MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Anaesthesia and intensive care medicine' source. Wed, 08 Feb 2012 07:39:16 +0100 http://www.medworm.com/index.php?rid=5666632&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002797%2Fabstract%3Frss%3Dyes (pp 56–58) Which of the following delay gastric emptying? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666632 Wed, 01 Feb 2012 05:00:00 +0100 5666632 http://www.medworm.com/index.php?rid=5666631&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002700%2Fabstract%3Frss%3Dyes Abstract: The liver is a major organ with multiple functions. Many drugs are metabolized by the liver during phase 1 and 2 reactions which include complex processes involving cytochrome P450. Additionally, drugs can also modify how the liver functions and cause dysfunction or even failure of the organ both by a direct effect on the liver or by alteration in liver blood flow. It is important to recognize the signs and symptoms of liver failure in patients and identify possible causes including drug interactions. Furthermore, once a patient has been recognized to be suffering with liver dysfunction or failure drug choice and dosing regime will need to be rationalized.Paracetamol overdose can have severe and life-threatening consequences for patients due to its effect on liver function. It is... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666631 Wed, 01 Feb 2012 05:00:00 +0100 5666631 http://www.medworm.com/index.php?rid=5666630&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002724%2Fabstract%3Frss%3Dyes Abstract: Gastric disorders have clinical implications in both anaesthesia and critical care medicine. Aspiration of acidic gastric contents in the perioperative setting is linked to pneumonitis and later development of pneumonia. Pharmacological strategies to minimize this risk include histamine-2 receptor antagonists, sucralfate, proton pump inhibitors and sodium citrate. Use of gastric acid-suppressing therapy is widespread in critical care. The aim is to reduce the incidence of stress-related mucosal bleeding. Intestinal failure is common in critical illness. Medications that decrease gastric motility and contribute to ileus, include opioid analgesics, catecholamines and α2-adrenoceptor antagonists. Current pharmacological strategies for increasing gastric motility include the use of ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666630 Wed, 01 Feb 2012 05:00:00 +0100 5666630 http://www.medworm.com/index.php?rid=5666629&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002736%2Fabstract%3Frss%3Dyes Abstract: Sympathomimetic agents are commonly encountered in anaesthetic and critical care settings. Some only act on autonomic nervous system reflexes, whilst others affect higher mental function – thus these agents are used frequently in the clinical setting, as well as being drugs of abuse (e.g. the amphetamines). Competition for various metabolic and transport processes can lead to dangerous drug interactions, with sympathetic nervous system overactivity being the major consequence leading to morbidity. They are an important group of drugs and a detailed understanding of their pharmacology is vital to the safe practice of anaesthesia and critical care medicine.Respiratory stimulants also have their place in modern medical treatment. Doxapram and the methylxanthines are used clinicall... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666629 Wed, 01 Feb 2012 05:00:00 +0100 5666629 http://www.medworm.com/index.php?rid=5666628&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002645%2Fabstract%3Frss%3Dyes Abstract: Carbohydrates, mostly as starch, are digested by salivary and pancreatic amylases to di-, tri- and oligosaccharides, then to monosaccharides by saccharidases on the wall of the small intestine, following which they are absorbed. Proteins are absorbed as amino acids and small peptides that are broken down further, in the cell, to amino acids. Monosaccharides and amino acids pass to the liver via the portal vein. Fats are digested and absorbed as free fatty acids and glycerides and are then mostly reconstituted to triglycerides in the mucosal cells of the small intestine. They combine with phospholipids and a protein to form chylomicrons, which pass via the lymphatics and the thoracic duct into the general circulation. Fatty acids are released in the tissues and are then either re-... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666628 Wed, 01 Feb 2012 05:00:00 +0100 5666628 http://www.medworm.com/index.php?rid=5666627&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002669%2Fabstract%3Frss%3Dyes Abstract: The gastrointestinal tract is composed of smooth muscle arranged in two layers: longitudinal and circular. Although its activity is influenced by the autonomic nervous system, it is mainly under local reflex control mediated by an enteric nervous system and local hormones. The motility of the gastrointestinal tract has several different well-defined patterns. Its function is to move the gastrointestinal contents through the various phases of homogenization (mixing), digestion, absorption and elimination. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666627 Wed, 01 Feb 2012 05:00:00 +0100 5666627 http://www.medworm.com/index.php?rid=5666626&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002657%2Fabstract%3Frss%3Dyes Abstract: Food is divided into digestible portions in the mouth and swallowed – a complex reflex process involving several cranial nerves. The stomach homogenizes food, begins digestion and regulates the rate at which food enters the duodenum. Pancreatic juices containing powerful digesting enzymes are added and digestion is completed in the small intestine. The large bowel dehydrates the gastrointestinal contents. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666626 Wed, 01 Feb 2012 05:00:00 +0100 5666626 http://www.medworm.com/index.php?rid=5666625&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002694%2Fabstract%3Frss%3Dyes Abstract: The liver is one of the most important organs in the body and serves a variety of important functions including metabolic, vascular, immunological, secretory and excretory functions. It plays a key role in the carbohydrate, protein and fat metabolism in the human body. In this article, we outline a brief overview of the metabolic functions. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666625 Wed, 01 Feb 2012 05:00:00 +0100 5666625 http://www.medworm.com/index.php?rid=5666624&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002682%2Fabstract%3Frss%3Dyes Abstract: The liver is the second-largest organ in the human body. Traditionally, the anatomy of the liver has been described on the basis of its external appearance/gross anatomy. However, with the increase in surgical procedures, for example resection and transplant, the need for a more functional description of the liver based on its vascular and biliary architecture evolved. Different models of functional anatomy of the liver have been described in the literature in the past, but Couinaud’s model of functional anatomy of the liver is the most popular. The liver has dual vascular supply, with most of its supply coming from the portal vein and the remainder through the hepatic artery. In this article, we outline the functional anatomy of the liver along with its blood supply. (Source:... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666624 Wed, 01 Feb 2012 05:00:00 +0100 5666624 http://www.medworm.com/index.php?rid=5666623&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002670%2Fabstract%3Frss%3Dyes This article will focus on the pathophysiological changes caused by CO2 pneumoperitoneum, the anaesthetic management for patients undergoing laparoscopy, and potential complications. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666623 Wed, 01 Feb 2012 05:00:00 +0100 5666623 http://www.medworm.com/index.php?rid=5666622&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002761%2Fabstract%3Frss%3Dyes Abstract: Laboratory tests of liver function are among most commonly ordered blood tests. However, interpretation of parameters should be based not only on measuring the metabolic and synthetic function of the liver, but also parameters which reflect liver injury. Clinical and laboratory assessment of liver function help to identify causes of liver failure, monitor clinical deterioration and prognosis, and determine treatment options including liver transplantation. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666622 Wed, 01 Feb 2012 05:00:00 +0100 5666622 http://www.medworm.com/index.php?rid=5666621&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002773%2Fabstract%3Frss%3Dyes Abstract: Liver disease has a high prevalence. Patients with advanced liver disease have poor outcome after surgery. Prognostic scoring systems help to identify those at high risk. Chronic liver disease is associated with typical extra-hepatic manifestations, resulting from failure to clear endogenous vasodilators, splanchnic vasodilation, high cardiac output and decreased central blood volume. Complications include hepatorenal syndrome, hepatopulmonary syndrome and porto-pulmonary hypertension. In fulminant liver failure, cerebral oedema is a prominent feature. Without liver transplantation, prognosis is dismal. Appreciation of the multi-system sequelae of liver disease is a prerequisite to appropriate management. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666621 Wed, 01 Feb 2012 05:00:00 +0100 5666621 http://www.medworm.com/index.php?rid=5666620&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002712%2Fabstract%3Frss%3Dyes This article will discuss how to recognize these problems and try to minimize their impact on recovery. A growing body of evidence shows that adoption of a package of care known collectively as enhanced recovery significantly reduces postoperative morbidity and reduces length of hospital stay. For anaesthetists the changes involve analgesic regimens and perioperative fluid and nutrition management. This evidence has been brought together in the national Enhanced Recovery After Surgery Programme and has been introduced to many hospitals for elective bowel surgery patients. The principles of the programme will be discussed. Aspects of it can be applied to many other surgical groups. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666620 Wed, 01 Feb 2012 05:00:00 +0100 5666620 http://www.medworm.com/index.php?rid=5666619&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029912000161%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666619 Wed, 01 Feb 2012 05:00:00 +0100 5666619 http://www.medworm.com/index.php?rid=5666618&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029912000148%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5666618 Wed, 01 Feb 2012 05:00:00 +0100 5666618 http://www.medworm.com/index.php?rid=5544049&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002785%2Fabstract%3Frss%3Dyes (pp 28–30) Which of the following are true regarding the uses and complications of intraosseous cannulation? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544049 Wed, 28 Dec 2011 00:55:56 +0100 5544049 http://www.medworm.com/index.php?rid=5544048&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002360%2Fabstract%3Frss%3Dyes Abstract: Trauma is the leading cause of preventable death in children, most often resulting from accidents involving motor vehicles or falls. A coordinated resuscitation effort in the early phase may contribute to improved morbidity and mortality outcomes. A multi-professional approach to the initial treatment of a critically injured child should be adopted: the primary survey aims to identify and manage immediately life-threatening conditions relating to a patients airway, breathing or circulatory system. Following cardiovascular stabilization, the secondary survey serves to structure a detailed examination for less severe or more occult injuries. Attention to fluid therapy, analgesia, thermoregulation and glucose homeostasis forms an important component of the secondary survey. Children... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544048 Wed, 28 Dec 2011 00:55:55 +0100 5544048 http://www.medworm.com/index.php?rid=5544047&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002293%2Fabstract%3Frss%3Dyes Abstract: This review outlines the current recommendations for use of intraosseous access in children. It describes the technique of intraosseous cannulation, anatomy, physiology and possible complications. It also briefly describes currently available devices that allow for rapid and effective intraosseous access in infants, children and young adults. