Anaesthesia and Intensive Care最新文献_第7页

Airway management of lingual tonsillar hypertrophy: A narrative review. 舌扁桃体肥大的气道管理:叙述回顾。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-11-25 DOI: 10.1177/0310057X231196910

Patrick Wong, Jamie W Sleigh

{"title":"Airway management of lingual tonsillar hypertrophy: A narrative review.","authors":"Patrick Wong, Jamie W Sleigh","doi":"10.1177/0310057X231196910","DOIUrl":"10.1177/0310057X231196910","url":null,"abstract":"Lingual tonsillar hypertrophy is rarely identified on routine airway assessment but may cause difficulties in airway management. We conducted a narrative review of case reports of lingual tonsillar hypertrophy to examine associated patient factors, success rates of airway management techniques and complications. We searched the literature for anaesthetic management of cases with lingual tonsillar hypertrophy. We found 89 patients in various case reports, from which we derived 92 cases to analyse. 64% of cases were assessed as having a normal airway. Difficult and impossible face mask ventilation occurred in 29.6% and 1.4% of cases, respectively. Difficult intubation and failed intubation occurred in 89.1% and 21.7% of cases, respectively. Multiple attempts (up to six) at intubation were performed, with no successful intubation after the third attempt with direct laryngoscopy. Some 16.5% of patients were woken up and 4.3% required emergency front of neck access. Complications included oesophageal intubation (10.9%), bleeding (9.8%) and severe hypoxia (3.2%). Our findings show that severe cases of lingual hypertrophy may cause an unanticipated difficult airway and serious complications, including hypoxic brain damage and death. A robust airway strategy is required which includes limiting the number of attempts at laryngoscopy, and early priming and performance of emergency front of neck access if required. In patients with known severe lingual tonsillar hypertrophy, awake intubation should be considered.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"16-27"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440206","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

Response to "What is a case-control study? Comment on 'Oral midodrine does not expedite liberation from protracted vasopressor infusions: A case-control study'". 对“什么是病例对照研究?”对“口服米多卡因不能加速长期血管加压素输注的释放:一项病例对照研究”的评论。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-11-24 DOI: 10.1177/0310057X231197692

Alexander Jt Wood, Rashmi Rauniyar, Angela Jacques, Robert N Palmer, Bradley Wibrow, Matthew H Anstey

引用次数: 0

Preliminary pharmacokinetics and patient experience of jet-injected dexmedetomidine in healthy adults. 健康成人喷射注射右美托咪定的初步药代动力学和患者体验。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-09-15 DOI: 10.1177/0310057X231178841

Nicola M Whittle, Jamie W Sleigh, James W McKeage, Jonathan Termaat, Logan J Voss, Brian J Anderson

{"title":"Preliminary pharmacokinetics and patient experience of jet-injected dexmedetomidine in healthy adults.","authors":"Nicola M Whittle, Jamie W Sleigh, James W McKeage, Jonathan Termaat, Logan J Voss, Brian J Anderson","doi":"10.1177/0310057X231178841","DOIUrl":"10.1177/0310057X231178841","url":null,"abstract":"Jet injection is a drug delivery system without a needle. A compressed liquid drug formulation pierces the skin, depositing the drug into the subcutaneous or intramuscular tissues. We investigated the pharmacokinetics and patient experience of dexmedetomidine administered using jet injection in six healthy adult study participants. This needleless jet injection device was used to administer dexmedetomidine 0.5 μg/kg to the subcutaneous tissues overlying the deltoid muscle. Serum concentrations of dexmedetomidine were assayed at approximately 5 minutes, 15 minutes, 30 minutes, 1 hour and 4 hours after administration. Pharmacokinetic interrogation of concentration time profiles estimated an absorption half time for jet-injected dexmedetomidine of 21 minutes (coefficient of variation 69.4%) with a relative bioavailability assumed unity. In our samples the measured median peak (range) concentration was 0.164 μg/l (0.011-0.325 μg/l), observed in the sample taken at a median (range) of 13.5 minutes (11-30 minutes). The Richmond agitation sedation scale was used to assess the sedative effect, and scored 0 (alert and calm) or -1 (drowsy) in all participants. Five of the six participants stated they would prefer jet injection to needle injection in the future and one had no preference. The findings suggest that the use of a larger dose (>2 μg/kg) would be required to achieve the clinically relevant target concentration of 1 μg/l necessary to achieve deeper sedation (Richmond agitation sedation scale ≤3).","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"37-44"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10298222","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

