Mechanisms of drug interactions: pharmacodynamics and pharmacokinetics
Publication date: Available online 19 March 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Kathryn Corrie, Jonathan G. Hardman (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 19, 2020 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 13 March 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 15, 2020 Category: Anesthesiology Source Type: research

Contents
Publication date: March 2020Source: Anaesthesia & Intensive Care Medicine, Volume 21, Issue 3Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 13, 2020 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: March 2020Source: Anaesthesia & Intensive Care Medicine, Volume 21, Issue 3Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 13, 2020 Category: Anesthesiology Source Type: research

Gas, tubes and flow
Publication date: Available online 10 March 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Mark A. Henderson, Colin Runcie (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 11, 2020 Category: Anesthesiology Source Type: research

Obstructive sleep apnoea and anaesthesia
Publication date: Available online 4 March 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Kim Flatman, Diana Raj (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 6, 2020 Category: Anesthesiology Source Type: research

Percutaneous tracheostomy and cricothyrotomy techniques
Publication date: Available online 5 March 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Nicola Doody, Neil Smart (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 6, 2020 Category: Anesthesiology Source Type: research

Adverse drug reactions
Publication date: Available online 29 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Hina Lodhi, Jonathan Thompson (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2020 Category: Anesthesiology Source Type: research

Transtracheal jet ventilation
Publication date: Available online 29 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Shubhranshu Gupta, Rob O'Donnell (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2020 Category: Anesthesiology Source Type: research

Ear, nose and throat emergencies
Publication date: Available online 29 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Dmitrijs Sokolovs, Ker Wei Tan (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2020 Category: Anesthesiology Source Type: research

Airway trauma
Publication date: Available online 29 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Deirdre Conway, Craig Urquhart (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2020 Category: Anesthesiology Source Type: research

Anaesthesia for endoscopic surgery
Publication date: Available online 29 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Michael H. MacMillan, Marie Davidson (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 1, 2020 Category: Anesthesiology Source Type: research

Alternative techniques for tracheal intubation
Publication date: Available online 28 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Karen McCluskey, Miriam Stephens (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 29, 2020 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 21 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 22, 2020 Category: Anesthesiology Source Type: research

Maintenance of anaesthesia
Publication date: Available online 12 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Thomas E.F. Walton, James PalmerAbstractThe maintenance phase of general anaesthesia begins immediately following induction of, and ends immediately prior to emergence from, a state of intended unrousable unconsciousness. Maintenance of anaesthesia requires the application of a wide range of knowledge and skills, demanding a solid grounding in basic science, practical abilities and team management. These factors are considered in this article. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 13, 2020 Category: Anesthesiology Source Type: research

Intermediary metabolism
Publication date: Available online 13 February 2020Source: Anaesthesia & Intensive Care MedicineAuthor(s): Shilpa Veerappa, Jason McClureAbstractIntermediary metabolism refers to the sum of all intracellular chemical processes by which nutritive material is converted into cellular components. It includes anabolism (synthesis of macromolecules) and catabolism (breakdown of macromolecules). Cellular energy is generated from aerobic oxidation of metabolic fuels (carbohydrates, fats, proteins) derived from digestion of a meal or from breakdown of internal stores. These metabolic fuels are broken down into basic substrates ...
Source: Anaesthesia and intensive care medicine - February 13, 2020 Category: Anesthesiology Source Type: research

Contents
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

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 acc...
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 e...
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 w...
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....
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 measur...
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, gastro...
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...
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, increa...
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 mul...
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 ...
Source: Anaesthesia and intensive care medicine - January 26, 2020 Category: Anesthesiology Source Type: research

Contents
Publication date: January 2020Source: Anaesthesia & Intensive Care Medicine, Volume 21, Issue 1Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 17, 2020 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: January 2020Source: Anaesthesia & Intensive Care Medicine, Volume 21, Issue 1Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 17, 2020 Category: Anesthesiology Source Type: research

Preoperative evaluation of neurosurgical patients
This article focuses on the required preoperative preparation of neurosurgical patients. Both intracranial and spinal surgery is associated with significant morbidity (22 % and 11 %, respectively). There is an overall estimated 30-day mortality risk of around 0.5% for spinal surgery, rising to 4.8 % for intracranial surgery. The most common complications include: the need for re-intervention, blood transfusion, pneumonia and urinary tract infection. Preoperative assessment must consider the surgical procedure being undertaken, pathology and its presentation, as well as patient related factors that can be optimized prior to...
Source: Anaesthesia and intensive care medicine - December 24, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 19 December 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 20, 2019 Category: Anesthesiology Source Type: research

Acute management of ischaemic stroke
Publication date: Available online 19 December 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Deborah R. Douglas, Valpuri Luoma, Ugan ReddyAbstractAn acute ischaemic stroke (AIS) is a non-specific state of brain injury with neuronal dysfunction that has several pathophysiologic causes and is time critical. More than 70% of cases are due to thrombotic or embolic causes with resultant focal ischaemia and an accompanying neurological deficit. Initial assessment, stabilization and early imaging are important aspects of effective stroke management. Over the last two decades, thrombolysis and mechanical thrombec...
Source: Anaesthesia and intensive care medicine - December 20, 2019 Category: Anesthesiology Source Type: research

Clinical approach to comatose patients
Publication date: Available online 20 December 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Rosie May, Katharine HuntAbstractComa is a state of unarousable unconsciousness and can occur as result of many general medical and neurological conditions. In this article we present a structured approach to the investigation and management of a patient who presents with coma and discuss the importance of identifying the underlying cause in attempting to prevent secondary brain damage, as well as for prognostication. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 20, 2019 Category: Anesthesiology Source Type: research

