Anaesthesia and Intensive Care最新文献_第5页

Experiences of Australian anaesthetists and anaesthetic trainees of working whilst pregnant: Results of a national survey. 澳大利亚麻醉师和麻醉师培训生在怀孕期间工作的经验：一项全国性调查的结果。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-03-01 Epub Date: 2025-02-04 DOI: 10.1177/0310057X241263116

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

{"title":"Experiences of Australian anaesthetists and anaesthetic trainees of working whilst pregnant: Results of a national survey.","authors":"Rosmarin Zacher, Isabelle L Cooper, Anna F Pietzsch, Lachlan Webb, Anita M Pelecanos, Victoria A Eley","doi":"10.1177/0310057X241263116","DOIUrl":"10.1177/0310057X241263116","url":null,"abstract":"Changing medical workforce demographics emphasise the need to understand and effectively manage pregnancy in the workplace. An Australian survey exploring pregnancy experiences of specialists and trainees working in anaesthesia received 242 responses describing 549 pregnancies. One hundred and sixty-two (67%) of these respondents were aged 31-40 years, 185 (76%) were specialists and 159 (66%) reported one or two pregnancies. Reported pregnancy complication rates were similar to national averages. Potentially harmful exposures included working >40 h per week (n = 298, 55%), ionising radiation and unscavenged gases. Other than ergonomic hazards and stress, exposures were not associated with an increase in self-reported complications. Moving heavy patients on a daily to weekly basis (n = 278, 53%) was associated with an increased risk for any maternal complication; odds ratio (OR) 2.13, 95% confidence interval (CI) 1.37 to 3.33, P < 0.001. High or debilitating stress levels were associated with any maternal complication, OR 2.93, 95% CI 2.06 to 4.17, P < 0.001, and any adverse neonatal/fetal outcome, OR 1.72, 95% CI 1.10 to 2.69, P = 0.018. The most common stress contributors were 'work-related', 'exams' and 'pregnancy anxiety'. Ninety-one (38%) respondents reported experiencing stigma or negative attitudes toward their pregnancy from anaesthetic colleagues. Overall, 171 (71%) of respondents were satisfied with their experience of working in anaesthesia whilst pregnant. Thematic analysis of free text comments identified three major themes: workplace culture, maternal and fetal wellbeing, and career impacts on both pregnancy and family planning. Development of multilevel mechanisms to guide and support pregnant trainees and specialists in anaesthesia is recommended to address these findings.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"103-115"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188206","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

Effects of polymyxin B haemoperfusion on septic shock caused by Gram-positive bacteria. 多粘菌素B血灌流对革兰氏阳性菌感染性休克的影响。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-03-01 Epub Date: 2025-01-27 DOI: 10.1177/0310057X241284300

Soichi Tanaka, Junpei Haruna, Satoshi Kazuma, Hiroomi Tatsumi, Yoshiki Masuda

{"title":"Effects of polymyxin B haemoperfusion on septic shock caused by Gram-positive bacteria.","authors":"Soichi Tanaka, Junpei Haruna, Satoshi Kazuma, Hiroomi Tatsumi, Yoshiki Masuda","doi":"10.1177/0310057X241284300","DOIUrl":"10.1177/0310057X241284300","url":null,"abstract":"Polymyxin B haemoperfusion is commonly used to adsorb endotoxins in septic shock caused by Gram-negative bacterial infections. Polymyxin B haemoperfusion has been reported to improve hypotension in Gram-positive bacterial infections; however, its efficacy and mechanism in treating such cases are unclear. We hypothesised that polymyxin B haemoperfusion would be equally effective in improving haemodynamics during Gram-positive bacterial infections as in Gram-negative bacterial infections. We conducted a retrospective study that included patients with septic shock admitted to the intensive care unit. The patients were divided into two groups according to bacterial culture results: Gram-negative rod (GNR) and Gram-positive coccus (GPC). We calculated the vasoactive inotropic score (VIS) before (0 h) and 2, 6, 12 and 24 h after polymyxin B haemoperfusion therapy. Data were analysed using two-way analysis of variance and post hoc tests for the associations between infection type and treatment time. Overall, 157 patients with septic shock were enrolled in the study: 81 and 76 patients were treated or not treated with extracorporeal haemoperfusion therapy, respectively. Although there was no significant difference in the VIS in polymyxin B haemoperfusion between patients with GNR and GPC infections, there was a significant decrease in the VIS over time, even when GPC was the causative organism. In addition, the degree of reduction in the VIS was significantly different in both the GNR and GPC groups compared with that in the non-extracorporeally treated group. Thus, polymyxin B haemoperfusion for septic shock caused by GNR reduced the VIS and could be effective even in cases of GPC infection.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"125-135"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045607","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

