pituitary disease and anaesthesia
Abstract: Patients with pituitary gland tumours comprise a significant proportion of the neurosurgical population, making transsphenoidal pituitary surgery a relatively common procedure. Such patients present anaesthetists with unique challenges resulting from hormone hypersecretion, pituitary hypofunction or tumour mass effect. To understand this pathophysiology requires a good working knowledge of normal pituitary anatomy and physiology. An appreciation of the respiratory and cardiovascular comorbidities associated with pituitary tumours is also essential to the anaesthetist. We aim to review the key principles involved ...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Robert John, Nicholas Hirsch Tags: Neurosurgical anaesthesia Source Type: research

Subarachnoid haemorrhage and anaesthesia for neurovascular surgery
Abstract: Subarachnoid haemorrhage (SAH) is a life-threatening condition with multiple sequelae. The treatment of SAH requires urgent resuscitation and stabilization of the patient to prevent re-bleeding and to optimize cerebral oxygenation and perfusion. The perioperative care of these patients involves meticulous attention to maintain an appropriate fluid balance, cerebral blood flow and intracranial pressure. The majority of cases of SAH result from rupture of an intracerebral aneurysm and treatment involves obliteration of the aneurysmal sac either by surgical clipping or endoscopic coiling. Arteriovenous malformations...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Charlotte Moss, Sally R. Wilson Tags: Neurosurgical anaesthesia Source Type: research

Textbook of Pain
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Tags: Neurosurgical anaesthesia Source Type: research

Hypoxic–ischaemic brain injury following cardiac arrest
Abstract: Hypoxic–ischaemic brain injury (HIBI) has become an increasingly common cause of admission to intensive care units and prolonged or permanent neurological disability. It is essential to provide an accurate prognosis to guide management. Clinical assessment is often difficult and ancillary investigation is necessary. Outcome depends on the severity of the initial insult, the effectiveness of immediate resuscitation and transfer, and the post-resuscitation management on the intensive care unit. Some patients remain profoundly impaired and others may develop complications including myoclonic epilepsy, cognitiv...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Robin S. Howard Tags: Neurosurgical anaesthesia Source Type: research

Therapeutic hypothermia and acute brain injury
Abstract: The neuroprotective effects of therapeutic hypothermia (TH) have been recognized for decades, but these have generally failed to translate these into improved outcome in clinical studies. Here, we provide an overview of the putative mechanisms of hypothermia-induced neuroprotection, the technical considerations for the clinician wishing to use TH, and review the evidence for the clinical application of TH after acute brain injury (ABI).Although TH is increasingly used as a tool in the management of intracranial hypertension, its role in different ABI types is not yet fully established. Many questions remain regar...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Matthew A. Kirkman, Martin Smith Tags: Neurosurgical anaesthesia Source Type: research

Clinical neuroprotection and secondary neuronal injury mechanisms
Abstract: Multiple disease processes can ultimately lead to cerebral injury, a common cause of both severe morbidity and mortality in patients of all age groups. Cerebral injury is seen in a variety of both medical and surgical conditions, including stroke, subarachnoid haemorrhage, central nervous system infection, epilepsy, post cardiac arrest and, of course, traumatic brain injury.Although the primary damage to brain tissue may be irreversible, aggressive early physiological, pharmacological and surgical interventions may limit the ensuing secondary brain injury caused by ongoing ischaemia, and reduce the risk of severe...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Katharine Hunt, Surbhi Virmani Tags: Neurosurgical anaesthesia Source Type: research

Critical care management of severe head injury
Abstract: Severe traumatic brain injury (TBI) is a significant cause of morbidity and mortality. The intensive care management of TBI requires a coordinated and comprehensive approach to treatment, including strategies to prevent secondary brain injury by avoidance of systemic physiological disturbances, such as hypotension, hypoxaemia, hypoglycaemia, hyperglycaemia and hyperthermia, and maintenance of adequate cerebral perfusion and oxygenation. There have been marked improvements in the management of patients with severe TBI over the last two decades, and treatment advances in the pre-hospital setting and emergency depar...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Martin Smith Tags: Neurosurgical anaesthesia Source Type: research

