Anaesthesia and Intensive Care最新文献

Reduction of iatrogenic withdrawal syndrome in high-risk critically ill patients with acute respiratory distress syndrome. 高危危重患者急性呼吸窘迫综合征医源性戒断综合征的减少。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-22 DOI: 10.1177/0310057X241233604

Ruchi P Jain, Katarzyna Gosek, Madeline Johnston

{"title":"Reduction of iatrogenic withdrawal syndrome in high-risk critically ill patients with acute respiratory distress syndrome.","authors":"Ruchi P Jain, Katarzyna Gosek, Madeline Johnston","doi":"10.1177/0310057X241233604","DOIUrl":"https://doi.org/10.1177/0310057X241233604","url":null,"abstract":"Limited data suggest a subset of patients with acute respiratory distress syndrome receive high-dose and prolonged opioid and sedative infusions. With prolonged use, patients may be at risk for developing iatrogenic withdrawal syndrome after discontinuation or tapering of these agents. Iatrogenic withdrawal syndrome is well described in paediatric patients; however, limited guidance exists in adult intensive care unit patients regarding risk factors and ideal management strategies. This article discusses several weaning strategies for high-risk patients to minimise withdrawal symptoms and safely reduce or discontinue opioid and sedative infusions. Ideal weaning strategies are lacking, but several options exist. These include a gradual reduction of the agent, changing the route of delivery by switching to an enteral or parenteral longer-acting agent from the same class, and substitution to an alternative agent to help mitigate potential withdrawal symptoms. This should be accomplished through a multidisciplinary approach by involving experts from relevant specialties while closely observing for withdrawal symptoms.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241233604"},"PeriodicalIF":1.1,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The history of warfarin. 华法林的历史。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2025-04-26 DOI: 10.1177/0310057X251323777

Christine M Ball, Peter J Featherstone

引用次数: 0

Returning to work following parental leave: the experiences of Australian anaesthetists. 产假后重返工作岗位：澳大利亚麻醉师的经验。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2025-03-28 DOI: 10.1177/0310057X241265726

Isabelle L Cooper, Anna F Pietzsch, Rosmarin Zacher, Lachlan Webb, Anita Pelecanos, Victoria A Eley

{"title":"Returning to work following parental leave: the experiences of Australian anaesthetists.","authors":"Isabelle L Cooper, Anna F Pietzsch, Rosmarin Zacher, Lachlan Webb, Anita Pelecanos, Victoria A Eley","doi":"10.1177/0310057X241265726","DOIUrl":"10.1177/0310057X241265726","url":null,"abstract":"With increasing gender balance in specialist medical training and employment in Australia, there is a corresponding need to consider how parental leave and subsequent return to work is managed in the workplace. An electronic survey exploring the experiences of pregnancy and return to work following parental leave was distributed by the Australian and New Zealand College of Anaesthetists (ANZCA). The return-to-work component of the survey evaluated parental leave and return-to-work patterns, lactation practices and facilities, supports and resources utilised during the return-to-work process. We report on 391 return-to-work episodes from 219 respondents. One hundred and seventy-two (79%) were specialists at the time of survey completion. Six to 11 months was the most frequent duration of parental leave, and this duration was associated with higher satisfaction levels than shorter durations of leave (odds ratio 5.44, 95% confidence interval 3.18-9.31, P < 0.001). Breastfeeding continued in 246 (63%) return-to-work episodes, and absent or inadequate lactation facilities were reported in 239 (88%). In 227 (58%) return-to-work experiences, respondents received no formal support on returning to work. One hundred and thirty-five (62%) respondents did not utilise any existing return-to-work resources, and family and friends were the main source of support for 113 (52%) respondents. Return-to-work processes should be tailored to meet individual needs. Consistent with existing recommendations, satisfactory lactation facilities must be provided. We recommend that the period of one-to-one supervision be flexible and negotiated, to suit the unique return-to-work trajectory of each worker. Existing ANZCA resources could assist departments in supporting anaesthetists who return to work following parental leave.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"181-189"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative anaphylaxis in Malaysia: A nine-year retrospective study. 马来西亚围手术期过敏反应：一项9年回顾性研究。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2025-02-04 DOI: 10.1177/0310057X241284655

Fan-Yin Kwok, Mun-Tsong Hui, Cindy Thomas Joseph, Arfah Hanim Binti Mohamad, Mohammed-Faizal Bakhtiar

