Anaesthesia for vascular surgery on the extremities
Publication date: Available online 20 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Richard J. TelfordAbstractPeripheral arterial surgery is challenging, operations are frequently long and associated with insidious blood loss. Because of the high incidence of comorbidities these patients are a high-risk group with a high incidence of morbidity and mortality. They key to successful outcome is meticulous attention to detail by all those professions involved in their care. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 20, 2019 Category: Anesthesiology Source Type: research

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

Contents
Publication date: March 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 3Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 15, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: March 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 3Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 15, 2019 Category: Anesthesiology Source Type: research

Insertion of a chest drain for pneumothorax
Publication date: Available online 15 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Bilal Kirmani, Joseph ZachariasAbstractThe insertion of a chest drain, either using the Seldinger technique or as a cut-down for a wide bore tube, is common and relatively straightforward. An appreciation of the anatomy, procedural technique and potential complications is important. The process is outlined here. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 15, 2019 Category: Anesthesiology Source Type: research

Complications of regional anaesthesia
Publication date: Available online 14 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Alasdair Taylor, Calum R.K. GrantAbstractComplications of regional anaesthesia can be divided into those specific to central neuraxial blockade, those specific to peripheral nerve blockade, and those that pertain to both. Fortunately, severe complications, namely spinal cord damage, vertebral cord haematoma and epidural abscess are rare. Here we have given an overview of these complications, with reference to incidences available following the 3rd National Audit Project of the Royal College of Anaesthetists. A thorou...
Source: Anaesthesia and intensive care medicine - March 14, 2019 Category: Anesthesiology Source Type: research

Lower limb nerve blocks
Publication date: Available online 14 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Calum R.K. GrantAbstractThe proliferation of ultrasound use is changing the approach to regional anaesthesia of the lower limb. Techniques are being developed that provide high-quality postoperative analgesia while minimizing associated motor block that may impair mobilization. Regional anaesthetic techniques also provide significant opioid-sparing benefits (e.g. less sedation, nausea and urinary retention) that are key principles of current enhanced recovery protocols. Ultrasound-guided nerve localization offers sev...
Source: Anaesthesia and intensive care medicine - March 14, 2019 Category: Anesthesiology Source Type: research

Systemic toxic effects of local anaesthetics
Publication date: Available online 13 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Heather N. Sheppard, Ravi AnandampillaiAbstractLocal anaesthetics are widely used in the provision of local/regional anaesthesia and the management of acute and chronic pain. Their mechanism of action temporarily inhibits voltage gated sodium channels in neuronal plasma membranes. Local anaesthetic systemic toxicity (LAST) is a serious yet largely preventable complication that can occur by any of the multiple routes of administration. LAST predominantly affects the central nervous and cardiovascular systems. Awarenes...
Source: Anaesthesia and intensive care medicine - March 14, 2019 Category: Anesthesiology Source Type: research