Traumatic brain injury: initial resuscitation and transfer
Abstract: Traumatic brain injury (TBI) is common and carries a high morbidity and mortality. Initial management of the traumatic brain injury patient is directed toward preventing and limiting secondary brain injury while facilitating rapid transport to an appropriate facility capable of providing definitive neurocritical care. During resuscitation of the TBI patient, management is directed at correcting and maintaining mean arterial pressure (MAP), blood glucose, PaO2 and PaCO2 within their normal ranges. After the initial resuscitation, management is directed at limiting secondary damage to the brain that occurs in respo...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Robert John, Ian Appleby Tags: Neurosurgical anaesthesia Source Type: research

Neuromonitoring
Abstract: The monitoring of critically ill brain injured patients has become increasingly complex. Several techniques are now available for global and regional brain monitoring that provide assessment of cerebral perfusion, oxygenation and metabolic status, and early warning of impending brain hypoxia/ischaemia. Developments in multimodality monitoring have enabled a move away from rigid physiological target setting to an individually tailored, patient-specific approach to the management of acute brain injury. Multimodal monitoring generates large and complex datasets, and systems that analyse and present information in a ...
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Martin Smith Tags: Neurosurgical anaesthesia Source Type: research

Anatomy of the cranial nerves
Abstract: The cranial nerves are described, emphasizing their intracranial and extracranial relationships. Their function and distribution are emphasized as is the assessment of their integrity. A summary of how their clinical assessment is made and the consequences of their most common pathology are included. Their relevance in the diagnosis of brainstem death is made. Learning objectives focus on the practicalities of diagnosing brainstem death. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: John Craven Tags: Neurosurgical anaesthesia Source Type: research

Anatomy of the skull
Abstract: The external bony characteristics of the skull are described in this article, with emphasis on surface anatomical features, bony landmarks and relationships to nervous and vascular structures. Common fractures are described, together with their associated complications and diagnostic features. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: John Craven Tags: Neurosurgical anaesthesia Source Type: research

Cardiovascular system: critical incidents
Abstract: Cardiovascular events are an important group of critical incidents in anaesthesia. They include hypotension, hypertension, myocardial ischaemia/infarction, arrhythmias and cardiac arrest. These incidents require prompt recognition to stabilise the patient. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Authors: Amit Goswami, Ruth Spencer Tags: Perioperative care Source Type: research

Editorial Board
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 1, 2014 Category: Anesthesiology Source Type: research

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

MCQs
Which of the following are actively transported across the placenta? Glucose (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Viyayanand Nadella, Henry G.W. Paw Tags: Test yourself Source Type: research

Functions of the placenta
Abstract: The placenta is an ephemeral materno-fetal organ with chorionic (fetal) villi bathed in maternal blood spaces, which allows restricted transfer of metabolites and drugs across specialized transfer areas. The placenta develops respiratory, nutritive and excretory functions while the fetal organs mature, and is also an important endocrine organ. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Leo Donnelly, Gillian Campling Tags: Physiology Source Type: research

Uterine physiology
Abstract: The role of the uterus is to nurture the fetus until parturition. Functionally it consists of a lower cervix (which acts at different times as a passageway, a barrier and a reservoir) and an upper body in which the fetus develops. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Kamran Abbas, Suna D. Monaghan, Iain Campbell Tags: Physiology Source Type: research

Resuscitation of the newborn
This article provides a brief overview of resuscitation of the newborn. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: John Madar Tags: Neonatal anaesthesia Source Type: research

Anaesthesia for specialist surgery in infancy
Abstract: Common indications for neonatal surgery include inguinal hernias and hypertrophic pyloric stenosis. Less common conditions that have major implications for anaesthesia include tracheoesophageal fistula, congenital diaphragmatic hernia, exomphalos, gastroschisis and congenital lobar emphysema. The anaesthetic management of these conditions is outlined in this article. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Gillian Lauder, Helen Hume-Smith Tags: Neonatal anaesthesia Source Type: research

Acute pain management in the neonate
Abstract: Management of acute pain in the neonate is challenging and involves a multimodal approach using non-pharmacological and pharmacological techniques after pain assessment using appropriate tools. Simplicity equates to safety in these vulnerable patients. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Sarah Parry Tags: Neonatal anaesthesia Source Type: research

Special considerations in the premature and ex-premature infant
This article describes the clinical conditions unique to the premature and ex-premature infant, and some common surgical procedures and special considerations for the conduct of anaesthesia in this vulnerable population. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Guy Bayley Tags: Neonatal anaesthesia Source Type: research

