Anaesthesia and Intensive Care最新文献

{"title":"Paving a pathway for successful implementation of extracorporeal membrane oxygenation as a bridge to lung transplantation.","authors":"Samantha L Ennis, Bronwyn J Levvey, Helen V Shingles, Jitain K Sivarajah, Philip Marsh, David Pilcher, Vincent Pellegrino, Gregory I Snell","doi":"10.1177/0310057X251361574","DOIUrl":"https://doi.org/10.1177/0310057X251361574","url":null,"abstract":"<p><p>Patients with fulminant respiratory failure may receive extracorporeal membrane oxygenation (ECMO) as a bridge to lung transplantation (LTx). Historically, morbidity and mortality with this approach has been high. The aim of this study is to describe the current indications and identify patient characteristics that predict a successful outcome. We performed a retrospective audit including all patients referred and bridged to LTx with ECMO at Alfred Health over an 11-year period (between 1 January 2010 and 31 December 2020). Patient, clinical and donor characteristics were collected, and outcomes were compared with all lung transplant recipients over the same time period. Twenty-eight referrals for LTx were received and 25 patients on ECMO were ultimately added to the waiting list for LTx. Patients bridged with ECMO were comparatively young (mean age 30 years) compared with the non-ECMO group (mean age 52.4 years). Of the 25 on the waiting list, three died awaiting LTx. Median time from waiting list activation to LTx was seven (interquartile range (IQR) 2-16) days in the ECMO group, compared with 92 (IQR 38-218) days in the non-ECMO group (<i>P</i> < 0.001). Survival for the 22 patients bridged to LTx with ECMO was 95% at 30 days, 86% at one year and 64% at three years. There was no significant difference in median survival between the ECMO group versus the contemporaneous non-ECMO lung transplant recipients (<i>P</i> = 0.73). ECMO can be used successfully to bridge patients with end-stage lung disease to LTx. With adherence to stringent protocols and patient selection, ECMO can provide medium-term survival outcomes comparable to patients who did not require pre-LTx support.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251361574"},"PeriodicalIF":1.2,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145068874","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}

{"title":"Characteristics and outcomes of nonagenarians admitted to the intensive care unit: A single-centre observational study.","authors":"Ariane Flinkier, Laurence Weinberg, Benjamin Churilov, Nattaya Raykateeraroj, Thomas Freeman, Je Min Suh, Angelica Armellini, Ella Francis, Atthaphong Phongphithakchai, Glenn Eastwood, Rinaldo Bellomo, David Pilcher, Dong-Kyu Lee","doi":"10.1177/0310057X251346796","DOIUrl":"https://doi.org/10.1177/0310057X251346796","url":null,"abstract":"<p><p>There is limited data regarding the mortality risk factors for Australian nonagenarians requiring intensive care unit admission. The objectives of the study were to determine the mortality rates, length of stay, and indicators of poor outcomes in nonagenarian patients admitted to the intensive care unit. Data were retrospectively collected from a single-centre university hospital in Australia over a 10-year period. Cox regression survival analysis, hazard ratios (HRs) and receiver operating characteristic curves were used to assess characteristics and associated survival. A total of 25,766 adult patients were admitted to the intensive care unit during the study period, of whom 89 (0.35%) were nonagenarians. The intensive care unit and hospital mortality rates of nonagenarians were 10.1% and 22.5%, respectively. The Australian and New Zealand risk of death model was the most significant predictor of mortality among the risk scoring systems. Nonagenarians who experienced a cardiac arrest had the highest hazard of death in the intensive care unit (HR 7.60, 95% confidence interval (CI) 1.49 to 38.66, <i>P</i> = 0.015) and throughout their hospital admission (HR 6.77, 95% CI 1.52 to 30.28, <i>P</i> = 0.012). Acute renal failure and invasive ventilation had a significantly increased hazard of death in the intensive care unit and hospital admission. Lactate levels also demonstrated a significant increase in the hazard of death per 1 mmol/l increase (HR 1.64, 95% CI 1.3 to 2.08, <i>P</i> < 0.001). Over the study follow-up period of a minimum of 3.5 years, 50 of 89 patients (56.2%) died. Intensive care unit and hospital mortality among nonagenarians admitted to the intensive care unit was relatively low. These findings support early identification of mortality risk factors, allowing for the timely implementation or withdrawal of interventions.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251346796"},"PeriodicalIF":1.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058246","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}

{"title":"Blue laser as a safe option in laser airway surgery.","authors":"Abdulrahman Dardeer, Anas N Shallik, Nabil A Shallik","doi":"10.1177/0310057X251347975","DOIUrl":"https://doi.org/10.1177/0310057X251347975","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251347975"},"PeriodicalIF":1.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058285","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}

{"title":"Completeness of electronic anaesthesia records.","authors":"Andrew Th Tay, Morgan Roney, David Beilby, James C Jiang, Libia Machado Munoz, Mark Ng, Gary Katzman, Caitlin Sr Low","doi":"10.1177/0310057X251351651","DOIUrl":"https://doi.org/10.1177/0310057X251351651","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251351651"},"PeriodicalIF":1.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058244","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}

