Anaesthesia and Intensive Care最新文献_第8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

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

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

A simulated 'can't intubate, can't oxygenate' manikin crossover study investigating a modified front-of-neck access airway device. 一项模拟“不能插管，不能充氧”的人体交叉研究，研究一种改良的颈部前通道气道装置。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-01 Epub Date: 2024-12-23 DOI: 10.1177/0310057X241266861

Stuart Paterson, Zeik Devereaux-McLean, Georgia Mohler, Dheeraj Sharma, Malcolm B Anderson, Adam J Mahoney

{"title":"A simulated 'can't intubate, can't oxygenate' manikin crossover study investigating a modified front-of-neck access airway device.","authors":"Stuart Paterson, Zeik Devereaux-McLean, Georgia Mohler, Dheeraj Sharma, Malcolm B Anderson, Adam J Mahoney","doi":"10.1177/0310057X241266861","DOIUrl":"10.1177/0310057X241266861","url":null,"abstract":"A 'can't intubate, can't oxygenate' (CICO) situation is an uncommon and time-critical emergency. Many institutions have adopted a 'scalpel-bougie-endotracheal tube (ETT)' technique based on evidence produced by the 4th National Audit Project of the Royal College of Anaesthetists and 2015 Difficult Airway Society guidelines. We made a modification to the traditional 'scalpel-bougie-ETT' technique, using a shortened bougie and replacing the ETT with a cuffed Melker airway in a preassembled device (called 'Secure Airway for Front-of-neck Emergencies' (SAFE airway device)), which we felt might reduce cognitive load on a single operator in an emergency CICO situation. We then performed a simulation crossover study using 20 volunteer anaesthetic doctors to compare this modification with the traditional technique. After a standardised pre-recorded video demonstration, participants performed simulated tube insertion using both the standard 'scalpel-bougie-ETT' technique and the SAFE airway device in randomised order. Participants were filmed for accurate timestamping. The primary outcome was time to successful tube insertion while secondary outcomes included number of attempts and ease of insertion. Overall time to cuff inflation was shorter, statistically and practically, with the SAFE airway device compared with the ETT (median 30 vs. 52 seconds, P < 0.001). Twenty-five percent of participants required multiple attempts using the ETT method versus 5% using the SAFE airway device, which was also rated as being easier to use. This study demonstrates that the SAFE airway device was fast, effective, easy to use and acceptable to airway practitioners in a simulated manikin environment. These findings indicate that further studies of the SAFE airway device are warranted.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"63-69"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875603","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 effect of deep versus awake removal of the laryngeal mask airway on the incidence of emergence delirium in paediatric tonsillectomy: A randomised controlled trial. 在小儿扁桃体切除术中，深喉与清醒拔除喉罩气道对出现谵妄的影响：随机对照试验。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-01 Epub Date: 2024-10-17 DOI: 10.1177/0310057X241275114

Dhruv Kapoor, Eliza A Tweddle, Luke Baitch

{"title":"The effect of deep versus awake removal of the laryngeal mask airway on the incidence of emergence delirium in paediatric tonsillectomy: A randomised controlled trial.","authors":"Dhruv Kapoor, Eliza A Tweddle, Luke Baitch","doi":"10.1177/0310057X241275114","DOIUrl":"10.1177/0310057X241275114","url":null,"abstract":"Emergence delirium, characterised by inconsolable crying, perceptual disturbances and thrashing, occurs in young children during the recovery phase from general anaesthesia. Our aim was to determine whether timing of laryngeal mask airway removal (deeply anaesthetised versus awake) influenced the incidence of emergence delirium in children after tonsillectomy. A single-centre, randomised controlled trial was conducted at Albury Wodonga Health, a regional hospital in Australia. Included patients were two to seven years old, American Society of Anesthesiologists physical status classification 1-2, undergoing elective tonsillectomy (with or without adenoidectomy or grommet insertion) under general anaesthesia. Patients were randomised to have their laryngeal mask removed whilst deeply anaesthetised (in the operating theatre) or after awakening (in the post-anaesthesia care unit (PACU)). Pediatric Anesthesia Emergence Delirium score was determined at 5 and 20 min after eye opening, and frequency of complications (cough, vomiting, excessive salivation, oxygen desaturation and laryngospasm) in the PACU were recorded. Sixty-two patients were randomised to deep laryngeal mask removal and 62 to awake. In the awake versus deep groups, 33 (53%) versus 40 (65%) participants had emergence delirium at 5 min (odds ratio (OR) 0.63, 95% confidence interval (CI) 0.30 to 1.29, P = 0.20). At 20 min, 18 (29%) vs. 19 (31%) participants had emergence delirium (OR 0.93, 95% CI 0.43 to 2.00, P = 0.88). A greater incidence of most PACU complications was observed in the awake versus deep group; cough (24% vs. 8%), vomiting (8% vs. 0%), excessive salivation (23% vs. 8%) and oxygen desaturation (16% vs. 0%). We found no significant difference between the two techniques in terms of preventing emergence delirium. However, other PACU complications were more frequent with awake removal.","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"55-62"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456186","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

ChatGPT-4's capability in addressing multiple-choice questions within the primary examination of the Australian and New Zealand College of Anaesthetists. ChatGPT-4 解决澳大利亚和新西兰麻醉师学院初级考试中多项选择题的能力。

IF 1.1 4区医学

Anaesthesia and Intensive Care Pub Date : 2025-01-01 Epub Date: 2024-09-23 DOI: 10.1177/0310057X241266625

Steven C Cai, Alpha Ms Tung

引用次数: 0