Thanks to Reviewers. 感谢评论者。

IF 1.1 4区医学

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

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Anaesthetic practice and mortality in Scotland compared to England from 1847 to 1914. 1847年至1914年苏格兰麻醉药的使用和死亡率与英格兰的比较。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-12 DOI: 10.1177/0310057X241304419

Alistair G McKenzie

{"title":"Anaesthetic practice and mortality in Scotland compared to England from 1847 to 1914.","authors":"Alistair G McKenzie","doi":"10.1177/0310057X241304419","DOIUrl":"https://doi.org/10.1177/0310057X241304419","url":null,"abstract":"In the second half of the nineteenth century and up to the First World War, anaesthetic practice in Scotland differed markedly from that in England. Chloroform was invariably used in Scotland with apparent disregard for reports of deaths under its influence. By contrast, in England concern about chloroform deaths, which were subject to inquests there, led to ether often being chosen instead. This article examines the different interpretations and handling of chloroform deaths in the two countries, drawing on the medical journals of the period and archived documents. Quite symmetrical claims were made. Whereas in England the danger of chloroform was perceived to be an inherent property of the agent itself, in Scotland the blame was thrown on a timid method of administration. The interpretation in Scotland was supported by a network of doctors who promoted chloroform as effective, safe and easy to administer; manufacturers who had monopoly of its manufacture; and legal practitioners who were uninterested in investigating anaesthetic deaths. Although the reporting of anaesthetic deaths was flawed in England, underreporting was far worse in Scotland. The fear of anaesthetic deaths in England allowed the seeds of specialisation in anaesthesia to germinate, whereas in Scotland the downplaying of anaesthetic risk obviated the notion of such specialisation.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241304419"},"PeriodicalIF":1.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405385","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

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 : 2025-02-11 DOI: 10.1177/0310057X241298852

John A Loadsman, Michael G Cooper

引用次数: 0

Unrecognised drug error and subsequent airway management utilising ultrasound-guided cricothyroidotomy and Rapid-O2® oxygen insufflation. 未识别的药物错误和随后的气道管理利用超声引导环甲状腺切开术和快速o2®氧注入。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-02-11 DOI: 10.1177/0310057X241304426

Patrick Wong, Emma E Foster, Julian B White

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The Bruck inhaler: An ether inhaler misattributed to Ludwig Bruck, an Australian medical publisher and supplier of medical equipment. Bruck吸入器：一种乙醚吸入器，被误认为是澳大利亚医学出版商和医疗设备供应商Ludwig Bruck。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-27 DOI: 10.1177/0310057X241285171

Rajesh P Haridas, Michael G Cooper, Andrew J Kennedy

{"title":"The Bruck inhaler: An ether inhaler misattributed to Ludwig Bruck, an Australian medical publisher and supplier of medical equipment.","authors":"Rajesh P Haridas, Michael G Cooper, Andrew J Kennedy","doi":"10.1177/0310057X241285171","DOIUrl":"https://doi.org/10.1177/0310057X241285171","url":null,"abstract":"The acquisition of an early ether inhaler stimulated research into several inhalers classified as Bruck inhalers. Ludwig Hermann Bruck was a German migrant who arrived in Australia in 1873. He became a medical publisher, importer of medical instruments, and made unique contributions to early Australian medical publishing, most significantly as the first publisher of The Australasian Medical Gazette. He also published The Australian Medical Directory and Handbook which contained lists of unregistered medical practitioners and alternative therapists. In 1914, Bruck joined in business with Richard Thomson who had a company selling medical equipment to doctors and hospitals. During the First World War, both Bruck and Thomson were charged with trading with the enemy. Bruck committed suicide in August 1915 before the case was heard in court. We did not find any evidence that Bruck designed the inhaler later attributed to him. The Bruck inhaler is functionally similar to the Probyn-Williams inhaler and should therefore be regarded as a glass-domed version of this inhaler.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241285171"},"PeriodicalIF":1.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045611","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

