Anaesthesia and Intensive Care最新文献_第6页

The simple things, and the not so simple. 简单的事，和不那么简单的事。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-06-14 DOI: 10.1177/0310057X261433570

Philip J Peyton

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The quest for real time propofol monitoring: a review. 对异丙酚实时监测的探索：综述。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-06-14 DOI: 10.1177/0310057X261433579

Christina Fe Taplin, Kevin W Plaxco, Ben Kave

{"title":"The quest for real time propofol monitoring: a review.","authors":"Christina Fe Taplin, Kevin W Plaxco, Ben Kave","doi":"10.1177/0310057X261433579","DOIUrl":"10.1177/0310057X261433579","url":null,"abstract":"Propofol-based total intravenous anaesthesia (TIVA) is being increasingly used for maintenance of general anaesthesia due to benefits over volatile anaesthetic-based anaesthesia. An ongoing concern with the use of TIVA is the increased incidence of unintended awareness. The bispectral index (BIS) monitor has been proven to reduce the risk of awareness in relaxant general anaesthesia; however, it does not directly measure or ensure adequate anaesthesia delivery. Volatile anaesthetic delivery is confirmed by end-tidal gas monitoring; however, there is no comparable monitoring in TIVA. Recent research has thus focused on the development of technologies supporting the real-time monitoring of propofol levels, which could allow TIVA to operate with the same direct feedback that end-tidal monitoring provides for the volatile anaesthetics. It would not replace pharmacodynamic effect monitoring such as BIS, as inter-patient variability in anaesthesia doses required for an adequate depth of anaesthesia remains. It could, however, complement it, allowing TIVA to operate with the same level of real-time monitoring, and overall risk of awareness, as volatiles. There are currently no technologies for this in use in the clinical setting. This review provides an overview of the various propofol measuring technologies that have been or are being developed, as well as some of the key ongoing attempts at applying these technologies in clinical settings. We discuss challenges that have impeded the implementation of promising innovations, and outline future directions for making real-time propofol monitoring a clinical reality.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"307-313"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248915","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

Patient experiences and outcomes from a novel multidisciplinary preoperative shared decision-making clinic. 患者经验和结果从一个新的多学科术前共享决策诊所。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-04-20 DOI: 10.1177/0310057X261427783

Yiying Sally Tsang, Jia Hao Hui, Kate H Hurley, Sarah L Jones, Andrea Ditoro, Daire MacCormack, Andrew J Mackay

{"title":"Patient experiences and outcomes from a novel multidisciplinary preoperative shared decision-making clinic.","authors":"Yiying Sally Tsang, Jia Hao Hui, Kate H Hurley, Sarah L Jones, Andrea Ditoro, Daire MacCormack, Andrew J Mackay","doi":"10.1177/0310057X261427783","DOIUrl":"10.1177/0310057X261427783","url":null,"abstract":"We established a novel multidisciplinary preoperative clinic in 2023 to support elderly, frail and/or comorbid patients to make decisions about surgical treatment based on their goals and values. We aimed to examine the characteristics, postoperative outcomes and quality of shared decision-making (SDM) for patients seen in this clinic in its first year. We collected data regarding patient demographics, preoperative status and postoperative outcomes via review of the medical record, and conducted a telephone interview to assess quality of SDM via the CollaboRATE-5 and Decision Regret Scales. Seventy-one patients attended the clinic in 2023, with a median age of 78 years. Eighty-six percent of patients had an American Society of Anesthesiologists Physical Status classification of 3 or 4, and 69% were frail (Clinical Frailty Scale of 4 or more). Sixty-five percent of patients elected to proceed with surgery and 35% elected not to proceed. At follow-up, approximately 14 months after initial SDM review, 58% of patients had had surgery, with a median postoperative hospital length of stay of four days, and a median of 25.5 days alive and at home within 30 days of surgery. Telephone interview was successfully conducted with 24 patients. The CollaboRATE-5 top score was reported by 63% of respondents, and the median Decision Regret Scale score was 7.5 (interquartile range 0-25) suggesting a high quality of SDM. In the first year of its operation, our multidisciplinary preoperative clinic delivered high-quality SDM to a cohort of high-risk surgical patients, with those proceeding to surgery generally experiencing favourable postoperative outcomes.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"375-380"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Choosing reusable operating theatre devices at an Australian health service avoids hundreds of tonnes of waste and could save millions of dollars per annum. 澳大利亚一家医疗服务机构选择可重复使用的手术室设备，避免了数百吨的浪费，每年可节省数百万美元。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-04-21 DOI: 10.1177/0310057X261428146

