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Editorial Board
Publication date: February 2020Source: Anaesthesia & Intensive Care Medicine, Volume 21, Issue 2Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 7, 2020 Category: Anesthesiology Source Type: research

The management of pulmonary embolism
Publication date: Available online 6 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Tamara P. Banerjee, Juan Carlos. MoraAbstractPulmonary embolism (PE) is a significant cause of hospitalization, morbidity and mortality, frequently requiring critical care services. Critically ill patients are also at increased risk of developing venous thromboembolism and acute PE. Critical care clinicians should be confident in their approach to the patient with suspected and diagnosed PE. Furthermore, the comorbid conditions in this patient group may present additional challenges both in diagnosis (e.g. safe access ...
Source: Anaesthesia and intensive care medicine - February 6, 2020 Category: Anesthesiology Source Type: research

Electrolyte disorders in the critically ill
This article provides a guide to the aetiology, analysis and management of major electrolyte disorders in the critically ill. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 6, 2020 Category: Anesthesiology Source Type: research

Shock: causes, initial assessment, and investigations
Publication date: Available online 4 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Gráinne Gallagher, Dashiell GantnerAbstractShock is an umbrella term used to describe pathological processes that clinically manifest in a final common pathway of widespread cellular hypoxia. Shock develops through the interplay of disease processes and maladaptive host responses resulting in disrupted homeostasis. Central and generic components of shock include cellular hypoxia, hyperlactaemia and hypotension. Multiorgan failure usually ensues if left untreated or when management is delayed. The long-term effects inc...
Source: Anaesthesia and intensive care medicine - February 5, 2020 Category: Anesthesiology Source Type: research

Ischaemic cardiogenic shock
This article highlights several key recent advances in the management of ischaemic cardiogenic shock, including the use of early bedside echocardiography to confirm the diagnosis, and culprit only lesion strategies of early revascularization. Furthermore, we appraise the variety of mechanical cardiac supports that are increasingly being used to assist the management of ischaemic cardiogenic shock in those cases refractory to pharmacological intervention. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 4, 2020 Category: Anesthesiology Source Type: research

Macronutrients, minerals, vitamins and energy
Publication date: Available online 1 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Rahul Costa-Pinto, Dashiell GantnerAbstractMacronutrients comprise carbohydrates, fats and proteins and make up most of the body's soft tissue structure. Carbohydrates are organic molecules made of carbon, hydrogen and oxygen atoms. Fats are composed of carbon, hydrogen and oxygen, but the proportion of oxygen atoms to carbon and hydrogen is lower than in carbohydrates. Proteins are usually made up of more than 100 amino acids linked into chains by peptide bonds. Amino acids consist of an asymmetrical carbon atom with ...
Source: Anaesthesia and intensive care medicine - February 1, 2020 Category: Anesthesiology Source Type: research

Protective mechanisms of the body
Publication date: Available online 1 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Clemente Chia, Jason McClureAbstractThe skin and mucous membranes are the body's first line of defence against infection. The surface of the skin is acidic and inhibits the growth of organisms, and the openings to the various body cavities (respiratory tract, gastrointestinal tract, genitourinary tract) are lined with mucous membranes which trap bacteria and other particles. The body's outer surfaces produce chemicals which are bactericidal, skin is shed and membranes expectorate mucous in order to expel pathogens. Com...
Source: Anaesthesia and intensive care medicine - February 1, 2020 Category: Anesthesiology Source Type: research

Neonatal pharmacology
Publication date: Available online 27 January 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Brian J. AndersonAbstractNeonatal anaesthesia dosing needs to be based on physiological characteristics of the newborn, pharmacokinetic knowledge, pharmacodynamic considerations and the adverse effects profile. Disease processes and treatments in this group are distinct from adults. Immaturity of enzyme, anatomical and physiological systems cause extensive variability of drug disposition and drug response in neonates. This is further compounded by pharmacogenomic influences. Postmenstrual age is a reasonable measure fo...
Source: Anaesthesia and intensive care medicine - January 28, 2020 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 27 January 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 28, 2020 Category: Anesthesiology Source Type: research

Anaesthesia for surgery in infancy
Publication date: Available online 25 January 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Graham Knottenbelt, Amanda DaltonAbstractSpecialist surgery in infancy provides challenges for paediatric anaesthetists. There is growing appreciation that the relatively higher rate of severe critical events in infants during the perioperative period requires appropriate competence, experience and resources for the safe conduct of anaesthesia. Both common (inguinal hernias and hypertrophic pyloric stenosis) and less common conditions (tracheo-oesophageal fistula, congenital diaphragmatic hernia, exomphalos, gastroschi...
Source: Anaesthesia and intensive care medicine - January 26, 2020 Category: Anesthesiology Source Type: research

Adaptation for life after birth: a review of neonatal physiology
This article combines well-established and contemporary information to summarize a systems-based approach to traditional neonatal physiology. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 26, 2020 Category: Anesthesiology Source Type: research

Special considerations in the premature and ex-premature infant
Publication date: Available online 25 January 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Geoff FrawleyAbstractAdvances in neonatal medicine have progressively increased the survival of premature infants. Increased survival has, however, come at the cost of increased number of infants with prematurity related complications. This is represented by high rates of respiratory distress syndrome, bronchopulmonary dysplasia, necrotising enterocolitis, sepsis, periventricular leukomalacia, intraventricular haemorrhage, cerebral palsy, hypoxic ischaemic encephalopathy and visual and hearing problems in survivors. In...
Source: Anaesthesia and intensive care medicine - January 26, 2020 Category: Anesthesiology Source Type: research

Principles of anaesthesia for term neonates
Publication date: Available online 25 January 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Kylie McGregor, Saana TaylorAbstractAnaesthesia for term neonates is associated with increased perioperative morbidity and mortality and as a result should be reserved for specialized paediatric centres. Neonatal systems are immature and are undergoing rapid growth and development. Neonates are uniquely different in how they respond to surgery, drugs and fluids and this response varies across the neonatal period. Many of the physiological differences in neonates are a reflection of their high metabolic rate, increase i...
Source: Anaesthesia and intensive care medicine - January 26, 2020 Category: Anesthesiology Source Type: research

Acute pain management in the neonate
Publication date: Available online 25 January 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Peter Carachi, Glyn WilliamsAbstractAcute pain management in the neonatal period remains a challenge for the clinician. Responses to pain and analgesic intervention are developmentally influenced and cannot be directly extrapolated from the older child. Successful and safe intervention will minimize acute physiological and behavioural distress, reduce pain scores and potentially improve short- and long-term outcomes. This requires an understanding of the physiology and pharmacology in this age group alongside a multi-m...
Source: Anaesthesia and intensive care medicine - January 26, 2020 Category: Anesthesiology Source Type: research

Local anaesthetic drugs
Publication date: Available online 25 January 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Sarah L. Perrin, Christopher Bull, Sheila BlackAbstractLocal anaesthetics (LA) are weak bases consisting of a lipophilic aromatic ring linked to a hydrophilic tertiary amine by either an ester or amide bond. It is this chemical link that enables classification of the LA. They exist in solution as an equilibrium of ionized and unionized forms. The unionized form is free to diffuse across the axonal membrane, but it is the ionized form which then binds and blocks the intracellular portion of the voltage gated sodium chan...
Source: Anaesthesia and intensive care medicine - January 26, 2020 Category: Anesthesiology Source Type: research