Assessing the impact of COVID-19 on Australian public interest in critical care. 评估COVID-19对澳大利亚重症监护公众利益的影响。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-11-24 DOI: 10.1177/0310057X231198258

Rachel H T Yeong, Christopher B Hodge, Premkumar Gunasekaran

引用次数: 0

Inflammation risk before cardiac surgery and the treatment effect of intraoperative dexamethasone. 心脏手术前炎症风险及术中地塞米松治疗效果分析。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-11-24 DOI: 10.1177/0310057X231195098

Andrew J Toner, Tomas B Corcoran, Philip S Vlaskovsky, Arno P Nierich, Chris R Bain, Jan M Dieleman

{"title":"Inflammation risk before cardiac surgery and the treatment effect of intraoperative dexamethasone.","authors":"Andrew J Toner, Tomas B Corcoran, Philip S Vlaskovsky, Arno P Nierich, Chris R Bain, Jan M Dieleman","doi":"10.1177/0310057X231195098","DOIUrl":"10.1177/0310057X231195098","url":null,"abstract":"Patients who exhibit high systemic inflammation after cardiac surgery may benefit most from pre-emptive anti-inflammatory treatments. In this secondary analysis (n = 813) of the randomised, double-blind Intraoperative High-Dose Dexamethasone for Cardiac Surgery trial, we set out to develop an inflammation risk prediction model and assess whether patients at higher risk benefit from a single intraoperative dose of dexamethasone (1 mg/kg). Inflammation risk before surgery was quantified from a linear regression model developed in the placebo arm, relating preoperatively available covariates to peak postoperative C-reactive protein. The primary endpoint was the interaction between inflammation risk and the peak postoperative C-reactive protein reduction associated with dexamethasone treatment. The impact of dexamethasone on the main clinical outcome (a composite of death, myocardial infarction, stroke, renal failure, or respiratory failure within 30 days) was also explored in relation to inflammation risk. Preoperatively available covariates explained a minority of peak postoperative C-reactive protein variation and were not suitable for clinical application (R2 = 0.058, P = 0.012); C-reactive protein before surgery (excluded above 10 mg/L) was the most predictive covariate (P < 0.001). The anti-inflammatory effect of dexamethasone increased as the inflammation risk increased (-0.689 mg/L per unit predicted peak C-reactive protein, P = 0.002 for interaction). No treatment-effect heterogeneity was detected for the main clinical outcome (P = 0.167 for interaction). Overall, risk predictions from a model of inflammation after cardiac surgery were associated with the degree of peak postoperative C-reactive protein reduction derived from dexamethasone treatment. Future work should explore the impact of this phenomenon on clinical outcomes in larger surgical populations.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"28-36"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138433032","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

What is a case-control study? Comment on 'Oral midodrine does not expedite liberation from protracted vasopressor infusions: A case-control study'. 什么是病例对照研究?对“口服米多卡因不能加速长期血管加压素输注的释放:一项病例对照研究”的评论。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-11-24 DOI: 10.1177/0310057X231196914

Paul S Myles

引用次数: 0

Investigation of the HotDog, polymer resistive patient warming device. 调查研究 HotDog 聚合物电阻式病人取暖装置。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-09-17 DOI: 10.1177/0310057X231181405

Teneal E Baxter, Wallace G Grimmett

引用次数: 0

Publication outcomes among intensive care trainees. 重症监护受训者的出版结果。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-11-24 DOI: 10.1177/0310057X231194079

