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Routine cognitive screening for older people undergoing major elective surgery: Benefits, risks and costs. 对接受重大择期手术的老年人进行常规认知筛查：益处、风险和成本。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-09-01 Epub Date: 2024-08-30 DOI: 10.1177/0310057X241232421
Luke Km Chan, Alwin Chuan, Christophe R Berney, Daniel Ky Chan
{"title":"Routine cognitive screening for older people undergoing major elective surgery: Benefits, risks and costs.","authors":"Luke Km Chan, Alwin Chuan, Christophe R Berney, Daniel Ky Chan","doi":"10.1177/0310057X241232421","DOIUrl":"10.1177/0310057X241232421","url":null,"abstract":"<p><p>Cognitive impairment and older age are major risk factors for postoperative delirium. Professional societies have advocated preoperative screening to identify at-risk individuals for implementation of interventions, which have moderate effectiveness in preventing delirium. However, it remains unclear from the guidelines whether screening should be completed routinely for all older individuals or targeted, and also which specific screening tool is preferred. In addition, the responsibility for screening remains undesignated in the guidelines provided. We reviewed the benefits and risks of routine screening. We also performed a cost-benefit analysis of routine screening (versus no screening). Furthermore, we summarised the sensitivities and specificities of commonly used screening tools and reviewed evolving screening tools that may have an increasing role in future practice. We concluded that routine screening is useful and appears to be cost-effective for reducing postoperative delirium, with a cost-benefit ratio of 2.89 (adjusted ratio of 2.34), and has additional advantages over other approaches such as targeted screening or routine intervention.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"275-282"},"PeriodicalIF":1.1,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103611","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 of pursuing an intensivist career in regional and rural Australia: An interview study. 在澳大利亚地区和农村地区从事重症监护职业的经历：访谈研究。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-07-01 Epub Date: 2024-06-16 DOI: 10.1177/0310057X241242813
Benjamin K Cheung, James G Anderson, Alexander J Giles, Priya Martin
{"title":"Experiences of pursuing an intensivist career in regional and rural Australia: An interview study.","authors":"Benjamin K Cheung, James G Anderson, Alexander J Giles, Priya Martin","doi":"10.1177/0310057X241242813","DOIUrl":"10.1177/0310057X241242813","url":null,"abstract":"<p><p>The regional and rural intensivist workforce is vital to delivering high standards of healthcare to all Australians. Currently, there is an impending workforce disaster, with higher senior medical officer vacancy rates among regional and rural intensive care units, with these units being staffed by junior doctors who are in earlier stages of their training, which in turn increases supervisory burden. There is a lack of comprehensive literature on the barriers and enablers of training, recruiting and retaining regional and rural intensivists. To address this gap, a qualitative study was conducted, involving 13 in-depth, structured interviews with full-time and part-time intensivists from eight Australian regional and rural hospitals. Content analysis of the interview data resulted in the identification of four major categories: unique practice context, need for a broad generalist skill set, perks and challenges of working in a regional/rural area and workforce implications. The study findings revealed that regional and rural intensive care practice offers positive aspects, including work satisfaction, supportive local teams and an appealing lifestyle. However, these benefits are counterbalanced by challenges such as a heavier burden of on-call work, a higher proportion of junior staff which increase supervisory burden and limited access to subspecialist services. The implications of these findings are noteworthy and can be utilised to inform government policies, hospitals, the College of Intensive Care Medicine and the Australian and New Zealand College of Anaesthetists in developing strategies to enhance the provision of intensive care services and improve workforce planning in regional and rural areas.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"223-231"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327033","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
Pain and psychopathology after intensive care unit admission. 入住重症监护室后的疼痛和心理病理学。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-07-01 Epub Date: 2024-06-16 DOI: 10.1177/0310057X241226716