Reference value models for predicting preoperative six-minute walk test in patients scheduled for abdominal and pelvic cancer surgery. 预测腹部和盆腔癌症手术患者术前六分钟步行测试的参考值模型。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-01 Epub Date: 2024-10-17 DOI: 10.1177/0310057X241267907

Preet Gs Makker, Cherry Koh, Michael J Solomon, Nabila Ansari, Neil Pillinger, Linda Denehy, Bernhard Riedel, Lara Edbrooke, Jess Crowe, Duminda N Wijeysundera, Brian H Cuthbertson, Daniel Steffens

{"title":"Reference value models for predicting preoperative six-minute walk test in patients scheduled for abdominal and pelvic cancer surgery.","authors":"Preet Gs Makker, Cherry Koh, Michael J Solomon, Nabila Ansari, Neil Pillinger, Linda Denehy, Bernhard Riedel, Lara Edbrooke, Jess Crowe, Duminda N Wijeysundera, Brian H Cuthbertson, Daniel Steffens","doi":"10.1177/0310057X241267907","DOIUrl":"10.1177/0310057X241267907","url":null,"abstract":"Preoperative assessment of functional capacity with the six-minute walk test (6MWT) allows for estimation of surgical risk and targeted triage to prehabilitation services. Patient with abdominal and pelvic cancers have worse preoperative function compared with the general population. However, six-minute walk distance (6MWD) reference values from cancer patients are unknown, which limits the interpretation of 6MWT in this population. This study aimed to establish an explanatory reference value model for preoperative 6MWD in patients with abdominal or pelvic cancers undergoing elective surgery. Adult patients undergoing surgery for abdominal or pelvic cancers at major international hospitals were included. The 6MWT was assessed before surgery using a standardised protocol. Anthropometric data including age, sex, height, weight and body mass index (BMI) were collected and included in multiple linear regression analysis to model preoperative 6MWD. A total of 742 patients were included. Age, height and BMI were correlated with 6MWD. Six regression models were estimated, including two from the entire cohort, two from the subset of males and two from the subset of females. A sex-neutral model was the most representative, explaining 15% of the variance in 6MWD (6MWD = 761.00-3.00 * Age (years) -2.86 * BMI (kg/m2) - 48.09 * Sex (M1, F2)). The explored regression models, using anthropometric variables, poorly explained the variance between measured and modelled 6MWD, which suggests that these models have no clinical utility in the cancer population. Consideration of additional, non-anthropometric variables may improve regression modelling of preoperative 6MWD in patients in abdominal and pelvic cancers.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"37-44"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456184","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

Experiences and outcomes of patients participating in a perioperative shared decision-making pathway. 参与围手术期共同决策途径的患者的经历和结果。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-01 Epub Date: 2024-11-14 DOI: 10.1177/0310057X241265725

Heidi C Omundsen, Renee L Franklin, Mark S Omundsen, Trevor R Richardson

{"title":"Experiences and outcomes of patients participating in a perioperative shared decision-making pathway.","authors":"Heidi C Omundsen, Renee L Franklin, Mark S Omundsen, Trevor R Richardson","doi":"10.1177/0310057X241265725","DOIUrl":"10.1177/0310057X241265725","url":null,"abstract":"The Complex Decision Pathway (CDP) is a novel perioperative shared decision-making pathway that was established in the Bay of Plenty, New Zealand in 2018. Unique features of the pathway include the use of a structured communication tool to facilitate a goals-of-care conversation in addition to medical assessment, and the use of a tikanga Māori framework for Māori patients. From May 2019 until May 2022, 81 patients attending the CDP clinic were recruited to a prospective study of their demographics, health status and experience at the time of presentation, along with outcomes and opinions over the subsequent 12 months. Participants were mostly elderly and frail with multiple comorbidities, and just over half of participants chose to undergo surgery. Participants who chose, or were recommended, not to undergo surgery were older, more comorbid and had worse outcomes over the subsequent 12 months. Qualitative data suggested an overall positive patient experience of the pathway, and an economic analysis demonstrated its cost-effectiveness. Overall, the data presented here suggested that the CDP assisted in risk-stratifying patients into operative and non-operative groups, provided a positive patient experience, and was a cost-effective intervention.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"25-36"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142612031","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

Communication skills, patient voices and the art of listening. 沟通技巧，耐心的声音和倾听的艺术。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-01 Epub Date: 2025-01-06 DOI: 10.1177/0310057X241266006

Joanna R Sutherland, Helen Maxwell-Wright

引用次数: 0