Preoperative assessment in patients presenting for elective surgery
This article provides a systematic approach to the assessment process. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 1, 2018 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Vijayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 1, 2018 Category: Anesthesiology Source Type: research

Osmolarity and partitioning of fluids
This article first outlines definitions and descriptions of key terms that will be used in the discussions that follow, including osmolarity, osmolality, osmotic and oncotic pressure. The physicochemical properties of water, ions and organic molecules are discussed in terms of their biological roles. Similarly, the interactions of amphipathic molecules and their three-dimensional structures in aqueous and non-aqueous environments are then explored. The movement of solutes and solvents across semipermeable membranes is considered and an assessment is made of the contribution of such mechanisms to normal physiology. Firstly,...
Source: Anaesthesia and intensive care medicine - August 1, 2018 Category: Anesthesiology Source Type: research

Assessment of the emergency surgical patient
Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Caroline LakeAbstractIt is well known that emergency surgical patients have a higher risk of postoperative morbidity and mortality than those having elective procedures. A systematic preoperative assessment forms an important part of identifying risk factors and reducing their impact. Patients may require simultaneous resuscitation and assessment. Further deterioration in the patient's condition must not occur as a result of delays in decision making or awaiting results of investigations. A risk assessment score is us...
Source: Anaesthesia and intensive care medicine - August 1, 2018 Category: Anesthesiology Source Type: research

Body temperature and its regulation
Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): James Kuht, Andrew D FarmeryAbstractHumans are homeotherms, i.e. they fix their temperature regardless of their environment. This is vital for normal cellular function and for metabolism to be independent of external temperature. The body has a warm ‘core’ and a cooler peripheral ‘shell’ whose role is to regulate heat transfer in and out of the core. Body temperature is controlled by a feedback system with both peripheral and central sensors, and an integrator located in the hypothalamus. Anaes...
Source: Anaesthesia and intensive care medicine - August 1, 2018 Category: Anesthesiology Source Type: research

Regurgitation and aspiration
Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Sarah Jackson, Tracey Eastaugh-WaringAbstractRegurgitation and aspiration remains one of the major complications of general anaesthesia. Aspiration is defined as oropharyngeal or gastric content entering the airway below the level of the vocal cords. This can cause morbidity and mortality by direct effects of the particulate, acid-related damage and bacterial pneumonia. It occurs largely in patients with risk factors, although occasionally in patients that are low risk. Anaesthetic technique should be adjusted dependi...
Source: Anaesthesia and intensive care medicine - August 1, 2018 Category: Anesthesiology Source Type: research

Characteristics of special circulations
Publication date: Available online 30 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): John Chalmers, Jamie MacdonaldAbstractBlood flow through vascular beds is usually determined by the pressure gradient and the diameter of the precapillary resistance vessels. Special circulations have additional features of intrinsic blood flow control, allowing autoregulation. Coronary blood flow is linked to myocardial oxygen consumption by a metabolic mechanism, where increased metabolism releases vasodilator metabolites. Cerebral blood flow is primarily regulated by a myogenic mechanism whereby increases in transm...
Source: Anaesthesia and intensive care medicine - July 31, 2018 Category: Anesthesiology Source Type: research

Perioperative fluid therapy for anaesthetists and intensivists
Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Claire McCue, Kathryn PuxtyAbstractUnderstanding fluid physiology in homeostasis and disease is a key part of anaesthesia and intensive care. Decision making in perioperative fluid therapy is guided by knowledge of fluid compartments, shifts in illness and surgery and the composition of commonly used intravenous fluids. The implication of poor fluid management has significant outcomes for the patient, with both under-resuscitation and over administration of fluids leading to organ dysfunction and postoperative morbidi...
Source: Anaesthesia and intensive care medicine - July 31, 2018 Category: Anesthesiology Source Type: research

Extubation and emergence
Publication date: Available online 31 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Lynsey Foulds, Andrew DaltonAbstractEmergence and extubation are a time of increased risk in all anaesthetics, with more complications occurring then than at induction and intubation. The majority of problems are airway related due to airway obstruction, hypoxia, aspiration, airway trauma or post-obstructive pulmonary oedema. Other problems include a delayed recovery of consciousness, cardiovascular instability and delirium. Prompt identification and treatment of the underlying cause is essential to prevent serious mo...
Source: Anaesthesia and intensive care medicine - July 31, 2018 Category: Anesthesiology Source Type: research

Contents
Publication date: August 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 8Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 27, 2018 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: August 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 8Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 27, 2018 Category: Anesthesiology Source Type: research