Nour Smaisim, Mienke Rijsdijk, Yuri van der Does, Arjen Jc Slooter
{"title":"Pain and psychopathology after intensive care unit admission.","authors":"Nour Smaisim, Mienke Rijsdijk, Yuri van der Does, Arjen Jc Slooter","doi":"10.1177/0310057X241226716","DOIUrl":"10.1177/0310057X241226716","url":null,"abstract":"<p><p>Pain and psychopathology are observed in 18% and 55% of patients, respectively, 1 year after intensive care unit (ICU) admission. It is well known that chronic pain and psychopathology have a bidirectional relation in the general population, but it is not known whether this holds true for ICU survivors. The aim of this study was to investigate whether pain before, during and after ICU admission is related to psychopathology in ICU survivors 1 year after discharge. We performed a cohort study in a mixed ICU in the Netherlands between 2013 and 2016. At 1-year follow-up, patients completed the Hospital Anxiety and Depression Scale, the Impact of Event Scale/Impact of Event Scale-Revised, and answered standardised questions regarding pain. Psychopathology was defined as having anxiety, depressive and/or post-traumatic stress disorder symptoms. We used multivariable logistic regression analysis to evaluate the association of pain before, during and after ICU admission with psychopathology at 1 year follow-up. We included 1105 patients of whom 558 (50%) (95% confidence interval (CI) 0.48 to 0.54) had psychopathology at 1 year follow-up. Pain before ICU admission (odds ratio (OR) 1.18; 95% CI 1.10 to 1.26) and pain after ICU admission (OR 2.38; 95% CI 1.68 to 3.35) were associated with psychopathology. Pain during ICU stay was not associated with psychopathology, but the memory of insufficient pain management during ICU stay was (OR 2.19; 95% CI 1.39 to 3.45). Paying attention to pain and pain treatment experiences related to ICU admission may therefore contribute to early identification of ICU survivors at risk of psychopathology development.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"232-240"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11290044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327034","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
Awards for papers published in Anaesthesia and Intensive Care, 2022. 为 2022 年在《麻醉与重症监护》上发表的论文颁奖。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-07-01 Epub Date: 2024-06-16 DOI: 10.1177/0310057X241257815
John A Loadsman, Michael G Cooper
{"title":"Awards for papers published in <i>Anaesthesia and Intensive Care</i>, 2022.","authors":"John A Loadsman, Michael G Cooper","doi":"10.1177/0310057X241257815","DOIUrl":"https://doi.org/10.1177/0310057X241257815","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":"52 4","pages":"264"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141791704","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
Survival in hostile environments: Flying in the stratosphere. 在恶劣环境中生存：在平流层飞行
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-07-01 Epub Date: 2024-06-16 DOI: 10.1177/0310057X241253669
Peter J Featherstone, Christine M Ball
{"title":"Survival in hostile environments: Flying in the stratosphere.","authors":"Peter J Featherstone, Christine M Ball","doi":"10.1177/0310057X241253669","DOIUrl":"10.1177/0310057X241253669","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"211-213"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327035","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
Anaesthetic management of a parturient with hypokalaemic periodic paralysis for caesarean section: A case report and review of the literature. 剖腹产低钾周期性麻痹产妇的麻醉管理：病例报告和文献综述。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-07-01 Epub Date: 2024-06-16 DOI: 10.1177/0310057X231178840
Rachel M Vassiliadis
{"title":"Anaesthetic management of a parturient with hypokalaemic periodic paralysis for caesarean section: A case report and review of the literature.","authors":"Rachel M Vassiliadis","doi":"10.1177/0310057X231178840","DOIUrl":"10.1177/0310057X231178840","url":null,"abstract":"<p><p>A 32-year-old multigravida woman, with known familial hypokalaemic periodic paralysis, underwent spinal anaesthesia for an elective lower segment caesarean section. There are several case reports in the literature discussing the optimal anaesthetic technique. In the past there has not been an emphasis on aggressive and early potassium replacement. A target level to commence replacement of potassium at 4.0 mmol/L or less is proposed. Careful preoperative preparation, frequent perioperative monitoring and early potassium replacement resulted in no perioperative episodes of weakness in this case, in contrast with other case reports where potassium was either not monitored or not replaced early enough, resulting in postoperative attacks. Another factor to consider in hypokalaemic periodic paralysis is the avoidance of triggers, including certain medications. Misoprostol was used in this instance to avoid potential electrolyte derangements from other uterotonics.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"250-255"},"PeriodicalIF":1.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327031","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, 2022. 为 2022 年在《麻醉与重症监护》上发表的论文颁奖。