Pharmacological and pathological modulation of cerebral physiology
This article outlines how delivery of anaesthesia and disease processes affecting the brain modulate the mechanisms that regulate cerebral blood flow and metabolism. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 19, 2019 Category: Anesthesiology Source Type: research

Anaesthesia for neurosurgery
Publication date: Available online 18 December 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Selina Ho, Oliver Hambidge, Robert JohnAbstractNeuroanaesthesia is an expanding specialty that requires a good understanding of neurophysiology as well as the pathophysiology of raised intracranial pressure. Neuroanaesthetists need to ensure neurosurgical patients maintain an adequate cerebral perfusion pressure intraoperatively, whist providing optimum operating conditions. To achieve this, a balanced anaesthetic technique preventing hypertensive surges and optimizing cerebral venous drainage by careful patient p...
Source: Anaesthesia and intensive care medicine - December 19, 2019 Category: Anesthesiology Source Type: research

Ion channels, receptors, agonists and antagonists
This article describes the physiology of ion channels and the principal molecular mechanisms responsible for modulating their activity by commonly used drugs in anaesthesia and intensive care. The concept of efficient and selective transport of ions across ‘impermeable’ plasma membranes is introduced, together with the mechanisms influencing electrochemical signalling within cells. The classification and composition of voltage-gated ion channels are described in the context of their contribution to action potential generation in excitable cells. Drug–receptor interaction of the four main classes of recept...
Source: Anaesthesia and intensive care medicine - December 19, 2019 Category: Anesthesiology Source Type: research

Prion diseases
Publication date: Available online 19 December 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Michelle LeemansAbstractThe prion diseases, or transmissible spongiform encephalopathies (TSEs), are a group of neurodegenerative diseases. They are caused by an abnormal form of a naturally occurring cellular protein, known as prion protein. All prion diseases are fatal and without cure. Although all are rare, interest has increased over the last 20 years due to the appearance of a new prion disease called variant Creutzfeldt-Jakob disease. This disease is transmissible via medical devices and blood and therefore...
Source: Anaesthesia and intensive care medicine - December 19, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: December 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 12Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 17, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: December 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 12Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 17, 2019 Category: Anesthesiology Source Type: research

Cerebrospinal fluid and its physiology
This article describes the anatomy and physiology of CSF, and how abnormalities can result in hydrocephalus. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 13, 2019 Category: Anesthesiology Source Type: research

The management of spontaneous primary intracerebral haemorrhage
Publication date: Available online 12 December 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Christopher J. TaylorAbstractIntracerebral haemorrhage (ICH) accounts for around 10–20% of all strokes and results from a variety of disorders. ICH is more likely to result in death or major disability than ischaemic stroke or subarachnoid haemorrhage. Rapid imaging allows early diagnosis and characterization of the localization and severity of the haemorrhage. Patients with significant acute ICH should be managed in a critical care unit. Treatment entails general supportive care, control of blood pressure a...
Source: Anaesthesia and intensive care medicine - December 13, 2019 Category: Anesthesiology Source Type: research

Principles of intraoperative neurophysiological monitoring and anaesthetic considerations
Publication date: Available online 12 December 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Brett Sanders, Santiago Catania, Astri MV. LuomaAbstractSurgery to the nervous system poses risks to neural structures be that mechanical, haemodynamical, chemical or thermal. The role of intraoperative neurophysiological monitoring (IONM) is to facilitate the assessment of the functional integrity of neural structures and provide a real time alerting system when changes caused by surgically induced insults are detected, with the goal of reducing the risk of postoperative neurological deficits. Furthermore, it is ...
Source: Anaesthesia and intensive care medicine - December 13, 2019 Category: Anesthesiology Source Type: research

Anaesthesia for interventional neuroradiology
Publication date: Available online 12 December 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Sarah J. Muldoon, Ian ApplebyAbstractThe volume and range of procedures undertaken by interventional neuroradiologists continues to expand. They are now treating many conditions previously considered untreatable or only amenable to open surgical techniques. To facilitate the close cooperation required between radiologists and anaesthetists necessary for the successful outcome of these complex and lengthy procedures, it is important for the anaesthetist to have an appreciation of the pathophysiology, potential mult...
Source: Anaesthesia and intensive care medicine - December 13, 2019 Category: Anesthesiology Source Type: research

Applied cerebral physiology
This article reviews cerebral metabolism and blood flow, and the pressure dynamics within the cranial cavity. The brain functions within the confines of the cranial cavity and it is important to understand the dynamics of the parenchyma, cerebrospinal fluid and blood in relation to intracranial pressure (ICP) and metabolic needs. It requires an uninterrupted supply of oxygen and glucose to maintain its basal energy requirements and these are increased during periods of enhanced activity. Cerebral blood flow (CBF) is therefore critical for normal cerebral function. Its control is dictated by local intrinsic metabolic needs ...
Source: Anaesthesia and intensive care medicine - December 13, 2019 Category: Anesthesiology Source Type: research

Therapeutic hypothermia and acute brain injury
This article will review the basic science the practical aspects of delivering targeted temperature management and evaluate the evidence behind its use for acute brain injuries. With a lack of high-quality evidence for hypothermia, recent consensus statements are shifting the paradigm away from hypothermia to the maintenance of normothermia and prevention of pyrexia. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 13, 2019 Category: Anesthesiology Source Type: research