Practical aspects of ultrasound-guided regional anaesthesia
Publication date: Available online 8 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Pavan Kumar BC. Raju, Calum RK. GrantAbstractUltrasound-guided regional anaesthesia is increasingly popular, offering the user a number of advantages over alternative methods of nerve localization (neurostimulation or paraesthesia). These include a more accurate understanding of individual patient anatomy, identification of needle tip position and the ability to assess local anaesthetic spread in relation to a target nerve. An understanding of the basic principles and commonly used terminologies of ultrasound scanning...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Intravenous regional anaesthesia
Publication date: Available online 7 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Alastair J.M. Baird, Colin B. DonaldAbstractIntravenous regional anaesthesia, or Bier's block, is a useful and safe technique for anaesthetizing distal limbs for short surgical procedures. It is most commonly used for reduction of forearm fractures within the emergency department and can be a useful method of providing anaesthesia in patients who may be unsuitable for a general anaesthetic, or when skills or equipment for other forms of regional anaesthesia are unavailable. When performed as recommended it has a prove...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Nerve cell function and synaptic mechanisms
Publication date: Available online 7 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Allan FletcherAbstractNerve cells (neurones) are ‘excitable’ cells that can transduce a variety of stimuli into electrical signals, continuously sending information about the external and internal environment (in the form of sequences of action potentials) to the central nervous system (CNS). Interneurones in the CNS integrate this information and send signals along output (efferent) neurones to various parts of the body for the appropriate actions to be taken in response to environmental changes. Networks...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Peripheral nerve catheter techniques
Publication date: Available online 7 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Ayman H.M. MustafaAbstractPeripheral nerve catheters (PNC) or perineural catheters are used synonymously to describe placing a catheter in close proximity to nerve plexuses or individual nerves for the provision of continuous pain relief. The indications of PNCs extend beyond upper and lower extremity orthopaedic surgery to perioperative analgesia in patients undergoing a wide range of surgical procedures (e.g. abdominal, vascular, thoracic, breast and trauma surgeries). PNC use can facilitate early mobilization after...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Action potential: generation and propagation
Publication date: Available online 8 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Allan FletcherAbstractIn the normal resting state, the plasma membrane of nerve and muscle cells generates a transmembrane electrical potential difference – the intracellular surface of the membrane being approximately 70–80 mV negative to the extracellular surface. This is a result of markedly different concentrations of ions inside and outside the cell, together with different membrane permeabilities to different ions that permits K+ to flow down their concentration gradient from inside to outside t...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Upper limb nerve blocks
Publication date: Available online 8 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Pavan Kumar B.C. Raju, James S. BownessAbstractBrachial plexus blockade is used for a variety of upper limb surgical procedures. Ultrasound guidance is generally considered to be the gold-standard technique, although large-scale studies examining efficacy and complications of ultrasound-guided techniques compared with nerve stimulation are still needed. Interscalene block remains the approach of choice for shoulder surgery, although phrenic nerve blockade is common even using low volumes of local anaesthetic. Of the c...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Omics and anaesthesia: pharmacogenomics, proteomics and metabolomics
Publication date: Available online 8 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Thomas E.F. Walton, Jonathan N. RajanAbstractThe inter-individual response to medications and the presence of genetic polymorphisms which impact the safe conduct of anaesthesia and analgesia are of paramount importance to the anaesthetist, intensivist and pain physician. The frequency of these phenomena is not reflected in the attention afforded them in undergraduate or postgraduate curricula. In order to appreciate how these issues may affect our clinical practice, it is crucial to have a working understanding of the...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Strategies to avoid intraoperative blood transfusion
This article addresses the current evidence base for correction of preoperative anaemia, normalization of iatrogenic and pathological coagulopathy, intraoperative strategies for optimal blood product usage and management of postoperative anaemia. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 7, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 26 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Vijayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 27, 2019 Category: Anesthesiology Source Type: research

Capillary dynamics, interstitial fluid and the lymphatic system
Publication date: Available online 26 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Andrew Haggerty, Mahesh NirmalanAbstractThe regulation of small blood vessels (arterioles, venules and capillaries) and the formation of interstitial fluid at the capillary beds is an important process in the understanding of the healthy circulation. Traditionally, the Starling forces have been at the very heart of our understanding of this system. However more recent work shows that the trans-vascular fluid flux is significantly lower than what one would expect on the basis of Starling's forces alone and hence al...
Source: Anaesthesia and intensive care medicine - February 26, 2019 Category: Anesthesiology Source Type: research

Physiology of haemostasis
This article will provide an overview of the current concepts of haemostasis, and through this we will explain how antiplatelets and antithrombotic drugs work, as well as provide a basic understanding of how to interpret clotting tests used to measure coagulation disorders. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 25, 2019 Category: Anesthesiology Source Type: research

Iron metabolism
Publication date: Available online 22 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Deirdre Conway, Mark A. HendersonAbstractIron is a key micronutrient and has a vital role in oxygen transport through its presence in haemoglobin and a key part in oxidative phosphorylation via electron transfer in cytochromes. Total body iron is approximately 4000 mg in a 70 kg man. This goes through a continual cycle of conservation and re-utilization. Syndromes of iron deficiency and overload arise from aberrancy within the steps of iron metabolism. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 23, 2019 Category: Anesthesiology Source Type: research