Cardiac arrhythmias in the critically ill
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Matthew Kerton, Jessica Wiggins, Michael PurkissAbstractArrhythmias are a common problem in the critically ill and they can have significant effects on patient outcome. They often require immediate and swift action and it is, therefore, essential that clinicians have a structured approach to the recognition and management of arrhythmias. Here, we provide a framework for the appropriate management of the more frequently encountered cardiac arrhythmias in critical care. We include the algorithms from the 2015 Resuscitat...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Physical principles of defibrillators
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Alice Braga, Robin CooperAbstractDefibrillators are employed in the treatment of cardiac arrhythmias in both emergency and elective settings. Components of a defibrillator include: a power source, a capacitor, an inductor, a rectifier and a transformer. The different components allow electrical energy to be modulated and stored, and alter the timing, magnitude and waveform of the delivered energy. Modern defibrillators employ biphasic waveform technology to increase safety and efficacy. Automated machines increas...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Electromechanical coupling and regulation of force of cardiac contraction
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Emrys KirkmanAbstractCardiac muscle fibres, like skeletal muscle fibres, are divided into sarcomeres, the basic unit of contraction. The contractile elements include actin, myosin, tropomyosin and troponin. The myosin molecules are arranged into thick filaments, while the actin molecules form the basis of the thin filaments. The troponin and tropomyosin are attached to the thin filaments as in skeletal muscle. In contrast to fast skeletal muscle fibres, which need to produce repetitive mechanical action only for short...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Electrocardiogram and arrhythmias
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Rajender Singh, Jeremy J. MurphyAbstractIntroduced by Einthoven, electrocardiography remains the most common diagnostic procedure readily available to the physician in primary and secondary care. It is a graphical display of the electrical potential difference as it spreads through the heart and is recorded at the body surface. The electrocardiogram (ECG) is an indispensable tool to screen and monitor cardiac patients. Exercise ECG is used to diagnose coronary artery disease and ambulatory ECG to assess arrhythmias. (...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Initiation and regulation of the heartbeat
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Emrys KirkmanAbstractThe heart has all the components necessary to initiate and maintain a regular heartbeat, without the need for external influence. Thus, a transplanted heart without nervous connection, or a heart completely removed from the body, if adequately perfused with oxygen, beats rhythmically. In the normal intact body, the function of the nervous and humoral regulation is to modulate the activity of the heart, though some aspects of modulation are intrinsic properties of cardiac muscle. (Source: Anae...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Mechanical events and the pressure–volume relationships
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Emrys KirkmanAbstractDepolarization of cardiac muscle fibres spreads from fibre to fibre throughout the myocardium. In a single fibre, contraction starts just after depolarization and lasts until just after repolarization is complete. The atria contract, completing the filling of the ventricles and thus enhancing their action. In the absence of effective atrial contraction (e.g. atrial fibrillation) cardiac output is decreased on average by 15%. During diastole, when cardiac muscle is relaxed, blood returns to the hea...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Postoperative care of the adult cardiac surgical patient
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Patrick Markey, Palanikumar SaravananAbstractAdult cardiac surgical patients are managed by standardized protocols after surgery. For most of the patients this is an extended recovery period following elective major surgery, and communication is crucial in the management of early postoperative period. Some patients are critically ill before surgery and undergo complex and emergency cardiac procedures. These patients are more likely to experience complications such as bleeding, cardiac tamponade, arrhythmias, infection...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Anaesthesia for patients with cardiac disease undergoing non-cardiac surgery
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): K. Moyna BillAbstractOne of the biggest challenges for anaesthetists today is the safe conduct of anaesthesia for patients who might be elderly, have pre-existing cardiac disease and are scheduled to undergo non-cardiac surgery. Within the financial constraints of today’s health services, the appropriate investigations need to be decided and performed for these patients in order to inform the anaesthetist, surgeon and the patient of the risk of surgery. These should be undertaken only if they will influence mana...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Adult congenital heart disease
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Jonathan Weale, Andrea A. KelleherAbstractContinued advances in the understanding and management of congenital heart disease (CHD) mean that over 90% of children born with CHD now survive to adulthood. This in turn results in greater numbers of adult patients presenting for medical and surgical care at non-specialist centres. A simple classification of adult congenital heart disease (ACHD) according to complexity can help clinicians to understand the implications of the specific cardiac anomaly encountered. Issues rel...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Contents
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Cardiopulmonary transplantation
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Barbora Parizkova, Gavin WrightAbstractThe Registry of the International Society for Heart and Lung Transplantation reported 4196 heart transplants and 3812 lung transplants worldwide in 2015. The 100,000th heart transplant mark has been passed. Heart transplantation is a proven surgical option for selected patients who have advanced heart failure refractory to surgical or medical management. Lung transplantation is the definitive treatment for end-stage lung disease for patients who have failed medical therapy. More ...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Anaesthesia for off-pump coronary artery bypass grafting
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Leon Dryden, Marco MaccarioAbstractAchieving surgical revascularization of the heart, while avoiding the insult of cardiopulmonary bypass, is particularly desirable in specific high-risk patient groups. The relatively recent advances in surgical technique allowing high-quality grafting without mechanical arrest have led to an increase in popularity of off-pump coronary artery bypass surgery. Nonetheless, operating on the beating heart, manipulating it and purposely inducing ischaemia, invariably has significant haemod...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Control of cardiac function