Eddie Shen, Jayesh Dhanani, Elissa M Milford, Vanessa Raileanu, Kevin B Laupland

{"title":"Publication outcomes among intensive care trainees.","authors":"Eddie Shen, Jayesh Dhanani, Elissa M Milford, Vanessa Raileanu, Kevin B Laupland","doi":"10.1177/0310057X231194079","DOIUrl":"10.1177/0310057X231194079","url":null,"abstract":"There is a paucity of literature describing the research productivity among trainees in intensive care medicine. We sought to examine the occurrence and determinants of successful publication outcomes associated with intensive care training. The study cohort consisted of all individuals admitted to fellowship of the College of Intensive Care Medicine of Australia and New Zealand (CICM) from 2012 to 2019. The primary outcome measure of this study was manuscripts indexed on PubMed within one year after and four years prior to admittance to CICM fellowship. Four hundred and eighty-five fellows were identified of whom 216 (45%) had at least one publication; 129 (27%) had one, 34 (7%) had two, 21 (4%) had three and 32 (7%) had four or more publications. Overall 138 (28%) fellows had at least one publication that was likely associated with their mandatory CICM training project for which they were first (n = 110; 80%) and/or corresponding (n = 72; 52%) author in the majority of cases. Overall 107 different senior/mentor authors were identified, with 13 individuals supporting more than one publication. Although gender and location at the time of fellowship award were not associated, location of receipt of medical degree, shorter time period between medical school graduation and fellowship award, more recent year of award, and completion of medical degree/fellowship in the same geographical region were associated with project publication. A minority of CICM fellows have PubMed-indexed publications related to their training. Further efforts are warranted to better define the determinants of successful project publication to optimise future opportunities.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"45-51"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138433033","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 new Diploma of Rural Generalist Anaesthesia: Supporting Australian rural and remote communities. 新的农村全科麻醉学文凭:支持澳大利亚农村和偏远社区。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2024-01-01 Epub Date: 2023-11-25 DOI: 10.1177/0310057X231196909

Peter T Gilchrist, Neil St M Beaton, Jodie N Atkin, Lindy J Roberts

{"title":"The new Diploma of Rural Generalist Anaesthesia: Supporting Australian rural and remote communities.","authors":"Peter T Gilchrist, Neil St M Beaton, Jodie N Atkin, Lindy J Roberts","doi":"10.1177/0310057X231196909","DOIUrl":"10.1177/0310057X231196909","url":null,"abstract":"In 2023, a Diploma of Rural Generalist Anaesthesia (DipRGA) was implemented across Australia. Developed collaboratively by the Australian and New Zealand College of Anaesthetists (ANZCA), the Australian College of Rural and Remote Medicine (ACRRM) and the Royal Australian College of General Practitioners (RACGP), the 12-month qualification is completed during or following ACRRM or RACGP Rural Generalist Fellowship training. Focused on the needs of rural and remote communities for elective and emergency surgery, maternity care, resuscitative care for medical illness or injury, and stabilisation for retrieval, the DipRGA supports rural generalist anaesthetists working within collaborative teams in geographically isolated settings. The goal is a graduate who can anaesthetise American Society of Anesthesiologists physical status class 1, 2 and stable 3 patients for elective surgery, provide obstetric anaesthesia and analgesia, anaesthetise paediatric patients and undertake advanced crisis care within their scope of practice. Crucially, they also recognise both limitations of their skills and local resources available when considering whether to provide care, defer, refer or transfer patients. DipRGA curriculum design commenced by adapting the ANZCA specialist training curriculum with consideration of the training approach of both the ACRRM and the RACGP, particularly the rural and remote context. Curriculum content is addressed in seven entrustable professional activities supported by workplace-based assessments and multisource feedback. Trainees are supervised by rural generalist anaesthetists and specialist anaesthetists, and complete flexible learning activities to accommodate geographical dispersion. Standardised summative assessments include an early test of knowledge and an examination, adapted from the ACRRM structured assessment using multiple patient scenarios.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"6-15"},"PeriodicalIF":1.5,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440210","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

Ultrasound in peripheral, neuraxial and perineuraxial regional anaesthesia, 1st ed. Switzerland: Published by Springer Nature, 351 pp. Price eBook $189, hardcover $241. ISBN 978-3-031-08803-2 (hardcover), 978-3-031-08804-9 (eBook) 外周、神经和会阴区域麻醉中的超声，第 1 版。瑞士：瑞士：Springer Nature 出版社，351 页。ISBN 978-3-031-08803-2（精装），978-3-031-08804-9（电子书）。

IF 1.5 4区医学

Anaesthesia and Intensive Care Pub Date : 2023-12-02 DOI: 10.1177/0310057x231210009

W. A. Watson

引用次数: 0