Characteristics of special circulations
Publication date: Available online 22 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Marina SawdonAbstractBlood flow through a vascular bed is usually determined by the pressure gradient across it and the diameter of the precapillary resistance vessels. Special circulations have additional specific features of blood flow control. Several organs control their blood supply by autoregulation. Coronary blood flow is linked to myocardial oxygen consumption, primarily by a metabolic mechanism. Increases in demand or decreases in supply of oxygen cause the release of vasodilator metabolites, which act on...
Source: Anaesthesia and intensive care medicine - February 23, 2019 Category: Anesthesiology Source Type: research

Clinical aspects of coagulation and haemorrhage
Publication date: Available online 21 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Jay Dhanapal, Nicola CurryAbstractHaemorrhage affects all patient groups. Coagulopathy (an abnormality of the clotting system) is closely interlinked with haemorrhage and can either place patients at risk of future bleeding or can exacerbate active ongoing bleeding. There are many causes of coagulopathy, both inherited and acquired. During major haemorrhage, the presence of an acquired coagulopathy increases the likelihood of a poor clinical outcome and a patient is more likely to require large transfusion volumes...
Source: Anaesthesia and intensive care medicine - February 22, 2019 Category: Anesthesiology Source Type: research

Risks of perioperative blood transfusions
This article outlines the risks associated with perioperative transfusions and discusses the current recommendations for transfusion and use of alternatives to blood transfusion. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 22, 2019 Category: Anesthesiology Source Type: research

Physiology of red and white blood cells
Publication date: Available online 21 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Amy Glenn, Catherine E. ArmstrongAbstractBlood is made up of plasma and formed elements, which are red blood cells, white blood cells and platelets. The red blood cells (erythrocytes) make up the vast majority of the cells present in the blood. Their principal function is the transport of oxygen from the lungs to the tissues and the transport of carbon dioxide from those tissues back to the lungs. This is due to the presence of haemoglobin, a protein that binds easily and reversibly with oxygen. The affinity of ha...
Source: Anaesthesia and intensive care medicine - February 22, 2019 Category: Anesthesiology Source Type: research

Jehovah's Witnesses
Publication date: Available online 21 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Catherine BrydonAbstractThe Jehovah's Witness Society is a Christian movement established in the 1870s. It has around 8 million members worldwide who believe that the Bible prohibits the transfusion of blood and its primary components. Some minor components of plasma and clotting factors may be acceptable to some members of the faith. Similarly, some will accept intraoperative cell salvage where their own blood from the surgical site can be aspirated and returned to them provided the blood remains within a closed ...
Source: Anaesthesia and intensive care medicine - February 22, 2019 Category: Anesthesiology Source Type: research

Pre-optimization of the anaemic patient
Publication date: Available online 21 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Alwyn KotzéAbstractPreoperative anaemia is common. Its prevalence varies according to the population studied and the definition of what constitutes anaemia. Where the widely accepted definition of the World Health Organization is used (haemoglobin concentration
Source: Anaesthesia and intensive care medicine - February 22, 2019 Category: Anesthesiology Source Type: research

Cardiac output measurement
Publication date: Available online 22 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Benjamin Kolb, Vikas KapoorAbstractCardiac output measurement has become increasingly important in anaesthesia and critical care, particularly with the growing emphasis on perioperative medicine. Flow cannot be measured by any direct means and therefore models are employed to deduce useful information from other parameters. Numerous techniques are available, each with advantages and disadvantages in terms of invasiveness and validity. Often a balance is struck between invasiveness and validity of the measurements,...
Source: Anaesthesia and intensive care medicine - February 22, 2019 Category: Anesthesiology Source Type: research

Anaesthesia for patients with sickle cell and other haemoglobinopathies
Publication date: Available online 22 February 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Lorna CJ. Sissons, Kailash BhatiaAbstractSickle cell disease is an autosomal recessive multi-systemic condition, caused as a result of a mutation in chromosome 11 resulting in production of abnormal beta globin of haemoglobin or HbS. The abnormality under specific conditions results in polymerization of the globin chain resulting in deformed sickle-shaped red cells. These haemolyse under adverse conditions resulting in occlusion within the circulatory system resulting in cardiorespiratory, neurological, renal, mus...
Source: Anaesthesia and intensive care medicine - February 22, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: February 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 2Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 7, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: February 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 2Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - February 7, 2019 Category: Anesthesiology Source Type: research