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Michael Charlesworth, Andrew KnowlesAbstractAn understanding of the core cardiovascular physiological principles is fundamental to delivering clinical care to patients. In order to successfully deliver oxygen and other nutrients to end organs whist eliminating waste products, cardiac output is manipulated through the control of heart rate, blood pressure, stroke volume, preload, afterload and contractility. Though controlled through intrinsic physiological mechanisms in health, the delivery of fluids, drugs, external/...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Equipment for airway management
Publication date: Available online 23 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Andrew Laurie, Jamie MacdonaldAbstractAirway management provides gas exchange, protects the lungs from injury and permits treatment. This requires safe, effective and reliable use of equipment, often in combination. A management plan with backups is essential, but a sequence of logical plans forming an airway management strategy is better. Correct equipment use needs correct knowledge, skill and attitudes. There are five approaches to airway management in which equipment is used: facemask ventilation with adjuncts, us...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Humidification devices
Publication date: Available online 23 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Stuart Gaffney, Andrew DaltonAbstractHumidification is concerned with the addition of water vapour to a gas and can be measured as either absolute or relative. Adequate humidification is a vital consideration in anaesthesia given that the anatomical source of natural gas humidification (the nasopharynx) is generally bypassed, which can lead to complications including hypothermia, thickening of respiratory secretions, mucus plugging and airway keratinization. Humidification may be passive or active. Equipment involved ...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Safeguarding for anaesthetists: working to protect children
Publication date: Available online 23 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Kathy Wilkinson, Alistair J. CranstonAbstractAn awareness of what may constitute neglect or ill treatment to children and young people is important for all healthcare staff, and prevention of harm is everyone's business. While it is relatively unusual to see serious signs of abuse in a routine surgical context, anaesthetists also see children in many different settings and should be able to clearly communicate their concerns. While there are differences in both relevant law and statutory advice in the various parts of...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Equipment and monitoring in paediatric anaesthesia
This article will discuss all of these devices and techniques with particular emphasis on paediatric anaesthetic practice. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Induction of anaesthesia
Publication date: Available online 25 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Charlotte Dean, Eleanor ChapmanAbstractGeneral anaesthesia is a temporary state of unconsciousness which is induced to facilitate a therapeutic procedure. Induction is the first stage of a sequential process. It commences with patient preparation and assessment away from theatre then continues in the safe and monitored environment of the anaesthetic room or operating theatre where the administration of drugs and airway interventions take place. The anaesthetic then transits through maintenance, emergence and recovery ...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Developmental paediatric anaesthetic pharmacology
Publication date: Available online 25 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Tom G. HansenAbstractSafe and effective drug therapy in neonates, infants and children require detailed knowledge about the ontogeny of drug disposition and action as well how these interact with genetics and co-morbidity in children. Recent advances in developmental pharmacology in children follow the increased understanding of the impact of growth and development on drug disposition (absorption, distribution, metabolism and excretion–ADME). Numerous approaches have been used to determine optimal dosing of drug...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Anaesthetic implications of congenital heart disease for children undergoing non-cardiac surgery
Publication date: Available online 27 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Sarah Smith, Alyson WalkerAbstractA diagnosis of congenital heart disease (CHD) increases perioperative risk for children having surgical procedures. Some will require anaesthesia at a specialist cardiac centre, while for others it is safe and appropriate to have their procedure in a local district general hospital (DGH). Children with complex CHD and poor physiological status carry the highest risk of cardiac arrest and mortality. Clinical features of cardiomyopathy, cyanosis, pulmonary hypertension, arrhythmia and c...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 28 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Preoperative assessment and preparation for safe paediatric anaesthesia
Publication date: Available online 30 June 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Matthew Harvey, Tim GearyAbstractThe delivery of anaesthesia to children and young people provides unique challenges. A careful, systematic approach to assessment and preparation can deliver a positive experience for the child, carers and staff while mitigating potential complications. Preparation for anaesthesia should encompass information gathering, assessment and planning for anatomical, physiological, social and behavioural elements specific to the child and the surgery. Delivery of appropriate information, conse...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Contents
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Drugs acting on the heart: heart failure and coronary insufficiency
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Matthew Charlton, Jonathan P. ThompsonAbstractHeart failure (HF) and coronary insufficiency are common amongst surgical and critical care patients. Both are chronic conditions interrupted by acute episodes. HF activates neurohormonal mechanisms that worsen renal and cardiac function. Acute heart failure (AHF) commonly presents with dyspnoea as a consequence of systolic and/or diastolic dysfunction. Goals of treatment are symptom relief, to maintain tissue perfusion and optimize cardiac function. Diuretics and vasodila...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Drugs acting on the heart: antiarrhythmics
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Christopher Hebbes, Jonathan P. ThompsonAbstractArrhythmias are abnormalities of cardiac rate or rhythm occurring for a variety of reasons. They are common in the perioperative period and in intensive care. Causes may reflect an underlying heritable predisposition, the presence of new pathology either of the heart or conducting system, or as a result of systemic illness. Targets for antiarrhythmics include myocardial ion channels, muscarinic or nicotinic acetylcholine receptors, adrenergic or adenosine receptors. Arrh...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