Jessica F Davies, Elizabeth Hu, Stephanie Best, Forbes McGain

{"title":"Choosing reusable operating theatre devices at an Australian health service avoids hundreds of tonnes of waste and could save millions of dollars per annum.","authors":"Jessica F Davies, Elizabeth Hu, Stephanie Best, Forbes McGain","doi":"10.1177/0310057X261428146","DOIUrl":"10.1177/0310057X261428146","url":null,"abstract":"Healthcare services rely on large amounts of disposable medical devices, even though similar reusable devices exist. This retrospective audit of operating theatre and endoscopy procurement data across two hospitals aimed to examine the number and mass of simple single-use devices and cost (purchasing and disposal) of such devices in operating theatres where a reusable device alternative exists. This was assessed at one health service across two hospitals with a total of 19 operating theatres and five endoscopy procedure rooms. The main outcome was the number of single-use devices procured and disposed of, mass of devices procured, cost of procurement, cost of disposal, and estimated environmental impact of device procurement and disposal. In a five-year period of operating at two hospitals, 2,683,412 simple single-use devices that have a reusable alternative were purchased and disposed of, with a combined mass of 748 t, an approximate purchasing cost of A$16.1m, and an approximate disposal cost of around A$1.2m. The associated environmental impact of these devices was estimated at 3690 tonnes carbon dioxide equivalent. Simple disposable medical devices in operating theatres such as bowls, jugs, drapes, gowns, scissors, towels and anaesthesia equipment produce tonnes of waste per annum, cost millions to procure and dispose of, and produce greenhouse gas emissions from production to disposal. Replacing some single-use devices with reusable alternatives presents an opportunity for health services to save money from purchasing and disposing of single-use devices, as well as reducing their waste and greenhouse gas footprint. Replacing disposable equipment with reusable equipment can divert tonnes of waste from landfill and save on procurement and disposal costs.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"338-346"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anaesthetic mumps associated with laryngeal mask airway use - a case report. 麻醉性腮腺炎与喉罩气道使用有关- 1例报告。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-02-16 DOI: 10.1177/0310057X261416480

Dick M Ongley

引用次数: 0

Inflation of area under the receiver operating characteristic curve due to spectrum bias in case-control studies. 在病例对照研究中，由于频谱偏倚，受试者工作特征曲线下的面积膨胀。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-02-16 DOI: 10.1177/0310057X251400349

Mandy Hm Chu, Henry Mk Wong, Kwok M Ho

引用次数: 0

Risk factors for prolonged hospital stay after surgery in older patients. 老年患者术后住院时间延长的危险因素

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-04-20 DOI: 10.1177/0310057X261427455

Kobi J Rischin, Mark Shulman, Margot Lodge, Anthony Stark, David John, Paul Myles

{"title":"Risk factors for prolonged hospital stay after surgery in older patients.","authors":"Kobi J Rischin, Mark Shulman, Margot Lodge, Anthony Stark, David John, Paul Myles","doi":"10.1177/0310057X261427455","DOIUrl":"10.1177/0310057X261427455","url":null,"abstract":"Prolonged hospital stay after surgery is an important patient-centred outcome in older patients and is associated with increased healthcare costs. This case-control study aimed to identify risk factors for prolonged hospital stay in older patients having surgery. We matched 57 cases (patients 65 years of age or older, with a postoperative length of stay of greater than 21 days) with 165 controls (patients 65 years of age or older who underwent a comparable surgical procedure but were discharged home within 14 days). Patients had a greater risk of prolonged hospital stay if they had a history of cognitive impairment (odds ratio (OR) 2.41, 95% confidence interval (CI) 1.10 to 5.28, P=0.025), lung disease (OR 2.41, 95% CI 1.30 to 4.46, P=0.005) or past or current smoking (OR 1.58, 95% CI 1.14 to 2.19, P=0.009). Patients were also more likely to have longer hospital admission if they underwent emergency surgery (OR 1.26, 95% CI 1.12 to 1.41, P=0.002), were admitted to the intensive care unit (OR 4.57, 95% CI 2.80 to 7.56, P <0.001), had a blood transfusion (OR 4.83, 95% CI 2.92 to 7.96, P <0.001) or had any postoperative complication (OR 4.34, 95% CI 3.06 to 6.16, P <0.001). There were no significant differences in age, preoperative mobility status, or living arrangements between groups. In practice, these findings should assist clinicians and their patients in preoperative shared decision-making.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"356-363"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728158","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

A brief history of colour in the operating theatre. 手术室的色彩简史。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-07-04 DOI: 10.1177/0310057X261449830

Peter J Featherstone, Christine M Ball

引用次数: 0

Peripheral intravenous catheters: the impact of compliance with standards on patient-reported experience measures. 外周静脉导管：遵守标准对患者报告经验措施的影响。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2025-12-02 DOI: 10.1177/0310057X251387731

Bhavna Brijball, Renata Hadzic, Alisa Shvartsbart, Bernadette R Findlay, Matthew Harland, Timothy De Solom, Fatemeh Emadi, Jonathan Penm, Jennifer A Stevens

引用次数: 0

Microcirculatory alterations in critical care: A narrative review. 危重症患者微循环改变：叙述性回顾。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2026-07-01 Epub Date: 2026-01-23 DOI: 10.1177/0310057X251397427

Hayley You, Nai An Lai, I Anne Leditschke

{"title":"Microcirculatory alterations in critical care: A narrative review.","authors":"Hayley You, Nai An Lai, I Anne Leditschke","doi":"10.1177/0310057X251397427","DOIUrl":"10.1177/0310057X251397427","url":null,"abstract":"Microcirculatory failure is recognised as a critical pathophysiological factor in the development of multi-organ failure in critically ill patients. However, traditional resuscitative efforts have focused on macrohaemodynamic variables such as blood pressure and cardiac output. These parameters may be insensitive for detecting changes in tissue perfusion when haemodynamic coherence is disturbed in states of shock. Several clinical studies using direct visualisation of the microcirculation have revealed that microcirculatory abnormalities can persist despite optimised global haemodynamic parameters. These abnormalities are independently associated with increased mortality. As the goal of resuscitation is to restore tissue perfusion, and the microcirculation closely reflects perfusion at the tissue level, interest in the microcirculation has grown over the years. Technological advances now allow direct observation and measurement of the microcirculation. This narrative review explores the current understanding of the microcirculation and its role in critical illness, with an overview of microcirculatory monitoring and its utility in clinical decision making.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"314-327"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146027784","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