Principles of artificial ventilation
Publication date: Available online 23 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Ben Brown, Justin RobertsAbstractThe application of intermittent positive pressure ventilation (IPPV) during the 1952 Copenhagen polio epidemic led to the development of the world's first intensive care unit. The requirement for ventilatory support is the most common indication for intensive therapy unit (ITU) admission and is a defining feature of the specialty. Ventilator technology continues to develop and there are many ways to deliver IPPV. The variety of modes of ventilation is increasingly complex and expand...
Source: Anaesthesia and intensive care medicine - January 24, 2019 Category: Anesthesiology Source Type: research

Intravenous anaesthetic agents
This article gives an overview of drugs frequently used for intravenous anaesthetic induction, as well as a brief overview of total intravenous anaesthesia. Physio chemical properties of intravenous anaesthetic drugs, their clinical and adverse effects are summarized. The article also discusses the historical context on the introduction of intravenous anaesthetic agents and highlights developments of novel agents. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 20, 2019 Category: Anesthesiology Source Type: research

Postoperative analgesia
Publication date: Available online 18 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Katharine C. Ireland, Abdul G. LalkhenAbstractPain is a complex experience consisting of sensory, affective, behavioural and physiological components. Pain management is therefore best achieved through an approach which acknowledges the complex interaction between biological, psychological and sociocultural factors. Effective pain management requires preoperative patient engagement and education in order to manage expectations and a structured inpatient service to facilitate evidence-based postoperative pain manage...
Source: Anaesthesia and intensive care medicine - January 20, 2019 Category: Anesthesiology Source Type: research

The anaesthetic machine
Publication date: Available online 18 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Nicholas Record, Christina BeecroftAbstractModern anaesthetic machines have improved greatly since 1917 when Boyle modified the American Gwathmey apparatus of 1912 to develop the ubiquitous continuous flow anaesthetic machine. Despite this, the basic principles and many components remain, albeit in modernized form. Gas is still supplied to the machine from a high-pressure source which is stepped down to a safe pressure supplying the breathing system. Flowmeters control gas flow and allow for adjustment of different...
Source: Anaesthesia and intensive care medicine - January 20, 2019 Category: Anesthesiology Source Type: research

Inhalational anaesthetic agents
Publication date: Available online 17 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Emma Temple, Matt WilesAbstractThe continued development of anaesthetic agents since the late 18th century has paved the way for the progression of surgical techniques. Inhalational agents are used worldwide for the delivery of safe, effective anaesthesia. These include the volatile agents halothane, isoflurane, sevoflurane and desflurane, in addition to the anaesthetic gases nitrous oxide and xenon. Although the newer volatiles have an improved safety profile in comparison to older agents, the ideal anaesthetic ag...
Source: Anaesthesia and intensive care medicine - January 18, 2019 Category: Anesthesiology Source Type: research

Total intravenous anaesthesia
This article describes the use of target controlled infusion models and principles, which enable anaesthetists to deliver TIVA safely. The Association of Anaesthetists of Great Britain and Ireland and the Society of Intravenous Anaesthesia have produced Guidelines for safe practice of TIVA in 2018. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 18, 2019 Category: Anesthesiology Source Type: research

The principles of anaesthetic vaporizers
Publication date: Available online 17 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Paul Wasik, Ravi AnandampillaiAbstractFluorinated hydrocarbons have transformed inhalational anaesthesia, and vaporizers are essential for safe and accurate delivery of these agents. The modern day vaporizers have evolved considerably since the ether inhaler invented by John Snow in 1847 and are robust, precise and efficient. For an anaesthetist to administer safe inhalational anaesthetic, it is important to understand the physical principles of the various inhalational anaesthetic agents along with the working pri...
Source: Anaesthesia and intensive care medicine - January 18, 2019 Category: Anesthesiology Source Type: research

Anaesthetic breathing systems
Publication date: Available online 17 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Andrew Donnelly, Stuart DollingAbstractA breathing system is a series of components that allows the delivery of oxygen and other anaesthetic gases to the patient as well as aiding in the removal of carbon dioxide. There are key elements that feature in all anaesthetic breathing systems with numerous classification systems used. The layout of individual breathing systems determines their clinical application and use. All of the above will be discussed further in this article as well as a brief summary of the use of ...
Source: Anaesthesia and intensive care medicine - January 18, 2019 Category: Anesthesiology Source Type: research