IF 1.5 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-06-16 DOI: 10.1177/0310057X241257815
John A Loadsman, Michael G Cooper
{"title":"Awards for papers published in <i>Anaesthesia and Intensive Care</i>, 2022.","authors":"John A Loadsman, Michael G Cooper","doi":"10.1177/0310057X241257815","DOIUrl":"https://doi.org/10.1177/0310057X241257815","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X241257815"},"PeriodicalIF":1.5,"publicationDate":"2024-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327032","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
Development of a symbiotic culture of bacteria and yeast (SCOBY) farm to manufacture artificial skin for front of neck airway access simulation. 开发细菌和酵母（SCOBY）共生培养农场，用于制造颈前气道通路模拟人工皮肤。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-05-01 Epub Date: 2024-02-06 DOI: 10.1177/0310057X231213109
Jeremy S Young, Raja R Palepu, Melita Macdonald, James R Mcalpine, James R Broadbent
{"title":"Development of a symbiotic culture of bacteria and yeast (SCOBY) farm to manufacture artificial skin for front of neck airway access simulation.","authors":"Jeremy S Young, Raja R Palepu, Melita Macdonald, James R Mcalpine, James R Broadbent","doi":"10.1177/0310057X231213109","DOIUrl":"10.1177/0310057X231213109","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"184-187"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691019","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
Ability of anaesthetists to identify the position of the right internal jugular vein using anatomical landmarks: A double-blind study. 麻醉师利用解剖标志识别右颈内静脉位置的能力：双盲研究。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-05-01 Epub Date: 2024-02-06 DOI: 10.1177/0310057X231212504
Apurv Sehgal, Bethany Walker, Fideron Sl Tsang, Sameen Anodiyil, David W Hewson
{"title":"Ability of anaesthetists to identify the position of the right internal jugular vein using anatomical landmarks: A double-blind study.","authors":"Apurv Sehgal, Bethany Walker, Fideron Sl Tsang, Sameen Anodiyil, David W Hewson","doi":"10.1177/0310057X231212504","DOIUrl":"10.1177/0310057X231212504","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"200-202"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691018","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 case series of the Royal Perth Hospital cannula-first approach in the 'can't intubate, can't oxygenate' scenario. 珀斯皇家医院在 "无法插管、无法吸氧 "的情况下采用插管先行法的病例系列。
IF 1.1 4区 医学
Anaesthesia and Intensive Care Pub Date : 2024-05-01 Epub Date: 2024-03-28 DOI: 10.1177/0310057X231214548
Andrew Mb Heard, David A Lacquiere, Helen L Gordon, Scott G Douglas, Hans J Avis
{"title":"A case series of the Royal Perth Hospital cannula-first approach in the 'can't intubate, can't oxygenate' scenario.","authors":"Andrew Mb Heard, David A Lacquiere, Helen L Gordon, Scott G Douglas, Hans J Avis","doi":"10.1177/0310057X231214548","DOIUrl":"10.1177/0310057X231214548","url":null,"abstract":"<p><p>At the Royal Perth Hospital, we have been developing and teaching a can't intubate, can't oxygenate (CICO) rescue algorithm for over 19 years, based on live animal simulation. The algorithm involves a 'cannula-first' approach, with jet oxygenation and progression to scalpel techniques if required in a stepwise fashion. There is little reported experience of this approach to the CICO scenario in humans. We present eight cases in which a cannula-first Royal Perth Hospital approach was successfully implemented during an airway crisis. We recommend that institutions teach and practice this approach; we believe it is effective, safe and minimally invasive when undertaken by clinicians who have been trained in it and have immediate access to the requisite equipment. The equipment is low cost, comprising a 14G Insyte cannula, saline, 5 ml syringe and a Rapid-O2. Training can be provided using low-fidelity manikins or part-task trainers.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"159-167"},"PeriodicalIF":1.1,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140304431","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
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