{"title":"Perioperative anaphylaxis in Malaysia: A nine-year retrospective study.","authors":"Fan-Yin Kwok, Mun-Tsong Hui, Cindy Thomas Joseph, Arfah Hanim Binti Mohamad, Mohammed-Faizal Bakhtiar","doi":"10.1177/0310057X241284655","DOIUrl":"10.1177/0310057X241284655","url":null,"abstract":"Diagnosis of perioperative anaphylaxis (POA) and identification of causative agents remain challenging. This study aimed to describe the estimated incidence, characteristics and causative agents of POA in Malaysia. This is a retrospective review of all cases of suspected POA referred to the only anaesthetic allergy centre in Malaysia from March 2014 to December 2022. One hundred and ninety patients with suspected POA of Grade 2 and above were included. Data on clinical presentation, severity, management, serum tryptase and subsequent allergy workup (including skin and serum testing results) of these patients were extracted from the database. Dynamic tryptase was elevated in half of the cases where tryptase results were available and skin tests were positive in 96% of these cases. Skin testing was positive in 113 patients (60%) overall, and more than 70% of Grades 3 and 4 anaphylaxis cases. Neuromuscular blocking agents (NMBAs) and antibiotics were the most commonly identified causative agents (27.4% and 23% respectively). The commonest NMBAs were rocuronium and atracurium, both commonly cross-reacting with cisatracurium. The overall cross-reactivity rate among NMBAs was 58%. For antibiotics, the commonest causative agents were cefuroxime, ceftriaxone and amoxicillin/clavulanic acid. Using these data, the estimated incidence of Grades 2-4 POA over this period in Malaysia was approximately 1 in 30,000 anaesthetics. However, owing to the voluntary nature of reporting, it is possible that this is an underestimate, particularly in relation to some milder Grade 2 cases which may have gone unrecognised or unreported.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"171-180"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of enhanced recovery room care models. 评估康复室强化护理模式。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2024-09-23 DOI: 10.1177/0310057X241275110

Guy L Ludbrook, Nick Koning, Tarik Sammour

引用次数: 0

Awards for papers published in Anaesthesia and Intensive Care, 2023. 发表在《麻醉与重症监护》杂志上的论文获奖，2023年。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2025-02-11 DOI: 10.1177/0310057X241298852

John A Loadsman, Michael G Cooper

引用次数: 0

Expert opinions on the applicability of the European guidelines on postoperative delirium in Australia and New Zealand. 关于欧洲术后谵妄指南在澳大利亚和新西兰的适用性的专家意见。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2025-02-11 DOI: 10.1177/0310057X241300166

Neil L Pillinger, Robert D Sanders

引用次数: 0

Thanks to Reviewers. 感谢评论者。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2025-02-12 DOI: 10.1177/0310057X251317125

引用次数: 0

The elective use of percutaneous transtracheal oxygen insufflation for laryngeal surgery in a patient with a known difficult airway. 择期应用经皮经气管充氧治疗已知气道困难的喉部手术。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2025-02-04 DOI: 10.1177/0310057X241285921

Matthew J Bolland, David T Andrews, Daryl L Williams

引用次数: 0

Survey of administration of intravenous ketamine for perioperative pain management in Australia and New Zealand. 澳大利亚和新西兰静脉注射氯胺酮治疗围手术期疼痛的调查。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-05-01 Epub Date: 2025-02-12 DOI: 10.1177/0310057X241309655

Patryck J Lloyd-Donald, Philip J Peyton

{"title":"Survey of administration of intravenous ketamine for perioperative pain management in Australia and New Zealand.","authors":"Patryck J Lloyd-Donald, Philip J Peyton","doi":"10.1177/0310057X241309655","DOIUrl":"10.1177/0310057X241309655","url":null,"abstract":"Ketamine is an N-methyl-d-aspartate receptor antagonist approved for use in anaesthesia, with analgesic properties. Despite publication of numerous trials and expert guidelines on its use for pain management, administration of ketamine as part of multimodal perioperative analgesia remains 'off-label'. We conducted an online, prospective survey of ANZCA Fellows, exploring current prescribing practices of intravenous ketamine for perioperative analgesia. We surveyed 2000 Fellows and received 806 responses. The factors mostly likely to influence their administration of perioperative ketamine included pre-existing chronic pain, and heavy or multiple opioid use by patients preoperatively. Amongst respondents, less senior anaesthetists and those working in public hospitals were more likely to administer intraoperative ketamine. The surgical procedures most likely to result in ketamine administration intraoperatively were open pelvic/abdominal, thoracic and major spinal surgery, where ketamine administration was likely practice for the majority of respondents, with typical loading doses that ranged widely. The commonest choices of intraoperative loading dose were between 0.2 mg kg-1 and 0.6 mg kg-1. The commonest choice of intraoperative and postoperative infusion rate was in the range of 0.1-0.2 mg kg-1 h-1. Postoperative ketamine infusion was most commonly prescribed as third-line or rescue analgesia. The majority of respondents thought it either 'likely' or 'very likely' ketamine would reduce postoperative chronic pain after thoracic surgery, but not in other surgical categories. Our findings suggest that off-label perioperative administration of ketamine at analgesic dose ranges is routine or common practice in major surgery for a majority of specialist anaesthetists in Australia and New Zealand.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"190-198"},"PeriodicalIF":1.1,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0