Pharmacokinetic variation
This article will review how physiological, pathological and pharmacological processes can influence all of these factors. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 17, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 14 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Vijayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 15, 2019 Category: Anesthesiology Source Type: research

Effects of smoking on health and anaesthesia
Publication date: Available online 14 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Phillippa Shorrock, Nawar BakerlyAbstractLegislation prohibiting smoking in workplaces and enclosed public places was introduced in England in July 2007. This, in addition to the 2012 prohibition of tobacco promotion, and the increased use of e-cigarettes, are all changing our smoking behaviour as a nation. Nevertheless tobacco remains a major factor in disease development and smokers continue to present a number of anaesthetic challenges. Perioperative smoking cessation is beneficial and NHS support is available t...
Source: Anaesthesia and intensive care medicine - January 15, 2019 Category: Anesthesiology Source Type: research

Patient selection for day case surgery
Publication date: Available online 14 January 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Alexandra Humphreys, Mary StockerAbstractDay surgery provides many benefits to patients and trusts. Currently, almost all surgery should be performed as day case or very short stay and as such the criteria for suitability for day case surgery have been much expanded over recent decades. Social and medical criteria should rarely prevent successful day case surgery; we present suggestions whereby historic barriers to discharge can be overcome. We discuss the suitability of surgical procedures to be performed as a day...
Source: Anaesthesia and intensive care medicine - January 15, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: January 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 1Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 9, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: January 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 1Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 9, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 20 December 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 20, 2018 Category: Anesthesiology Source Type: research

Nosocomial infections in the ICU
Publication date: Available online 18 December 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Stuart Edwardson, Chris CairnsAbstractNosocomial infections are a major cause of avoidable morbidity, mortality and extended length of stay in ICU. Prevention of these infections is key. Continual surveillance, audit and hand hygiene are therefore vital. The recent introduction of ‘care bundles’ grouping best practices for care of invasive devices have proven highly successful for reducing the rates of nosocomial infection in the ICU. Despite these strategies patients in the ICU are still twice as like...
Source: Anaesthesia and intensive care medicine - December 19, 2018 Category: Anesthesiology Source Type: research

Recognition of the critically ill patient and escalation of therapy
Publication date: Available online 17 December 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Amy Brown, Apoorva Ballal, Mo Al-HaddadAbstractCritical illness often involves multiple organ failures and is associated with significant morbidity and mortality. In the vast majority of patients, there is a recognizable period of physiological deterioration which heralds the development of organ failure and critical illness. Despite efforts to improve the detection and management of critical illness, signs of deterioration are often missed and decisions to move patients to critical care units are delayed. Standar...
Source: Anaesthesia and intensive care medicine - December 18, 2018 Category: Anesthesiology Source Type: research

Developmental anatomy of the airway
Publication date: Available online 14 December 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Niall Wilton, Henrik HackAbstractThe airway develops from the primitive foregut at 4 weeks’ gestation. Congenital anomalies may result when this process is abnormal. The anatomy of the airway at birth is uniquely different from older children and adults, with a large tongue, long floppy epiglottis, large occiput and cephalad larynx. These features affect the technique required for facemask ventilation, supraglottic airway use and endotracheal intubation. A neutral head position and straight bladed laryngosco...
Source: Anaesthesia and intensive care medicine - December 15, 2018 Category: Anesthesiology Source Type: research

Consent and children
This article discusses consent, and its refusal, to medical interventions by children and adolescents. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 15, 2018 Category: Anesthesiology Source Type: research

Principles of intravenous drug infusion
Publication date: Available online 15 December 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): David J. ChambersAbstractIntravenous infusions are required when a drug has a short half-life or a narrow therapeutic window. Pharmacokinetic models are employed to calculate the infusion rate for a particular target plasma concentration. While the one-compartment model is based on relatively simple mathematics, it is of little practical use. Multi-compartment models involve complex mathematics: a bolus-infusion regimen requires a variable-infusion rate. In clinical practice, this means incorporating the pharmacok...
Source: Anaesthesia and intensive care medicine - December 15, 2018 Category: Anesthesiology Source Type: research