{"title":"Physiology of haemostasis","authors":"Abbas Zaidi, Laura Green","doi":"10.1016/j.mpaic.2024.09.015","DOIUrl":"10.1016/j.mpaic.2024.09.015","url":null,"abstract":"<div><div>Haemostasis is a complex process that ensures the maintenance of blood flow under normal physiological conditions and prevents major blood loss following vascular injury. The process is tightly regulated to prevent pathological thrombosis. Normal haemostasis relies on the delicate balance of prothrombotic and anticoagulant processes, where five components play a significant role in maintaining the haemostasis, these include: (i) endothelial cells; (ii) platelets which are key to platelet plug formation; (iii) coagulation factors that are essential to formation of insoluble fibrin clot; (iv) coagulation inhibitors; and (v) fibrinolysis. 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.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 1","pages":"Pages 41-47"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cardiac output monitoring","authors":"Nathan Betteridge, Fiona Armstrong","doi":"10.1016/j.mpaic.2024.09.013","DOIUrl":"10.1016/j.mpaic.2024.09.013","url":null,"abstract":"<div><div>Cardiac output monitoring has become commonplace amongst the standard monitoring in anaesthesia for major surgery and in intensive care. Multiple techniques are used, employing different models to calculate flow, which cannot be directly measured. Each method has differing advantage and disadvantage profiles and so the choice of device should consider a balance of invasiveness, usability, reliability and validity. Trend monitoring is generally emphasized over absolute values.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"26 1","pages":"Pages 31-40"},"PeriodicalIF":0.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143144002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pharmacokinetic variation","authors":"Alexander T Vidouris, Craig Carroll","doi":"10.1016/j.mpaic.2024.09.010","DOIUrl":"10.1016/j.mpaic.2024.09.010","url":null,"abstract":"<div><div>Pharmacokinetics is the study of how a drug is handled by the body, including absorption, distribution, metabolism and excretion. Pharmacokinetic variation is variability in the effector site concentration after a standard dose. This means there is potential for dosing to be ineffective for one patient but potentially toxic with increased side effects for another. This article aims to review some of the causes of variation by looking at physiological, pathological and pharmacological factors.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 12","pages":"Pages 845-849"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Patient selection for day surgery","authors":"Tsz Ying Apple Lo, Man Ting Chan","doi":"10.1016/j.mpaic.2024.09.007","DOIUrl":"10.1016/j.mpaic.2024.09.007","url":null,"abstract":"<div><div>Day surgery allows surgery to be delivered in a more efficient and convenient manner. Inclusion criteria and protocols have evolved and expanded in recent decades. It represents a modern and patient-centred approach to surgical care, bringing numerous advantages to patients’ postoperative recovery. For safer outcomes and lower risk of complications, it is crucial for clinicians to have clear patient selection criteria and enhanced recovery protocols. We discuss the benefits of day surgery, explore factors in patient selection and methods to help smooth recovery.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 12","pages":"Pages 831-836"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Intravenous anaesthetic agents","authors":"Swarnendu Dey, Kenichi Ode","doi":"10.1016/j.mpaic.2024.09.008","DOIUrl":"10.1016/j.mpaic.2024.09.008","url":null,"abstract":"<div><div>This article gives an overview of drugs frequently used for intravenous anaesthetic induction, as well as a brief overview of total intravenous anaesthesia.</div><div>The physio-chemical properties of intravenous anaesthetic drugs, their clinical and adverse effects are summarized.</div><div>The article also discusses the historical context on the introduction of intravenous anaesthetic agents and highlights developments of novel agents.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 12","pages":"Pages 837-844"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Postoperative analgesia","authors":"Katharine C Ireland, Abdul G Lalkhen","doi":"10.1016/j.mpaic.2024.09.005","DOIUrl":"10.1016/j.mpaic.2024.09.005","url":null,"abstract":"<div><div>Pain is a complex experience consisting of sensory, affective, behavioural and physiological components. The management of pain is therefore best achieved with an approach which acknowledges that the experience of pain is produced through the interaction of biological, psychological and sociocultural factors. Effective pain management requires preoperative patient engagement and education to manage expectations regarding pain relief and an inpatient pain service to coordinate the implementation of evidence-based postoperative pain management protocols and facilitate continuous staff education. Multimodal postoperative analgesia, built on an opioid-sparing ethos, is an essential component of perioperative pain management. Effective pain management enhances recovery after surgery by facilitating early patient mobilization, a reduction in respiratory and cardiac complications and amelioration of the stress response to surgery with consequent improved wound healing. Inadequate pain control can contribute to prolonged hospitalization and the development of chronic postsurgical pain.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 12","pages":"Pages 823-830"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Principles of the anaesthetic machine","authors":"Michaela J van der Walt, Leo G Kevin","doi":"10.1016/j.mpaic.2024.09.006","DOIUrl":"10.1016/j.mpaic.2024.09.006","url":null,"abstract":"<div><div>Anaesthetic machines are designed to accurately mix and deliver medical gases and anaesthetic vapours. Although these machines have evolved greatly from the original Boyle's Trolley, and they are now sophisticated computer-controlled interfaces with integrated measurement tools and controls, the fundamental principles have remained broadly unchanged. An understanding of the structure, function and safety features of the anaesthetic machine is essential to the practising anaesthetist.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 12","pages":"Pages 799-803"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Self-assessment","authors":"Vijayanand Nadella","doi":"10.1016/j.mpaic.2024.10.003","DOIUrl":"10.1016/j.mpaic.2024.10.003","url":null,"abstract":"","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 12","pages":"Pages 861-862"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The principles of anaesthetic vaporizers","authors":"Ravi Anandampillai","doi":"10.1016/j.mpaic.2024.09.001","DOIUrl":"10.1016/j.mpaic.2024.09.001","url":null,"abstract":"<div><div>Fluorinated 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 principles of the vaporizers. Almost all modern vaporizers are located outside the circle system and the have multiple safety mechanisms in place.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 12","pages":"Pages 813-817"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Anaesthetic breathing systems","authors":"Áine McCarthy, Brian Harte","doi":"10.1016/j.mpaic.2024.09.004","DOIUrl":"10.1016/j.mpaic.2024.09.004","url":null,"abstract":"<div><div>Breathing systems are designed to deliver oxygen, air and anaesthetic agent to the patient, and, in the case of circle systems, allow the recycling of expired gases after removal of CO<sub>2</sub>. A relatively small number of distinct breathing varieties are used in modern practice. They consist of similar components but in different configurations, with the layout of each determining their clinical attributes and preferred role. Various classification systems will be described in this article. Modern anaesthesia machines primarily use circle systems with CO<sub>2</sub> absorbers designed for low-flow anaesthesia.</div></div>","PeriodicalId":45856,"journal":{"name":"Anaesthesia and Intensive Care Medicine","volume":"25 12","pages":"Pages 818-822"},"PeriodicalIF":0.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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