The principles of cardiac anaesthesia
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Michael Charlesworth, Petr MartinovskyAbstractDespite the origins of cardiac surgery and anaesthesia involving experimentation and danger, modern practice has evolved to dramatically reduce risk and increase patient safety. Outcomes from cardiac surgery in the UK are consistently improving despite an aging population, increasing clinical complexity and an increasing incidence of chronic conditions such as anaemia and frailty. The management of bleeding is a great challenge to the surgeon and anaesthetist; knowledge of...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Preoperative assessment for cardiac surgery
This article provides an overview of history, examination and preoperative management of patients undergoing cardiac surgery. Scoring systems and practical investigations are reviewed. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Transoesophageal echocardiography in cardiac anaesthesia
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Christine Herr, Andrew RoscoeAbstractEchocardiography is the most widely used minimally invasive investigation to diagnose heart disease. Transoesophageal echocardiography (TOE) was first introduced perioperatively in the 1980s and is now an important monitoring tool for patients undergoing cardiac surgery. Because of the close proximity of the oesophagus to the heart, TOE facilitates the acquisition of high-resolution images. The TOE probe is a multiplane transducer. This means that the image planes can be rotated fr...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Cardiopulmonary bypass
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Hannah Kiziltug, Guillermo MartinezAbstractThe primary function of the cardiopulmonary bypass (CPB) machine is to provide oxygenated blood flow to the systemic circulation while providing the surgeon with a motionless, bloodless surgical field. The CPB circuit consists of a reservoir, blood pump, oxygenator, heat exchanger, arterial filter, cardioplegia delivery device and cannulae, interconnected by various sized tubing. The venous cannula directs blood away from the heart and lungs via the CBP circuit and the arteri...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Mechanical support of the heart
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Guarang Vaidya, Barbora Parizkova, Emma J BirksAbstractMechanical support of the heart can be offered to patients who are refractory to pharmacological treatment, therapy for coronary or valvular disease or resynchronization therapy. Ventricular assist devices enable end-organ perfusion in the setting of heart failure. This can be temporary (as a bridge to recovery or transplantation) or permanent (destination therapy). Devices can be extracorporeal or implanted, and generated flows can be pulsatile or non-pulsatile. ...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Drugs acting on the heart: antihypertensive drugs
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Matthew Charlton, Jonathan ThompsonAbstractAntihypertensive drugs are used commonly in anaesthesia and intensive care medicine. Patients might require antihypertensive drugs before surgery for the treatment of essential hypertension, pre-eclampsia or, occasionally for conditions such as phaeochromocytoma; during surgery as part of a deliberate hypotensive anaesthetic technique; or to reduce postoperative cardiovascular complications. Here, we discuss the physiology of blood pressure control, the pharmacology of antihy...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: July 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 7Author(s): Vijayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Associated medical conditions in children
Publication date: Available online 7 July 2018Source: Anaesthesia & Intensive Care MedicineAuthor(s): Elena FernandezAbstractChildren with acute and chronic associated medical conditions often present for surgical and radiological procedures. An understanding of the implications of these conditions for anaesthesia is important in preventing perioperative adverse events. In this article, we outline the relevant clinical features of some of the commonly encountered associated medical conditions and provide guidance on the current evidence for the perioperative anaesthetic management of these children. (Source: Anaesthesi...
Source: Anaesthesia and intensive care medicine - July 10, 2018 Category: Anesthesiology Source Type: research

Control of cardiac function
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Michael Charlesworth, Andrew KnowlesAbstractAn understanding of the core cardiovascular physiological principles is fundamental to delivering clinical care to patients. In order to successfully deliver oxygen and other nutrients to end organs whist eliminating waste products, cardiac output is manipulated through the control of heart rate, blood pressure, stroke volume, preload, afterload and contractility. Though controlled through intrinsic physiological mechanisms in health, the delivery of fluids, drugs, external/...
Source: Anaesthesia and intensive care medicine - July 5, 2018 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: June 2018Source: Anaesthesia & Intensive Care Medicine, Volume 19, Issue 6Author(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 5, 2018 Category: Anesthesiology Source Type: research