{"title":"A prelude to Ether Day 1846: Charles F Heywood's letter to William TG Morton.","authors":"Rajesh P Haridas","doi":"10.1177/0310057X251347974","DOIUrl":"https://doi.org/10.1177/0310057X251347974","url":null,"abstract":"<p><p>On 14 October 1846, Charles F Heywood, house-surgeon at the Massachusetts General Hospital, Boston, MA, USA, penned an invitation to the dentist William TG Morton to demonstrate his preparation to prevent pain during a surgical operation at the Hospital on 16 October 1846. The operation would become the first public operation performed with the aid of insensibility produced by the inhalation of sulphuric ether. From Boston, news of the discovery spread around the world-the date of this momentous operation is now celebrated as Ether Day. Although Heywood's letter is well-known from 19th century transcripts, it is apparent from examining a letter believed to be the original, now preserved in the WTG Morton papers held by the Massachusetts Historical Society, Boston, MA, USA, that these transcripts were edited before publication. A faithful transcript of Heywood's letter is published along with two images of the historic letter.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251347974"},"PeriodicalIF":1.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058221","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}

{"title":"Impact of the location of the initial admitting intensive care unit on the delivery of extracorporeal membrane oxygenation in Australia and New Zealand.","authors":"C Jake D Barlow, Alastair J Brown, Tess Evans, David A Sidebotham, David V Pilcher","doi":"10.1177/0310057X251358274","DOIUrl":"https://doi.org/10.1177/0310057X251358274","url":null,"abstract":"<p><p>Extracorporeal membrane oxygenation (ECMO) is a method of life support provided in a limited number of (typically centralised) intensive care units (ICUs) which may lead to inequity in the delivery of ECMO. We conducted a retrospective cohort study of all ICU admissions in Australia and New Zealand reported to the Australian and New Zealand Intensive Care Society Adult Patient Database between 2018 and 2022. We performed descriptive and propensity-matched analyses to determine how healthcare jurisdiction, remoteness, and initial admitting hospital type (based on ECMO capability) affected the chance of receiving ECMO. There were 703,529 patients at 199 hospitals who met inclusion criteria, of whom 1654 (0.2%) received ECMO. After propensity matching, patients had a reduced odds of receiving ECMO if admitted in the Australian Capital Territory (odds ratio (OR) 0.54, 95% confidence interval (CI) 0.34 to 0.86), New Zealand (OR 0.42, 95% CI 0.26 to 0.67), Northern Territory (OR 0.29, 95% CI 0.1 to 0.86), Queensland (OR 0.53, 95% CI 0.45 to 0.63) or Western Australia (OR 0.46, 95% CI 0.35 to 0.62) compared with New South Wales. Patients from Outer Regional areas were less likely to receive ECMO than those residing in a Major City (OR 0.77, 95% CI 0.63 to 0.94). Initial admission in a non-ECMO centre was associated with reduced odds of receiving ECMO (OR 0.60, 95% CI 0.52 to 0.69), whilst initial admission in a Major ECMO centre was associated with increased odds of receiving ECMO (OR 2.03, 95% CI 1.78 to 2.31), compared with Minor ECMO centres. Our study suggests there is inequity in the delivery of ECMO in Australia and New Zealand, which should inform policy and planning for ECMO provision throughout the region.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251358274"},"PeriodicalIF":1.2,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058296","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}

{"title":"Comment on: A case of cardiorespiratory collapse following bilateral sub-Tenon's block from brainstem anaesthesia.","authors":"Howard D Palte","doi":"10.1177/0310057X251332301","DOIUrl":"https://doi.org/10.1177/0310057X251332301","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251332301"},"PeriodicalIF":1.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145038966","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}

{"title":"Reply to Comment on: A case of cardiorespiratory collapse following bilateral sub-Tenon's block from brainstem anaesthesia.","authors":"Steven C Cai, Anne-Marie Amie Dempster, Alfred Wy Chua","doi":"10.1177/0310057X251332303","DOIUrl":"https://doi.org/10.1177/0310057X251332303","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X251332303"},"PeriodicalIF":1.2,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039002","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}

{"title":"Comparative strategies for overcoming pseudohypoxaemia: Guided by a case of leukocyte larceny in COVID-19 severe acute respiratory distress syndrome with chronic myelogenous leukaemia.","authors":"Daniel Grahf","doi":"10.1177/0310057X251334658","DOIUrl":"10.1177/0310057X251334658","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"347-349"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301018","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}

{"title":"The Royal Alexandra Hospital for Children heart-lung machine 1959. The story behind a photograph.","authors":"Michael G Cooper","doi":"10.1177/0310057X251342257","DOIUrl":"https://doi.org/10.1177/0310057X251342257","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"53 4_suppl","pages":"3-5"},"PeriodicalIF":1.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939046","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}