Principles of anaesthesia for term neonates: an updated practical guide
Abstract: Term neonates present for various surgical procedures, many of which are urgent and are probably best cared for in specialised paediatric centres where expertise is concentrated. Pathophysiological derangements caused by the underlying condition, associated congenital anomalies and immaturity of key physiological and metabolic processes all contribute to make anaesthesia especially challenging in the neonate. For these reasons, anaesthesia-associated morbidity and mortality is greater in this group than in older infants and children. Meticulous attention to all aspects of perioperative care is vital to ensure the...
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Iskra Ivanova, Andrew Pittaway Tags: Neonatal anaesthesia Source Type: research

Neonatal pharmacology
Abstract: The neonatal period represents a time of rapid growth and development. As a consequence, significant pharmacokinetic and pharmacodynamic changes occur. In addition, size, age, physiological changes, pathological processes and genomics all contribute to between patient variability that should be considered when trying to predict the action and disposition of drugs in the neonate. The problem is compounded by a relative paucity of research and data on many aspects of neonatal pharmacology. These issues pose significant challenges to the clinician to deliver safe and effective drug therapy to these vulnerable patien...
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Adam V. Skinner Tags: Neonatal anaesthesia Source Type: research

Adaptation for life: a review of neonatal physiology
This article describes neonatal physiological changes in a system-based approach, including the changes that may extend beyond the neonatal period. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Authors: Alok Sharma, Simon Ford, Jennifer Calvert Tags: Neonatal anaesthesia Source Type: research

Editorial Board
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2014 Category: Anesthesiology Source Type: research

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

MCQs
Which of the following are associated with hyperkalaemia? Cushing's syndrome (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 27, 2014 Category: Anesthesiology Authors: Henry G.W. Paw, Vijayanand Nadella Tags: Test yourself Source Type: research

Local anaesthetic agents
Abstract: Local anaesthetics are weak bases and consist of a lipophilic aromatic ring, a link and a hydrophilic amine. The chemistry of the link classifies them as amides or esters. They act by blocking the sodium ionophore, especially in the activated state of the channel, and frequency dependence can be shown. The speed of onset is related to dose and proportion of drug in the unionized lipid-soluble form, which in turn is determined by the pKa and the ambient pH. Local anaesthetic agents, being weak bases, are bound in the plasma to α1-acid glycoproteins, influencing duration of action. Esters undergo hydrolysis b...
Source: Anaesthesia and intensive care medicine - January 27, 2014 Category: Anesthesiology Authors: Malachy O. Columb, Robert Hartley Tags: Pharmacology Source Type: research

Electrolyte disorders in the critically ill
This article provides a review of and guide to aetiology, analysis, and management of the major electrolytes in the critically ill. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 27, 2014 Category: Anesthesiology Authors: Raja Palepu, Ross Freebairn Tags: Intensive care Source Type: research

Management of pulmonary embolism
Abstract: Pulmonary embolism (PE) is a common condition with significant mortality and morbidity. Its occurrence frequently triggers referral to critical care services. Patients within critical care environments are also at elevated risk of developing venous thrombo-embolism and PE. This highlights the need for critical care clinicians to be confident in their approach to the patient with PE. Furthermore, the co-morbid conditions in this patient group may present additional challenges both in diagnosis (e.g. safe access to radiology) and management (e.g. relative contraindication to anticoagulation/thrombolysis in trauma o...
Source: Anaesthesia and intensive care medicine - January 27, 2014 Category: Anesthesiology Authors: John A. Strange, David Pilcher Tags: Intensive care Source Type: research

Ischaemic cardiogenic shock
Abstract: Ischaemia is the most common underlying cause of cardiogenic shock. Cardiogenic shock occurs in up to 10% of patients presenting with acute myocardial infarction and is the leading cause of death. Myocardial ischaemia results in both systolic and diastolic dysfunction and triggers a maladaptive feedback loop that can ultimately result in tissue hypoxia, multi-organ dysfunction and death. Myocardial dysfunction can be complicated by a systemic inflammatory response syndrome (SIRS) as a result of systemic hypoxia. Echocardiography is key to diagnosis and to exclude conditions requiring urgent surgical intervention....
Source: Anaesthesia and intensive care medicine - January 27, 2014 Category: Anesthesiology Authors: Ida-Fong Ukor, Lisen E. Hockings Tags: Intensive care Source Type: research