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544047 Wed, 28 Dec 2011 00:55:55 +0100 5544047 http://www.medworm.com/index.php?rid=5544046&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002359%2Fabstract%3Frss%3Dyes This article will highlight techniques that have been used in order to reduce or avoid the use of blood products. It will also present the specific issues relating to the transfusion of blood products which must be considered in order to reduce the incidence of associated adverse events. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544046 Wed, 28 Dec 2011 00:55:55 +0100 5544046 http://www.medworm.com/index.php?rid=5544045&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002347%2Fabstract%3Frss%3Dyes This article will present information concerning lower levels of haemoglobin that can be tolerated without detrimental effects, and how blood loss can be assessed to ensure that blood products are not transfused unnecessarily. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544045 Wed, 28 Dec 2011 00:55:55 +0100 5544045 http://www.medworm.com/index.php?rid=5544044&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002323%2Fabstract%3Frss%3Dyes Abstract: Fluid therapy in children requires an understanding of certain basic principles to avoid adverse events. Careful consideration needs to be given to both the appropriate rate and composition of the fluids to be administered with frequent re-assessment. Parenteral fluid management is used to meet maintenance requirements, correct any deficit and replace ongoing losses. Non-osmotic secretion of antidiuretic hormone (ADH) may occur, particularly in critically ill children and those in the perioperative period, resulting in an inability to compensate for an inappropriate administration of free water. Excess free water administration may result in cerebral oedema, which is poorly tolerated in children due to the proportionally larger size of the brain within the skull, compared to adul... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544044 Wed, 28 Dec 2011 00:55:55 +0100 5544044 http://www.medworm.com/index.php?rid=5544043&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002372%2Fabstract%3Frss%3Dyes This article looks at the causes of arrests in children, the likely outcomes, and the ways in which this can be improved. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544043 Wed, 28 Dec 2011 00:55:54 +0100 5544043 http://www.medworm.com/index.php?rid=5544042&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002335%2Fabstract%3Frss%3Dyes Abstract: Beneficence, non-maleficence, autonomy and justice: these are the four pillars of modern medical ethics. To ensure beneficence, and non-maleficence in our treatment of patients we need the evidence of clinical trials. The Declaration of Helsinki of 1964, and its numerous amendments, provides the ethical ground rules for the conduct of clinical trials. Key elements include the concepts of informed consent, voluntary participation and the right to opt out, and that the well-being of the individual takes precedence over the interests of society. Randomization of patients is ethical only if there is equipoise between the different interventions. Patients should be entered into only those trials which are adequately powered. There is also the need to monitor the safety of trials and t... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544042 Wed, 28 Dec 2011 00:55:54 +0100 5544042 http://www.medworm.com/index.php?rid=5544041&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002384%2Fabstract%3Frss%3Dyes This article examines the physical principles that underlie transducer design and function, and the sources of error and inaccuracy. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544041 Wed, 28 Dec 2011 00:55:54 +0100 5544041 http://www.medworm.com/index.php?rid=5544040&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002827%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544040 Wed, 28 Dec 2011 00:55:53 +0100 5544040 http://www.medworm.com/index.php?rid=5544039&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002803%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5544039 Wed, 28 Dec 2011 00:55:53 +0100 5544039 http://www.medworm.com/index.php?rid=5468329&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100230X%2Fabstract%3Frss%3Dyes (pp 574–577) Which of the following safety measures are generally taken to reduce fire hazards due to laser? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468329 Thu, 01 Dec 2011 05:00:00 +0100 5468329 http://www.medworm.com/index.php?rid=5468328&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002177%2Fabstract%3Frss%3Dyes Abstract: While monitoring systems have undoubtedly reduced the morbidity and mortality associated with anaesthesia, the principal patient monitor should be the close observation of vital signs by a trained anaesthetist. All monitors appear to provide accurate useful information. However, the values displayed may often not reflect the true state of the patient, or not even reflect the desired information. Errors may be seen across the full range of measurement (systematic) or only under certain conditions (contextual). The best solution to these problems is for anaesthetists to have a sound understanding of how each monitor works and the conditions under which its outputs may become inaccurate. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468328 Thu, 01 Dec 2011 05:00:00 +0100 5468328 http://www.medworm.com/index.php?rid=5468327&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100227X%2Fabstract%3Frss%3Dyes Abstract: The word laser is an acronym of Light Amplification by Stimulated Emission of Radiation. A laser emits a beam of electromagnetic radiation that is always monochromatic, collimated and coherent in nature. Lasers consist of three main components: a lasing medium (solid, liquid or gas), a stimulating energy source (pump) and an optical resonator; and have a wide variety of uses in clinical medicine. Lasers cause tissue damage by various mechanisms and these are mainly determined by power density (irradiance) of the beam and exposure time. It is imperative to be aware of the risks associated with laser use in terms of tissue damage (burns and eye injuries) and fire hazards. Strict controls should be implemented governing the safe use of lasers in hospital practice, and all staff must... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468327 Thu, 01 Dec 2011 05:00:00 +0100 5468327 http://www.medworm.com/index.php?rid=5468326&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002220%2Fabstract%3Frss%3Dyes Abstract: The ability to measure gases of clinical significance is key to the practice of anaesthesia and Intensive Care Medicine. Various gas analysers, employing different physical techniques, exist to measure concentrations of these gases.Commonly used techniques in clinical practice include the use of the paramagnetic analyser or galvanic fuel cell to measure oxygen concentration and infrared spectrography to measure carbon dioxide concentration. The Clark electrode and Severinghaus electrode are used to measure oxygen and carbon dioxide tension respectively. Raman spectroscopy and mass spectrometry can be used to measure concentrations of oxygen, carbon dioxide and volatile agents. Piezoelectric gas analysers and refractometers can be used to measure concentrations of volatile agents.... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468326 Thu, 01 Dec 2011 05:00:00 +0100 5468326 http://www.medworm.com/index.php?rid=5468325&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002256%2Fabstract%3Frss%3Dyes Abstract: Measurements of pH, SpO2 and ETCO2 are fundamental to safe clinical practice in anaesthesia, and are part of the monitoring standards defined by the Association of Anaesthetists in Great Britain and Ireland.Invasive measurement of blood pH enables the acid–base state of the patient to be determined, and is frequently used in the hospital environment. Pulse oximetry and capnography allow non-invasive monitoring of patients during anaesthesia, and it is essential to understand the fundamental principles on which they are based. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468325 Thu, 01 Dec 2011 05:00:00 +0100 5468325 http://www.medworm.com/index.php?rid=5468324&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002207%2Fabstract%3Frss%3Dyes Abstract: Thoracotomy pain, if untreated, is excruciating and risks acute and chronic complications. Muscle dissection, rib retraction and intercostal nerve damage activate nociceptors. Management is challenging particularly with pre-existing respiratory and co-morbid disease. The gold standard of thoracic epidural analgesia is potentially eclipsed by paravertebral blockade. Post-thoracotomy pain syndrome, previously understated, is a significant problem. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468324 Thu, 01 Dec 2011 05:00:00 +0100 5468324 http://www.medworm.com/index.php?rid=5468323&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002190%2Fabstract%3Frss%3Dyes Abstract: Major surgery on the trachea and airway is an anaesthetic challenge, which necessitates the simultaneous control of the airway, maintenance of gas exchange and good surgical exposure. Advance planning, good communication and teamwork among surgeon, anaesthetist and theatre nurses are never more important. A major indication for laryngeal and tracheal surgery is laryngotracheal stenosis, a rare condition, which can cause significant morbidity and life-threatening airway obstruction. In the era of modern medicine, post-intubation injury has superseded infection and external trauma as the commonest aetiology. Definitive surgery is usually carried out in tertiary specialist centres, where segmental resection of the trachea with primary end-to-end anastomotic reconstruction is usually... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468323 Thu, 01 Dec 2011 05:00:00 +0100 5468323 http://www.medworm.com/index.php?rid=5468322&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002505%2Fabstract%3Frss%3Dyes Abstract: Double-lumen tubes should be placed using a fibreoptic bronchoscope. This allows correct positioning of the bronchial lumen in the chosen mainstem bronchus. It also ensures that the blue bronchial cuff does not obstruct the side to be ventilated when it is inflated under direct vision. Fibreoptic bronchoscopy facilitates correct positioning of the ventilatory side slot of a right double-lumen tube over the right upper lobe bronchus. The anaesthetist must know the fibreoptic tracheo-bronchial anatomy to properly position left- and right-sided double-lumen tubes (DLTs) and should always reconfirm the position of a DLT with fibreoptic bronchoscopy after repositioning the patient. Maintaining orientation (anterior–posterior) during fibreoptic bronchoscopy is crucial to position a D... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468322 Thu, 01 Dec 2011 05:00:00 +0100 5468322 http://www.medworm.com/index.php?rid=5468321&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002232%2Fabstract%3Frss%3Dyes This article concentrates on anaesthesia for major thoracotomy and lung resection, which is most usually carried out for malignant disease. This is a relatively small patient population, but procedures carry significant mortality of up to 6% for pneumonectomy. Physiological changes that occur during anaesthesia and one lung ventilation (OLV) are discussed, and the optimal ventilatory management of these patients is covered. Postoperative management of analgesia and chest drains is also discussed, as is the pathophysiology of acute lung injury (ALI) which may occur after lobectomy or pneumonectomy. Aspects of video-assisted thoracoscopy (VATS) and lung volume reduction surgery (LVRS) are also mentioned. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468321 Thu, 01 Dec 2011 05:00:00 +0100 5468321 http://www.medworm.com/index.php?rid=5468320&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002165%2Fabstract%3Frss%3Dyes This article outlines the development and use of the currently available double-lumen tubes and bronchus blockers. It concludes with some comparisons between the two methods of lung isolation. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468320 Thu, 01 Dec 2011 05:00:00 +0100 5468320 http://www.medworm.com/index.php?rid=5468319&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002244%2Fabstract%3Frss%3Dyes Abstract: Manipulation of respiratory physiology by pharmacological intervention is a significant role of the anaesthetist and intensivist. Successful use of these various agents requires a thorough understanding of their mechanisms of actions, potential side effects and limitations. These interventions involve changes in airway calibre, secretions and sensitivity of the airway to noxious stimuli. Other agents act to inhibit the depressant effect that sedatives may have on the patient’s respiratory drive. The effects, both advantageous and detrimental, may be complicated by the action of other disease processes which affect the metabolism of these drugs. There are multiple possible routes of administration which allows flexibility for the clinician and may reduce systemic effects, thereb... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468319 Thu, 01 Dec 2011 05:00:00 +0100 5468319 http://www.medworm.com/index.php?rid=5468318&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002268%2Fabstract%3Frss%3Dyes Abstract: Respiratory complications contribute significantly to perioperative morbidity and mortality after surgery. There are evidence based guidelines that support the use of pulmonary function tests (PFT) in the preoperative assessment of patients undergoing lung resection surgery to determine whether patients can tolerate the resection. Spirometry, lung volumes and flow volume analysis provide information on the respiratory mechanics of the patient while transfer factor and arterial blood gas analysis help to evaluate the ability of lung parenchyma in gas exchange. The cardiopulmonary exercise test evaluates the dynamic response of the cardiac and pulmonary function to exercise. The forced expiratory volume in 1 second (FEV1) and predicted postoperative FEV1 (ppoFEV1) are useful indica... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468318 Thu, 01 Dec 2011 05:00:00 +0100 5468318 http://www.medworm.com/index.php?rid=5468317&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002189%2Fabstract%3Frss%3Dyes Abstract: The diaphragm is unique to mammals. It is mainly responsible for quiet respiration and accounts for up to 75% of total tidal volume. Its nerve supply from the phrenic nerve (derived from cervical segments C 3, 4, 5 on either side) is explained by its embryological origin by caudal migration of the septum transversum.The trachea bifurcates into the main bronchi. The right bronchus is larger and less obliquely placed than the left; thus an inhaled foreign body or an overlong endotracheal tube will lodge in the right main bronchus.The right lung is bulkier than the left since the latter is indented by the cardiac impression. The left lung is divided into an upper and lower lobe by the oblique fissure. On the right, the additional transverse fissure results in an additional middle l... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468317 Thu, 01 Dec 2011 05:00:00 +0100 5468317 http://www.medworm.com/index.php?rid=5468316&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002281%2Fabstract%3Frss%3Dyes This article examines the indications for chest drain insertion for pneumothorax and the choice of drain. The equipment required is outlined and the positioning and preparation for the procedure described, including the choice of pre-medication. Techniques for insertion of both Seldinger-style and wide-bore chest drain are also described, including safe administration of local anaesthesia for intercostal block. The procedure outline includes how to place securing sutures and the preferred alternative to the old ‘purse-string’ technique for later closure of a tract following wide-bore chest drain. Troubleshooting for potential complications is also briefly covered. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468316 Thu, 01 Dec 2011 05:00:00 +0100 5468316 http://www.medworm.com/index.php?rid=5468315&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002219%2Fabstract%3Frss%3Dyes Abstract: The primary function of the lung is gas exchange between alveolar gas and the blood flowing through the nearby capillaries. This stage of gas exchange takes place by diffusion. Because gases such as oxygen diffuse relatively slowly through liquids it is essential that the fluid barrier is kept as short as possible. Furthermore, it is vital that interstitial fluid does not escape into the alveoli because this would abolish gas exchange in the flooded alveoli and lead to shunt. A number of physiological mechanisms normally ensure that fluid that does leave the pulmonary microvasculature is quickly removed and hence gas transfer is not impaired. The lungs, in addition, perform a number of other important functions, including modification of circulating levels of a range of biologica... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468315 Thu, 01 Dec 2011 05:00:00 +0100 5468315 http://www.medworm.com/index.php?rid=5468314&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002530%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468314 Thu, 01 Dec 2011 05:00:00 +0100 5468314 http://www.medworm.com/index.php?rid=5468313&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002517%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5468313 Thu, 01 Dec 2011 05:00:00 +0100 5468313 http://www.medworm.com/index.php?rid=5399971&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002141%2Fabstract%3Frss%3Dyes (pp 504–506) Which of the following regarding cervical spine imaging are true? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399971 Tue, 01 Nov 2011 04:00:00 +0100 5399971 http://www.medworm.com/index.php?rid=5399970&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001937%2Fabstract%3Frss%3Dyes Abstract: Bacterial infection of the respiratory tract is amongst the commonest presentations to primary and secondary care. In addition to supportive care the mainstay of pharmacotherapy is antibiotics. Antibiotic treatment of bacterial infections of the respiratory tract needs to consider patient factors such as age, co-morbidities, location, previous antibiotic use, microbiological results and allergy. The emergence of multi-drug-resistant bacteria, partly a consequence of inappropriate antibiotic use, has both focussed the need for careful management of bacterial infection and presented a new therapeutic challenge. The choice of antibiotic for respiratory infections needs to be within national guidelines modified by local susceptibility profiles. Bacterial infections of the respiratory... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399970 Tue, 01 Nov 2011 04:00:00 +0100 5399970 http://www.medworm.com/index.php?rid=5399969&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002153%2Fabstract%3Frss%3Dyes Abstract: Preoperative assessment of thoracic surgical patients is a multidisciplinary process designed to offer appropriate surgical treatment with acceptable risk. Recently updated UK guidelines for pulmonary resection associated with malignant disease have reviewed available evidence concerning operative risk. Patients displaying cardiopulmonary physiological parameters above previously recommended threshold values remain classified as good risk. Less certainty now exists about the utility of predicted post-operative pulmonary function values and preoperative performance status to confer unacceptable risk. The new guidelines suggest a tripartite risk assessment combining risks of operative mortality, perioperative adverse cardiac events and postoperative dyspnoea – to be discussed by ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399969 Tue, 01 Nov 2011 04:00:00 +0100 5399969 http://www.medworm.com/index.php?rid=5399968&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001974%2Fabstract%3Frss%3Dyes Abstract: A methodical system for looking at every chest radiograph is suggested. Readers are encouraged to decide whether an opacity on a chest radiograph is due to pleural, alveolar or interstitial pathology and then to consider the cause. Lung and pleural masses are considered and contrasted and the features of asbestos exposure listed. Special consideration is given to the problems of interpretation of the chest radiograph in the intensive care unit (ITU), and the various appearances of lines and tubes are outlined. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399968 Tue, 01 Nov 2011 04:00:00 +0100 5399968 http://www.medworm.com/index.php?rid=5399967&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001950%2Fabstract%3Frss%3Dyes This article aims to review the role of imaging in the management of a selection of thoracic surgical pathologies. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399967 Tue, 01 Nov 2011 04:00:00 +0100 5399967 http://www.medworm.com/index.php?rid=5399966&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001949%2Fabstract%3Frss%3Dyes Abstract: The lateral cervical spine radiograph is frequently utilized in the assessment of trauma patients and in perioperative care. Used in conjunction with a thorough clinical assessment it can demonstrate an unstable spine, be it due to trauma or rheumatological disease thus alerting the anaesthetist of the need for advanced precautions in airway management. In this article we review a systematic approach to the lateral cervical spine radiograph focussing on unstable cervical spines. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399966 Tue, 01 Nov 2011 04:00:00 +0100 5399966 http://www.medworm.com/index.php?rid=5399965&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002062%2Fabstract%3Frss%3Dyes Abstract: The anatomy of the lung is described, with its division into two lobes on the left and three on the right. The hilum and its contents are defined. The blood supply, lymphatic drainage and innervation are discussed, together with the importance of the bronchial arteries in the pathology of pulmonary embolism. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399965 Tue, 01 Nov 2011 04:00:00 +0100 5399965 http://www.medworm.com/index.php?rid=5399964&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001962%2Fabstract%3Frss%3Dyes Abstract: Ascent to elevated altitude, commonly achieved through flight, by climbing or by residence in highland regions, exposes the individual to reduced ambient pressure. Although there are physical manifestations of this exposure as a consequence of Boyle’s Law, the primary physiological challenge is of hypobaric hypoxia. The acute physiological and longer-term adaptive responses of the cardiovascular, respiratory, haematological and neurological systems to altitude are described, together with an outline of the presentation and management of acute mountain sickness, high-altitude pulmonary oedema and high-altitude cerebral oedema. Whilst many millions experience modest exposure to altitude as a result of flight in pressurized aircraft, fewer individuals are exposed to increased ambi... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399964 Tue, 01 Nov 2011 04:00:00 +0100 5399964 http://www.medworm.com/index.php?rid=5399963&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001986%2Fabstract%3Frss%3Dyes Abstract: Gas exchange is the main function of the lungs. Oxygen and carbon dioxide diffuse along their partial pressure gradient across the alveolar-capillary membrane. Lungs have a large reserve for gas exchange. Alveolar ventilation and pulmonary circulation are closely matched to provide efficient gas exchange in the lungs. Hypoxaemia often results from mismatch in ventilation–perfusion. Gas exchange can be impaired in various disease states. Measurement of the diffusing capacity for carbon monoxide (DLCO) provides estimation of the gas exchange function. A low DLCO indicates an impairment of oxygen transfer across the alveolar-capillary membrane. Anaesthesia and surgery adversely affect pulmonary function, many of which adverse effects can be prevented. (Source: Anaesthesia and inte... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399963 Tue, 01 Nov 2011 04:00:00 +0100 5399963 http://www.medworm.com/index.php?rid=5399962&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002086%2Fabstract%3Frss%3Dyes Abstract: Anaesthesia has many effects on respiratory physiology, the knowledge of which is relevant to clinical practice. Anaesthesia causes decreased muscle tone in the upper airway, which can lead to airway obstruction. Pulmonary hypoventilation occurs in the spontaneously breathing patient. There is a progressive decrease in the ventilatory response to CO2 with increasing concentration of volatile agents, and even low doses of volatile have a profound effect on the ventilatory response to hypoxia. Functional residual capacity (FRC) is significantly reduced in the anaesthetized patient. Airway closure occurs when closing capacity exceeds FRC, with a reduced FRC this is more likely to happen especially in older patients or patients with coexisting lung pathology when closing capacity may... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399962 Tue, 01 Nov 2011 04:00:00 +0100 5399962 http://www.medworm.com/index.php?rid=5399961&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002074%2Fabstract%3Frss%3Dyes Abstract: The principles of gas transfer between the atmosphere and cell mitochondria can be considered in a number of steps: inspired gases are humidified in the upper airways and mix with expired gases in the alveoli. In perfused alveoli, gases then diffuse passively down a partial pressure gradient into pulmonary capillary blood. Gases are transported by the blood, in a dissolved state or by specific transport systems, to the systemic capillaries from where they diffuse into cells. Efficient gas exchange between the atmosphere and mitochondria requires the transfer of large volumes of gas with minimal reduction in partial pressure. The nature of oxygen binding to haemoglobin and the transport of carbon dioxide as bicarbonate in the blood improve the body’s ability to transfer these ga... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399961 Tue, 01 Nov 2011 04:00:00 +0100 5399961 http://www.medworm.com/index.php?rid=5399960&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002414%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399960 Tue, 01 Nov 2011 04:00:00 +0100 5399960 http://www.medworm.com/index.php?rid=5399959&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002396%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5399959 Tue, 01 Nov 2011 04:00:00 +0100 5399959 http://www.medworm.com/index.php?rid=5236633&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001810%2Fabstract%3Frss%3Dyes (pp 453–457) Which of the following are true about the pulmonary function tests? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236633 Wed, 21 Sep 2011 16:38:58 +0100 5236633 http://www.medworm.com/index.php?rid=5236632&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001767%2Fabstract%3Frss%3Dyes Abstract: Surgery, trauma and critical illness evoke a series of hormonal and metabolic changes commonly referred to as the stress response. Activation of the hypothalamic–pituitary–adrenal axis results in increased secretion of hormones such as cortisol. Anaesthesia can suppress adrenocortical secretion either by an effect at the hypothalamus, for example by a decrease in neural input with regional anaesthesia, or by a direct effect on the adrenal cortex, for example by etomidate. For patients undergoing routine surgery an increase in cortisol secretion is unnecessary, uneventful recovery occurs in the presence of circulating cortisol concentrations within the normal range. Patients often present for surgery taking corticosteroids for a variety of medical conditions, but excessive sup... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236632 Wed, 21 Sep 2011 16:38:58 +0100 5236632 http://www.medworm.com/index.php?rid=5236631&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001780%2Fabstract%3Frss%3Dyes Abstract: Diabetes is a chronic and progressive metabolic disorder characterized by hyperglycaemia. The two main types of diabetes are type 1 diabetes (T1DM) where there is complete lack of insulin and type 2 diabetes (T2DM) which may be due to a combination of insulin resistance and relative insulin deficiency due to impaired β-cell function. Good control of blood glucose near physiological limits is vital to reduce long-term microvascular and macrovascular complications of diabetes. Insulin replacement is a life-saving measure in individuals with T1DM whereas the mainstay of therapy in T2DM includes oral agents, non-insulin injectables (incretin mimetics) and insulin. In T2DM, the incretin mimetics have revolutionized recent treatment options by reducing blood glucose, promoting weight ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236631 Wed, 21 Sep 2011 16:38:58 +0100 5236631 http://www.medworm.com/index.php?rid=5236630&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001779%2Fabstract%3Frss%3Dyes This article looks at the physiology of each of the hormones and enzymes released by the pancreas, the factors influencing their secretion, and how their secretion is coordinated. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236630 Wed, 21 Sep 2011 16:38:58 +0100 5236630 http://www.medworm.com/index.php?rid=5236629&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100169X%2Fabstract%3Frss%3Dyes Abstract: The thyroid gland is under the control of thyroid-stimulating hormone (TSH) from the pituitary. It secretes thyroxine (T4) and triiodothyronine (T3). Iodine is essential for the synthesis of thyroid hormones. T4 is probably converted to T3 in peripheral tissues. Thyroid hormones have a role in growth and development, but their principal effect is the control of basal metabolic rate. Deficiency or excess affects all the tissues of the body, reducing or increasing the metabolic rate, resulting in hypothermia or hyperthermia, respectively. Deficiency during development produces mental retardation. Lack of iodine leads to thyroid swelling (goitre) caused by continuing stimulation by TSH. Calcium is one of the most tightly controlled ions in the body; abnormalities can produce muscle ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236629 Wed, 21 Sep 2011 16:38:58 +0100 5236629 http://www.medworm.com/index.php?rid=5236628&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001706%2Fabstract%3Frss%3Dyes Abstract: The adrenal glands lie on top of the kidneys. The adrenal medulla produces catecholamines and the adrenal cortex produces three types of steroid hormone (mineralocorticoids (aldosterone), glucocorticoids (cortisol) and androgens (dehydroepiandrosterone, DHEA)). All are synthesized from cholesterol. Cortisol secretion is controlled by adrenocorticotrophic hormone from the pituitary. It rises in response to stress and is essential for life. It stimulates gluconeogenesis, breaking down lean tissue, and is anti-inflammatory. Aldosterone secretion is controlled by angiotensin II and extracellular potassium concentrations, so is influenced by renal perfusion. It provides the fine tuning for sodium and potassium, and thus water, balance via its action on the distal renal tubule. DHEA is... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236628 Wed, 21 Sep 2011 16:38:58 +0100 5236628 http://www.medworm.com/index.php?rid=5236627&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001718%2Fabstract%3Frss%3Dyes Abstract: The endocrine system consists of groups of cells (glands) that secrete messengers (hormones), which affect distant groups of cells (target organs). It controls mainly basal processes. Hormonal action may be on receptors in the target cell membrane (e.g. leading to alterations in membrane channel properties), in which case it is rapid, or it may affect gene function and thus protein synthesis, in which case the onset of action is relatively slow. Endocrine function is controlled via single and multiple feedback mechanisms from products of the various target organs. It is largely under the control of the hypothalamus via the pituitary gland. Releasing factors and hormones from the hypothalamus act on the pituitary, which produces its own hormones (antidiuretic hormone, oxytocin, gr... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236627 Wed, 21 Sep 2011 16:38:58 +0100 5236627 http://www.medworm.com/index.php?rid=5236626&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001809%2Fabstract%3Frss%3Dyes Abstract: Measurement of ventilatory function is often impeded by poor technique when individuals perform tests of respiratory function. Static lung volumes (with the exception of residual volume and other capacities that contain residual volume) can be easily measured with spirometry. Residual volume and functional residual capacity can be measured using helium dilution or body plethysmography, although neither of these techniques is used in daily clinical practice. Dead space (the volume of gas not participating in gas exchange) can be measured using a single-breath nitrogen washout technique, or by application of the Bohr equation. Dynamic volumes measure airflow through the lungs, and often require individuals to perform a forced vital capacity (FVC) manoeuvre. Data generated from such... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236626 Wed, 21 Sep 2011 16:38:58 +0100 5236626 http://www.medworm.com/index.php?rid=5236625&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100172X%2Fabstract%3Frss%3Dyes Abstract: Ventilation is the process by which air moves into and out of the lungs and is made available for gas exchange across the alveolar-capillary membrane. Ventilation occurs automatically in a continuous rhythmic pattern without any conscious effort. It is controlled by both neural and chemical inputs and is concerned with the homeostasis of oxygen and carbon dioxide as well as having a role in acid–base balance. Inspiration is an active process. The diaphragm is the main muscle of inspiration, but other muscles can be involved. Expiration is normally a passive process during quiet breathing, but in certain disease processes may require energy expenditure. Resistance to gas flow in the airways is determined by a number of factors. Airway radius is the most important factor influenc... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236625 Wed, 21 Sep 2011 16:38:58 +0100 5236625 http://www.medworm.com/index.php?rid=5236624&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001792%2Fabstract%3Frss%3Dyes Abstract: Rhythmic ventilation is an automatic process controlled by the central nervous system. Groups of cells in the brainstem, predominantly the ventral and dorsal respiratory groups, are responsible for generating basic respiratory rhythm. This basic rhythm is subject to modulation by both conscious and reflex actions. In normal individuals the respiratory minute volume is set to closely regulate arterial carbon dioxide tension (PaCO2) at approximately 5.3 kPa, predominantly via a negative feedback reflex involving the central chemoreceptors. A separate group of chemoreceptors, the arterial chemoreceptors, are responsible for initiating the increased ventilatory response to counter arterial hypoxia, but a brisk response is not seen until PaO2 levels fall to approximately 8.0 kPa from ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236624 Wed, 21 Sep 2011 16:38:58 +0100 5236624 http://www.medworm.com/index.php?rid=5236623&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001755%2Fabstract%3Frss%3Dyes Abstract: Phaeochromocytoma is a rare catecholamine-secreting tumour with a high incidence of perioperative mortality if not managed appropriately. It benefits from an experienced structured medical, anaesthetic and surgical pathway. For anaesthetists successful and safe perioperative care requires knowledge of the pathophysiology of the condition combined with appropriate treatment strategies for preoperative preparation and management of acute release of catecholamines during periods of peri operative stress. Awareness of the perioperative presentation of phaeochromocytoma and associated signs and symptoms is important for all anaesthetists as the condition can present acutely during anaesthesia for other surgery. This has potentially a high mortality if not managed correctly. (Source: A... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236623 Wed, 21 Sep 2011 16:38:57 +0100 5236623 http://www.medworm.com/index.php?rid=5236622&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001731%2Fabstract%3Frss%3Dyes Abstract: Diabetes is a metabolic disorder characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism. This results from defects in insulin secretion, insulin action, or both. The effects of diabetes include long-term damage, dysfunction and failure of key organ systems.The prevalence of diabetes is increasing in the UK, standing at 4.3% in 2005, compared to 2.8% in 1996. While the incidence of type 1 diabetes is static, the incidence of type 2 diabetes is rising rapidly. This trend is expected to continue, with some models predicting a prevalence of 9% (range 6.3–13.3%) by 2025.The burdens diabetes places on healthcare are great, both financially and on an individual patient's quality of life. Excellent anaesthetic management of the diabetic pa... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236622 Wed, 21 Sep 2011 16:38:57 +0100 5236622 http://www.medworm.com/index.php?rid=5236621&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001743%2Fabstract%3Frss%3Dyes This article concentrates on surgery for the thyroid gland encompassing details of the pathology, biochemistry and pharmacological management. Also addressed are surgery on the parathyroids and the implications for calcium homeostasis, and the implications of diseases of the adrenal cortex. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236621 Wed, 21 Sep 2011 16:38:57 +0100 5236621 http://www.medworm.com/index.php?rid=5236620&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911002013%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236620 Wed, 21 Sep 2011 16:38:57 +0100 5236620 http://www.medworm.com/index.php?rid=5236619&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001998%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5236619 Wed, 21 Sep 2011 16:38:57 +0100 5236619 http://www.medworm.com/index.php?rid=5196041&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001676%2Fabstract%3Frss%3Dyes (pp 409–411) Which of the following hormones are increasingly produced during stress? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196041 Wed, 31 Aug 2011 23:00:00 +0100 5196041 http://www.medworm.com/index.php?rid=5196040&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001494%2Fabstract%3Frss%3Dyes Abstract: In the UK, standards of monitoring required for the safe management of anaesthesia are set by the Association of Anaesthetists of Great Britain and Ireland. In the past physiological measurements of, for example, blood pressure, electrocardiograph (ECG), gas composition and airway pressures may have been performed by a collection of individual electronic machines. It is now common however to have an integrated monitoring system where signals from a variety of transducers are amplified, filtered, converted to digital form, processed by a computer and presented on a display to inform the user of both the condition of the patient and function of the anaesthesia system. It is important to have some understanding of the processes that take place between the production of the raw analo... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196040 Wed, 31 Aug 2011 23:00:00 +0100 5196040 http://www.medworm.com/index.php?rid=5196039&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001548%2Fabstract%3Frss%3Dyes This article outlines the areas of knowledge related to electricity and magnetism that are necessary to understand the functional aspects of these devices. Topics include the basic concepts of electricity, units of measurement, Ohm’s law, direct and alternating current, static electricity, capacitance, inductance and impedance. A description of magnetism and electromagnetism is included. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196039 Wed, 31 Aug 2011 23:00:00 +0100 5196039 http://www.medworm.com/index.php?rid=5196038&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001536%2Fabstract%3Frss%3Dyes This article is an overview of the key mathematical concepts required to understand computer science, physics and physiology as applied to anaesthesia.Topics include classification of numbers, base systems, scientific notation and rounding, logarithms, plain geometry, conic sections, graphical representation and periodic functions. Particular emphasis is given to exponential curves, as these relate to many phenomena in anaesthesia including uptake and elimination of drugs, and the flow of heat, gases, liquids and electrical current.The role of complex functions such as calculus and Fourier analysis is described; however a detailed understanding of these topics is not necessary to appreciate their application. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196038 Wed, 31 Aug 2011 23:00:00 +0100 5196038 http://www.medworm.com/index.php?rid=5196037&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001500%2Fabstract%3Frss%3Dyes Abstract: There are seven fundamental (base) SI (Système International) units defined for seven independent dimensions of measurement. Historically these definitions have changed, but they have been in their present form since 1960. Any measurement made in science can be expressed in terms of these independent dimensions and their units expressed in terms of the fundamental units, although some are given their own special names and symbols. Each side of a mathematical equation can be represented using basic dimensions, and both sides should balance.Force is an example of a dependent dimension made up of the independent dimensions of mass, length and time, and therefore the units of force can be expressed as kgm/s2, although this can be simplified to the newton (N). When the individual dim... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196037 Wed, 31 Aug 2011 23:00:00 +0100 5196037 http://www.medworm.com/index.php?rid=5196036&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001524%2Fabstract%3Frss%3Dyes Abstract: The sensors in medical monitors allow biological signals of various modalities to be converted into electrical signals allowing accurate measurement and display of these parameters. It is important to have an understanding of the potential limitations and problems associated with these devices in order to fully interpret the information displayed. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196036 Wed, 31 Aug 2011 23:00:00 +0100 5196036 http://www.medworm.com/index.php?rid=5196035&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100141X%2Fabstract%3Frss%3Dyes Abstract: Trauma induces the stress response which mobilizes physiological mechanisms to protect an otherwise threatened body homeostasis. Increasingly the maladaptive nature of this response is being recognized as a result of systemic derangements triggered by the sympathetic nervous system and hypothalamic-pituitary-adrenal axis. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196035 Wed, 31 Aug 2011 23:00:00 +0100 5196035 http://www.medworm.com/index.php?rid=5196034&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001421%2Fabstract%3Frss%3Dyes Abstract: Remote anaesthesia is the provision of anaesthesia and sedation outside of the theatre environment. The diverse range of locations, procedures and patient groups can provide for challenging anaesthesia. Anaesthetists must maintain the same high standards as in the operating room, which requires appropriate facilities and staff, as well as proper pre- and postanaesthesia care. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196034 Wed, 31 Aug 2011 23:00:00 +0100 5196034 http://www.medworm.com/index.php?rid=5196033&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001470%2Fabstract%3Frss%3Dyes Abstract: The annual incidence of acute spinal cord injury in the UK is 15–40 cases per million. More than half of these injuries are the result of road traffic accidents, with falls, industrial accidents, sports or violence making up most of the remainder. Violent injury accounts for only a small percentage of cases in the UK. The typical patient is male (male to female ratio is 4:1) and young (peak incidence is at 20–40 years). The initial mechanical trauma leads to injury of the neural elements, this is the primary injury. Blood vessels are damaged, axons disrupted and neural cell membranes broken. The spinal cord swells and is compressed in the spinal canal. Ischaemia occurs when the cord swelling exceeds venous blood pressure. This leads to failure of autoregulation of blood flow.... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196033 Wed, 31 Aug 2011 23:00:00 +0100 5196033 http://www.medworm.com/index.php?rid=5196032&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001433%2Fabstract%3Frss%3Dyes Abstract: ‘Drowning is a process resulting in primary respiratory impairment from submersion/immersion in a liquid medium. The victim may live or die after this process, but whatever the outcome, he or she has been involved in a drowning incident’. There are no specific interventions that have been proven to improve outcomes in drowning victims and thus prevention of drowning is the priority. Underlying medical conditions (whether previously diagnosed or not) must be considered as potentially having contributed to the drowning incident – and may have implications for both the victim and their relatives. Pathophysiological events in the process of drowning are secondary to hypoxaemia that results from the submersion/immersion insult. The major determinant of outcome after drowning is ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196032 Wed, 31 Aug 2011 23:00:00 +0100 5196032 http://www.medworm.com/index.php?rid=5196031&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001512%2Fabstract%3Frss%3Dyes Abstract: Burns are common and often preventable soft tissue injuries. They can vary from mild scalds to life-threatening full-thickness skin necrosis. Following effective basic first aid the priorities of care are a secured airway, fluid resuscitation, excision of the eschar, analgesia, nutrition and meticulous infection control. Patients at extremes of age with multiple co-morbidities have the highest mortality. Other factors increasing the risk of death include burn size, burn depth and the presence of inhalational injury. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196031 Wed, 31 Aug 2011 23:00:00 +0100 5196031 http://www.medworm.com/index.php?rid=5196030&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001457%2Fabstract%3Frss%3Dyes This article is a summary of major life-threatening injuries in thoracic trauma. Outlined are the timing, clinical features, necessary investigations and interventions involved with such injuries, within the clinical approach of primary and secondary surveys. The major focus is on immediate resuscitation with some discussion on further management. Injuries included are tension pneumothorax, open pneumothorax, massive haemothorax, pericardial tamponade, aortic injuries, cardiac injuries, lung contusion, flail chest, diaphragmatic injury, airway injury and oesophageal rupture. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196030 Wed, 31 Aug 2011 23:00:00 +0100 5196030 http://www.medworm.com/index.php?rid=5196029&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001445%2Fabstract%3Frss%3Dyes Abstract: Shock is failure of the circulatory system to provide the organ perfusion and tissue oxygenation required to meet cellular metabolic demands. Traumatic shock is most commonly associated with haemorrhage, however the trauma patient may present with non-haemorrhagic shock. The ‘lethal triad’ of acute coagulopathy, metabolic acidosis and hypothermia seen in trauma patients is developing the current approach to management of traumatic shock. The ‘ABCDE’ paradigm involves recognition of shock in a primary survey with simultaneous initiation of treatment. Hypotensive resuscitation involves limited volume replacement, during which time poor end-organ perfusion is tolerated, in order to prevent clot dislodgement and re-bleeding. Evidence now suggests that aggressive correction of... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196029 Wed, 31 Aug 2011 23:00:00 +0100 5196029 http://www.medworm.com/index.php?rid=5196028&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001688%2Fabstract%3Frss%3Dyes This article will review these reports, discuss the changes occurring in the organization of the care of major trauma and describe the anaesthetic management of this important group of patients. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196028 Wed, 31 Aug 2011 23:00:00 +0100 5196028 http://www.medworm.com/index.php?rid=5196027&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001482%2Fabstract%3Frss%3Dyes Abstract: Pain management in the pre-hospital environment is a priority following life- and limb-saving manoeuvres. Pain should be assessed and documented then managed according to a multimodal model. Even in the context of environmental challenges and limited resources, pharmacological, physical and psychological interventions can all be used to provide effective analgesia and relieve suffering prior and during transfer to hospital. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196027 Wed, 31 Aug 2011 23:00:00 +0100 5196027 http://www.medworm.com/index.php?rid=5196026&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001469%2Fabstract%3Frss%3Dyes Abstract: The approach to pre-hospital trauma care has undergone some changes in recent years. Some of the lessons have been learnt from the military as a direct result from experiences in recent conflicts. Personnel involved in pre-hospital care need to be aware of the dangers at the scene and have the ability to work with and liaise with other emergency services. Control of any massive haemorrhage needs to be gained as a priority before moving on to the more familiar Airway, Breathing and Circulation approach. The time-critical casualty needs to be recognized and any immediate life- or limb-threatening complications dealt with in the shortest possible time before expedited evacuation to a hospital that can provide definitive care. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196026 Wed, 31 Aug 2011 23:00:00 +0100 5196026 http://www.medworm.com/index.php?rid=5196025&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001846%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196025 Wed, 31 Aug 2011 23:00:00 +0100 5196025 http://www.medworm.com/index.php?rid=5196024&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001822%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5196024 Wed, 31 Aug 2011 23:00:00 +0100 5196024 http://www.medworm.com/index.php?rid=5078438&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001275%2Fabstract%3Frss%3Dyes (pp 368–370) Which of the following antibiotics induce the cytochrome p450 enzyme system? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078438 Sat, 30 Jul 2011 14:50:48 +0100 5078438 http://www.medworm.com/index.php?rid=5078437&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001202%2Fabstract%3Frss%3Dyes Abstract: Drug elimination is the removal of active drug from the body. Metabolism takes place largely in the liver and produces water-soluble metabolites which can be excreted in the bile or urine. Metabolism may also produce active or toxic metabolites or a pharmacologically active drug from an inactive prodrug. Most volatile anaesthetics are excreted unchanged via the lungs. Drug elimination can be affected by factors such as first-pass metabolism, genetic variants and various disease processes. Knowledge of these processes will allow better prediction of pharmacokinetics in practice. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078437 Sat, 30 Jul 2011 14:50:47 +0100 5078437 http://www.medworm.com/index.php?rid=5078436&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001196%2Fabstract%3Frss%3Dyes Abstract: Pharmacokinetics is the study of how a drug is handled within the body. Variations in drug absorption, distribution, metabolism or excretion will alter drug concentrations at its target site. Appreciation of the causes of pharmacokinetic variation will ensure avoidance of sub-therapeutic drug regimes and unnecessary side effects through over-dosage. The processes of absorption, distribution, metabolism and excretion can be affected by a number of physiological, pathological and pharmacological factors. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078436 Sat, 30 Jul 2011 14:50:47 +0100 5078436 http://www.medworm.com/index.php?rid=5078435&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001251%2Fabstract%3Frss%3Dyes Abstract: Pharmacokinetic analysis is an experimentally determined theory of how a drug behaves when in vivo. Volume of distribution, clearance and terminal half-life are defined. Compartmental modeling is introduced and some relevant graphs are described in this article. Applications of this theory in anaesthesia are considered. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078435 Sat, 30 Jul 2011 14:50:47 +0100 5078435 http://www.medworm.com/index.php?rid=5078434&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001238%2Fabstract%3Frss%3Dyes Abstract: Maxillofacial surgery covers a broad range of procedures on the head and neck, combining oral and facial procedures with the ear, nose and throat (ENT), plastics, neurosurgery and base of skull specialities. The main issues are that of managing a shared airway; providing good head, neck and oral access; the potential for difficult airways and measures to reduce tissue bleeding and oedema, both intra- and postoperatively. Good communication between all members of the team is essential. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078434 Sat, 30 Jul 2011 14:50:47 +0100 5078434 http://www.medworm.com/index.php?rid=5078433&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001408%2Fabstract%3Frss%3Dyes This article considers the causes of facial trauma and the differing patterns of injury seen. The relative strengths of the facial bones and Le Fort fractures lines are described. The important airway and other management issues for the initial acute phase and the later second-stage management for surgical treatment of facial fractures are discussed. The concern regarding actual and potential cerebrospinal fluid leak from Le Fort 2- and 3-level fractures is reviewed, and different strategies for airway management put forward. Specific difficulties with endotracheal intubation of patients with facial trauma are examined. The maintenance of anaesthesia and extubation problems are then discussed. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078433 Sat, 30 Jul 2011 14:50:47 +0100 5078433 http://www.medworm.com/index.php?rid=5078432&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001263%2Fabstract%3Frss%3Dyes Abstract: Damage to the teeth during general anaesthesia is a frequent cause of morbidity for patients and a source of litigation against anaesthetists. Most injuries occur as a result of laryngoscopy. To prevent damage during emergence from anaesthesia, bite blocks should be placed between molar teeth. However oropharyngeal airways should not be used. Patients should be advised about the possibility of dental trauma during anaesthesia and should be advised to have preoperative dental treatment to minimize dental factors that increase the risk of injury. Those with pre-existing dental problems and children in the mixed dentition phase (normally between the ages of 5 and 12 years) are at particular risk. Anaesthetic departments should have local protocols in place to refer patients for den... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078432 Sat, 30 Jul 2011 14:50:47 +0100 5078432 http://www.medworm.com/index.php?rid=5078431&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001214%2Fabstract%3Frss%3Dyes Abstract: Dental anaesthesia developed down a different pathway from the rest of anaesthesia. Techniques such as nasal mask anaesthesia in the sitting position were specific to dental surgery, which took place largely outside hospital in dental clinics. Now dental anaesthesia is confined to locations within the aegis of a hospital and anaesthetic techniques are similar to those in other surgical specialities. Dental surgery consists of extractions and conservation. Short procedures for the extraction of teeth may still be carried out in children using a nasal mask, but more difficult extractions in adults and children, or conservation procedures are best done with a laryngeal mask or endotracheal tube. Close liaison with the dental surgeon is imperative in the planning of the anaesthetic t... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078431 Sat, 30 Jul 2011 14:50:46 +0100 5078431 http://www.medworm.com/index.php?rid=5078430&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001226%2Fabstract%3Frss%3Dyes This article describes the variety of methods available for awake and asleep fibreoptic intubation, as well as techniques for anesthetizing the airway. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078430 Sat, 30 Jul 2011 14:50:46 +0100 5078430 http://www.medworm.com/index.php?rid=5078429&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001172%2Fabstract%3Frss%3Dyes Abstract: Nearly all patients who are seriously difficult to manage are easily identified because they have grossly obvious abnormalities. Conversely, it is difficult to identify the few normal-looking patients that are difficult to manage. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078429 Sat, 30 Jul 2011 14:50:46 +0100 5078429 http://www.medworm.com/index.php?rid=5078428&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001184%2Fabstract%3Frss%3Dyes This article presents the most important aspects of airway anatomy from the point of view of the anaesthetist, with particular emphasis on understanding the clinical implications of the relevant structures and how they interact. The anatomy of the larynx and its innervation is discussed in detail, and put into clinical context as appropriate. Bronchial anatomy is described to aid navigation during bronchoscopy. Where possible, diagrams are used to help understanding. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078428 Sat, 30 Jul 2011 14:50:45 +0100 5078428 http://www.medworm.com/index.php?rid=5078427&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100124X%2Fabstract%3Frss%3Dyes Abstract: While sedation can improve the patient experience of unpleasant procedures, if performed poorly it has the potential to cause harm. Some authorities believe that patients’ protective reflexes are impaired at any level of sedation, and indeed sedation merges into anaesthesia in a continuum of loss of consciousness. All anaesthetists should understand the definition of ‘conscious sedation’, and be aware of the concepts of ‘deep sedation’ and ‘monitored anaesthesia care’, which are prevalent in the USA. This paper discusses, in particular, dental sedation guidelines and, more generally, safe sedation practice for other procedures in which sedation is given. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078427 Sat, 30 Jul 2011 14:50:45 +0100 5078427 http://www.medworm.com/index.php?rid=5078426&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001573%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078426 Sat, 30 Jul 2011 14:50:45 +0100 5078426 http://www.medworm.com/index.php?rid=5078425&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100155X%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=5078425 Sat, 30 Jul 2011 14:50:45 +0100 5078425 http://www.medworm.com/index.php?rid=4969727&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000749%2Fabstract%3Frss%3Dyes (pp 277–279) Which of the following cardiorespiratory changes occur in the obese patient? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969727 Mon, 27 Jun 2011 16:26:01 +0100 4969727 http://www.medworm.com/index.php?rid=4969726&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000853%2Fabstract%3Frss%3Dyes Abstract: Histamine is one of the most extensively studied biological amines in medicine. It stimulates smooth muscle contraction and gastric acid secretion, increases vascular permeability, functions as a neurotransmitter, and plays various roles in immunomodulation, allergy, inflammation, haematopoiesis and cell proliferation. Histamine exerts its effects through four receptors, designated H1–H4. H1 and H2 receptors are widely distributed, H3 receptors are mainly presynaptic, and H4 receptors are mainly haematopoietic. H1 antihistamines are classified as first- and second-generation compounds. First-generation compounds lack specificity and cross the blood–brain barrier causing sedation. Second-generation compounds are less sedating and highly specific. H1 antihistamines have well-do... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969726 Mon, 27 Jun 2011 16:26:01 +0100 4969726 http://www.medworm.com/index.php?rid=4969725&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100083X%2Fabstract%3Frss%3Dyes Abstract: Adverse drug reactions (ADRs) are a common and important cause of morbidity and mortality. They occur frequently in patients undergoing anaesthesia or in intensive care. ADRs occur by a number of mechanisms, some of which remain unclear, but several risk factors have been identified. It is increasingly recognized that pharmacogenetic factors are important in determining susceptibility to ADRs. Medical practitioners should be aware of their responsibility to report ADRs and know how to report them. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969725 Mon, 27 Jun 2011 16:26:01 +0100 4969725 http://www.medworm.com/index.php?rid=4969724&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000841%2Fabstract%3Frss%3Dyes Abstract: Obstructive sleep apnoea (OSA) is a common condition affecting approximately 4% of middle-aged individuals. The condition is more common in men with a history of snoring. Patients experience fragmented sleep caused by repetitive obstruction of the upper airway during sleep. There is mounting evidence that OSA is associated with metabolic syndrome. Metabolic syndrome comprises hypertension and type 2 diabetes, with associated disturbances of lipid metabolism and central obesity that predisposes to cardiovascular disease. Sleep disruption causes excessive daytime sleepiness and patients may be a danger to themselves or others, especially when driving. Anaesthetists meet the condition frequently, and should have a high index of suspicion when assessing overweight middle-aged patient... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969724 Mon, 27 Jun 2011 16:26:01 +0100 4969724 http://www.medworm.com/index.php?rid=4969723&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000762%2Fabstract%3Frss%3Dyes Abstract: Shared airway procedures are unique in that both anaesthetist and surgeon are working in the same anatomical field. Close cooperation between anaesthetist and surgeon, an understanding of each other’s problems and knowledge of specialist equipment are often required. There is no ideal anaesthetic technique for all endoscopy procedures and the technique chosen depends on the patient’s general condition, the size, the mobility and location of the lesion, the use of a laser, and surgical requirements. Smooth emergence and recovery from anaesthesia are essential. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969723 Mon, 27 Jun 2011 16:26:01 +0100 4969723 http://www.medworm.com/index.php?rid=4969722&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000804%2Fabstract%3Frss%3Dyes Abstract: An airway emergency, including any lesion causing upper airway compromise, is potentially life-threatening in both adults and children. Stridor, acute epiglottitis, inhaled foreign body and bleeding tonsils, all require a prompt, methodical approach. Clear communication and cooperation between anaesthetic and surgical teams is vital. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969722 Mon, 27 Jun 2011 16:26:01 +0100 4969722 http://www.medworm.com/index.php?rid=4969721&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000828%2Fabstract%3Frss%3Dyes Abstract: Airway trauma can be considered according to the mechanism of injury, which may guide further management. Trauma may be mechanical, either blunt or penetrating, be due to burns or be iatrogenic as a result of instrumentation of the airway. Immediate airway intervention will be required for obvious airway compromise. Such patients may be difficult to manage, and may be complicated by polytrauma. It is important to appreciate the potential for rapid deterioration in patients with an injury to the aerodigestive tract. Delayed diagnosis can result in poor outcomes from airway and neck trauma, and a structured approach to resuscitation, investigations and ongoing care should be adopted. Iatrogenic airway trauma is not confined to patients in whom intubation is difficult or prolonged, ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969721 Mon, 27 Jun 2011 16:26:01 +0100 4969721 http://www.medworm.com/index.php?rid=4969720&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000816%2Fabstract%3Frss%3Dyes This article outlines the indications, equipment required, insertion technique and complications of transtracheal jet ventilation. It can be used electively to aid management of the difficult airway and for laryngeal surgery. It also has a vital role in the management of the ‘can't intubate – can' ventilate’ scenario. Death and hypoxic brain damage under anaesthesia are fortunately rare, but most commonly occur as a result of problems with tracheal intubation. No patient should suffer hypoxic brain damage without an attempt at transtracheal ventilation being made. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969720 Mon, 27 Jun 2011 16:26:00 +0100 4969720 http://www.medworm.com/index.php?rid=4969719&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000750%2Fabstract%3Frss%3Dyes Abstract: Percutaneous tracheostomy is currently accepted as a standard technique for longer-term airway care in the critically ill patients in many intensive care units (ICUs). Early tracheostomy has not shown any survival benefit compared to late tracheostomy following prolonged tracheal intubation in ICU patients. The main indications for tracheostomy in the ICU setting include weaning from artificial ventilation or airway protection. Nevertheless, many questions about choice of techniques, post-tracheostomy care and decannulation remain unanswered. This review gives an overview of current techniques. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969719 Mon, 27 Jun 2011 16:26:00 +0100 4969719 http://www.medworm.com/index.php?rid=4969718&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000786%2Fabstract%3Frss%3Dyes Abstract: Tracheostomy and cricothyrotomy are means of access to the respiratory tract in upper airway obstruction. Their safe performance relies on accurate anatomical knowledge of the region. The easily palpable gap between the thyroid and cricoid cartilages demarcates the tough cricothyroid ligament that lies safely distal to the vocal cords and is the site for cricothyrotomy. Tracheostomy, either between or dividing the upper rings of the trachea, is carried out by open operation or by the percutaneous route. In these procedures it is essential to have the head fully extended to keep exactly to the midline to protect vital lateral structures. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969718 Mon, 27 Jun 2011 16:26:00 +0100 4969718 http://www.medworm.com/index.php?rid=4969717&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000774%2Fabstract%3Frss%3Dyes Abstract: Alternative rigid blade intubation devices have become available in recent years including Glidescope, Airtraq and Bonfils laryngoscopes. The Macintosh curved blade works by displacing the tongue to one side and also into the submandibular space. This allows the device to get into the valleculum and hence lift the hyoid and epiglottis forward to reveal the laryngeal inlet. Under less favourable intubating conditions, the tongue tends to be compressed disproportionately, the valleculum is not accessed and the blade tip cannot be drawn forward. The retro-molar Bonfils avoids this problem by starting from a lower position in the mouth and approaching the larynx below and alongside the tongue. Bonfils also serves as a rigid stylet inside the tracheal tube which also implies minimal t... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969717 Mon, 27 Jun 2011 16:26:00 +0100 4969717 http://www.medworm.com/index.php?rid=4969716&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000865%2Fabstract%3Frss%3Dyes Abstract: Successful airway management requires an understanding of the upper and lower airway structures and functions. The nose and pharynx are important structures in the upper airway, providing: air quality control; protection of the lower airway; phonation and safe passage of food. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969716 Mon, 27 Jun 2011 16:26:00 +0100 4969716 http://www.medworm.com/index.php?rid=4969715&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001019%2Fabstract%3Frss%3Dyes This article will discuss the different types of obesity surgery commonly performed, and the practical aspects of how to manage these patients both perioperatively and postoperatively. The principles described can be utilized in the management of obese patients attending for other types of surgery. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969715 Mon, 27 Jun 2011 16:26:00 +0100 4969715 http://www.medworm.com/index.php?rid=4969714&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000798%2Fabstract%3Frss%3Dyes This article will present important aspects related to pathophysiology and pharmacology. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969714 Mon, 27 Jun 2011 16:25:59 +0100 4969714 http://www.medworm.com/index.php?rid=4969713&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001305%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969713 Mon, 27 Jun 2011 16:25:59 +0100 4969713 http://www.medworm.com/index.php?rid=4969712&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001287%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4969712 Mon, 27 Jun 2011 16:25:59 +0100 4969712 http://www.medworm.com/index.php?rid=4863590&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000580%2Fabstract%3Frss%3Dyes (pp 240–244) Which of the following are true about the heat loss and body’s ability to compensate? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863590 Thu, 26 May 2011 14:17:52 +0100 4863590 http://www.medworm.com/index.php?rid=4863589&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000658%2Fabstract%3Frss%3Dyes This article describes the main methods used to monitor the effects of muscle relaxants, and the ways in which they may be employed clinically to assess the effects of neuromuscular blockade and anticholinesterase drugs. It provides an overview of the main patterns of electrical stimulation used to assess residual muscle paralysis, including train-of-four and double burst stimulation. The article describes the techniques used to monitor depth of anaesthesia, and compares the advantages and disadvantages inherent in the methods currently in use. Methods based on processed electroencephalogram (EEG) signals are discussed, and include auditory evoked potentials (AEPs), bispectral index (BIS) and entropy. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863589 Thu, 26 May 2011 14:17:51 +0100 4863589 http://www.medworm.com/index.php?rid=4863588&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000609%2Fabstract%3Frss%3Dyes Abstract: The neuromuscular junction consists of the motor nerve terminal, the synaptic cleft and post-synaptic nicotinic receptors on the motor end plate of striated muscle. Neuromuscular blocking drugs are categorized into depolarizing and non-depolarizing agents. They are structurally related to acetylcholine (ACh), containing at least one positively charged quaternary ammonium radical which binds to the nicotinic receptor. Depolarizing agents (e.g. suxamethonium) act as agonists like ACh at the nicotinic receptor, but cause a more prolonged depolarization of the motor end-plate, thus rendering the ion channel insensitive to further action potentials. Non-depolarizing agents, in contrast, compete directly with ACh for nicotinic-receptor binding sites and prevent neurotransmitter–recep... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863588 Thu, 26 May 2011 14:17:51 +0100 4863588 http://www.medworm.com/index.php?rid=4863587&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000622%2Fabstract%3Frss%3Dyes This article will focus on these pathophysiological mechanisms and the rationale for published management guidelines. As MH is fundamentally a disorder of skeletal muscle calcium regulation it is necessary first to summarize the physiology of skeletal muscle calcium release and reuptake. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863587 Thu, 26 May 2011 14:17:51 +0100 4863587 http://www.medworm.com/index.php?rid=4863586&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000695%2Fabstract%3Frss%3Dyes Abstract: In the normal resting state, the plasma membrane of nerve and muscle cells generates a transmembrane electrical potential difference – the intracellular surface of the membrane being approximately 70–80 millivolts (mV) negative to the extracellular surface. This is a result of markedly different concentrations of ions inside and outside the cell, together with different membrane permeabilities to different ions which permits K+ ions to flow down their concentration gradient from inside to outside the cell. Nerve and muscle cells are ‘excitable’ because they can react to external stimuli by generating an extremely rapid change in transmembrane electrical potential difference known as the action potential. This comprises an initial explosive increase in membrane Na+ ion per... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863586 Thu, 26 May 2011 14:17:50 +0100 4863586 http://www.medworm.com/index.php?rid=4863585&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000701%2Fabstract%3Frss%3Dyes Abstract: Nerve cells (neurones) are ‘excitable’ cells which can transduce a variety of stimuli into electrical signals, continuously sending information about the external and internal environment (in the form of sequences of action potentials) to the central nervous system (CNS). Interneurones in the CNS integrate this information and send signals along output (efferent) neurones to various parts of the body for the appropriate actions to be taken in response to environmental changes. Networks of neurones have been arbitrarily classified into various nervous systems which gather and transmit sensory information and control skeletal muscle function and autonomic function, etc. The junctions between neurones (synapses) are either electrical or chemical. The former permit the direct tra... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863585 Thu, 26 May 2011 14:17:50 +0100 4863585 http://www.medworm.com/index.php?rid=4863584&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100066X%2Fabstract%3Frss%3Dyes Abstract: Two important types of muscle are skeletal and smooth muscle. Their similarities and differences are described with regard to general morphology and ultrastructure (arrangement of filaments and t-tubules), linking structure to physiological functions. The sliding-filament theory of muscle contraction is explained. Finally, the processes by which nerves excite muscle contraction (excitation-contraction coupling) are outlined, again relating variations in these processes in the two types of muscle to differences between them in their role in the body. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863584 Thu, 26 May 2011 14:17:50 +0100 4863584 http://www.medworm.com/index.php?rid=4863583&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000713%2Fabstract%3Frss%3Dyes Abstract: The neuromuscular junction (NMJ) is a chemical synapse between a motor neurone and a skeletal muscle cell. It has been the most intensively studied synapse in the body owing to its comparatively large size, relative simplicity and accessibility. Commands from the central nervous system are transmitted along motor neurone axons, resulting in the release of the neurotransmitter acetylcholine from axon terminals. The transmitter activates nicotinic cholinergic receptors located on the muscle cell membrane. These receptors are ligand-gated cation channels. Upon binding of acetylcholine, the receptor channel opens to allow mainly Na+ ions to enter the muscle cell, causing a partial membrane depolarization. This triggers action potentials in the muscle cell membrane, resulting in Ca2+ ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863583 Thu, 26 May 2011 14:17:49 +0100 4863583 http://www.medworm.com/index.php?rid=4863582&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000592%2Fabstract%3Frss%3Dyes Abstract: Body temperature is regulated to a ‘set point’ that is determined by the hypothalamus. The precise value of this set point has a circadian rhythm and is also affected (increased) by trauma and sepsis. In thermoregulatory terms, the body is thought of as a ‘central’ compartment containing all the heat-producing viscera, contained in a cooler ‘shell’ that consists of skin and subcutaneous tissue, particularly the arms and legs. Heat is generated by basal metabolism, by muscle contraction (shivering, voluntary activity and behaviour), by intake of food and, in the neonate, by non-shivering thermogenesis (brown adipose tissue). The input to the hypothalamus comes from receptors which respond to heat and cold. The receptors responding to heat are predominantly in the centr... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863582 Thu, 26 May 2011 14:17:49 +0100 4863582 http://www.medworm.com/index.php?rid=4863581&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000634%2Fabstract%3Frss%3Dyes Abstract: The primary aim of care immediately after neurosurgery is to detect and prevent neurological deterioration while supporting systemic and neurological homeostasis. A slow return to, or failure to regain, a patient's preoperative status may be due to surgical, anaesthetic or disease-related factors. A period of specified monitoring and observation by nursing and medical staff accustomed to neurosurgical and neurocritical care procedures should be planned preoperatively. In many neurosurgical cases (e.g. limited uneventful craniotomies), the period of postoperative observation required may be relatively short; however, if complicating factors such as cerebral oedema, intracranial haemorrhage, seizures or significant pre-morbid conditions are present, a period of higher dependency ca... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863581 Thu, 26 May 2011 14:17:48 +0100 4863581 http://www.medworm.com/index.php?rid=4863580&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000610%2Fabstract%3Frss%3Dyes Abstract: Although relatively rare, neuromuscular disease is important to both anaesthetists and intensivists as it may complicate general anaesthesia and result in neurogenic respiratory failure. The most common diseases that will be encountered in a general anaesthetic practice include motor neurone disease, Gullain–Barré syndrome, botulism, myasthenia gravis and the muscular dystrophies. The clinical features and anaesthetic implications for these conditions are discussed. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863580 Thu, 26 May 2011 14:17:48 +0100 4863580 http://www.medworm.com/index.php?rid=4863579&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000646%2Fabstract%3Frss%3Dyes Abstract: Surgery on the surgical spine is commonly performed to relieve compression of the spinal cord (myelopathy), a nerve root (radiculopathy) or to provide bony stabilization to prevent secondary neurological injury. The pathological causes of myelopathy and radiculopathy are a common consequence of osteoarthritis or less commonly due to tumours, trauma, disc herniation, infection and multisystem disease and in some conditions as a result of their associated pathologically or surgically induced instability. Successful anaesthetic management should involve a meticulous preoperative assessment of the patient’s airway, a systemic review especially in patients with comorbidities & multisystem disease and attention to their medication and analgesic requirements. Preoperative discussion w... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863579 Thu, 26 May 2011 14:17:48 +0100 4863579 http://www.medworm.com/index.php?rid=4863578&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001044%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863578 Thu, 26 May 2011 14:17:48 +0100 4863578 http://www.medworm.com/index.php?rid=4863577&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911001020%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4863577 Thu, 26 May 2011 14:17:48 +0100 4863577 http://www.medworm.com/index.php?rid=4805325&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000348%2Fabstract%3Frss%3Dyes (pp 204–207) Which of the following are the risk factors for SAH? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805325 Sat, 30 Apr 2011 23:00:00 +0100 4805325 http://www.medworm.com/index.php?rid=4805324&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000397%2Fabstract%3Frss%3Dyes Abstract: The Monro–Kellie hypothesis states that ‘if the skull is intact, then the sum of the volumes of the brain, cerebrospinal fluid (CSF) and intracranial blood volume is constant’. An increase in volume in one of the three components within the skull must be compensated for by a decrease in the volume of the other remaining components, otherwise the intracranial pressure (ICP) will increase. Brain tissue is not easily displaced; therefore changes in venous blood or CSF volumes initially act as the major buffers against a rise in ICP. In the normal adult, the ICP is 5–13 mmHg, with minor cyclical variations owing to the effects of the arterial pressure waveform and respiration. Cerebral blood flow (CBF) is determined by a number of factors. It is closely linked to the metaboli... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805324 Sat, 30 Apr 2011 23:00:00 +0100 4805324 http://www.medworm.com/index.php?rid=4805323&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000385%2Fabstract%3Frss%3Dyes Abstract: The body responds to changing circumstances and environmental threats both consciously and subconsciously. The cognitive response to a physical threat normally involves movement mediated by skeletal muscle. There are a number of control mechanisms ‘hardwired’ into the nervous system which enable muscle systems to respond in an integrated fashion without involving a conscious decision, although the subject is usually conscious of what has happened. These include the stretch reflex, the withdrawal reflex and the crossed extensor reflexes. Muscle spindles, Golgi tendon organs and cutaneous nociceptors provide the sensory input to these reflexes, and muscle spindles also play a role in the control of voluntary movement. The autonomic nervous system controls the internal environme... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805323 Sat, 30 Apr 2011 23:00:00 +0100 4805323 http://www.medworm.com/index.php?rid=4805322&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000452%2Fabstract%3Frss%3Dyes Abstract: The incompletely separated cerebral hemispheres consist of a thin outer folded cortex of grey matter containing organized neuronal cell bodies and interneurons. Some of the surface convolutions subserve particular sensory or motor functions. Incoming afferent and projected efferent fibres constitute the underlying white matter, which connects different parts of each hemisphere, the hemispheres to each other and (as the corona radiata) to subcortical nuclei, especially components of the deeply-embedded diencephalon and the basal ganglia, and continuing between the latter as the internal capsule to and from the cerebellum and brainstem. Divisions of the diencephalon, the deeper part of the embryonic forebrain, include the epithalamus (pineal gland), the thalamus (connected extensiv... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805322 Sat, 30 Apr 2011 23:00:00 +0100 4805322 http://www.medworm.com/index.php?rid=4805321&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000373%2Fabstract%3Frss%3Dyes Abstract: Subarachnoid haemorrhage (SAH) is a life-threatening condition with multiple sequelae. The treatment of SAH requires urgent resuscitation and stabilization of the patient to prevent re-bleeding and to optimize cerebral oxygenation and perfusion. The perioperative care of these patients involves meticulous attention to maintain an appropriate fluid balance, cerebral blood flow and intracranial pressure. The majority of cases of SAH result from rupture of an intracerebral aneurysm and treatment involves obliteration of the aneurysmal sac either by surgical clipping or endoscopic coiling. Arteriovenous malformations (AVMs) may also cause SAH and often require a combination of radiological and neurosurgical treatments. Haematomas resulting from SAH may require surgical intervention, ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805321 Sat, 30 Apr 2011 23:00:00 +0100 4805321 http://www.medworm.com/index.php?rid=4805320&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000300%2Fabstract%3Frss%3Dyes Abstract: Traumatic brain injury (TBI) is common and carries a high morbidity and mortality. Initial management of the traumatic brain injury patient is directed towards preventing and limiting secondary brain injury while facilitating rapid transport to an appropriate facility capable of providing definitive neurocritical care. During resuscitation of the TBI patient, management is directed at correcting and maintaining mean arterial pressure (MAP), blood glucose, PaO2 and PaCO2 within their normal ranges. After the initial resuscitation, management is directed at limiting secondary damage to the brain which occurs in response to inflammatory changes, expanding haematomas, cellular swelling, seizures, and systemic complications such as haemodynamic or pulmonary changes, fever and pain. Th... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805320 Sat, 30 Apr 2011 23:00:00 +0100 4805320 http://www.medworm.com/index.php?rid=4805319&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000336%2Fabstract%3Frss%3Dyes Abstract: Anaesthetists and intensive care physicians commonly encounter cerebral injury in their clinical practice. Insults may arise from cardiac arrest and traumatic brain injury, can follow cardiothoracic, vascular or major orthopaedic surgery, and are also seen in medical conditions including subarachnoid haemorrhage, central nervous system infection, epilepsy and stroke. In all cases, neuronal injury may lead to severe disability or death; however, aggressive early treatment may result in improvements to patient morbidity and mortality. Neuroprotection involves an intervention, initiated before the onset of ischaemia that can modify the cascade of events which lead to permanent cell damage when left unchecked. Neuroresuscitation refers to treatment aimed at restoring blood flow and o... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805319 Sat, 30 Apr 2011 23:00:00 +0100 4805319 http://www.medworm.com/index.php?rid=4805318&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS147202991100035X%2Fabstract%3Frss%3Dyes Abstract: Severe traumatic brain injury (TBI) is a significant cause of morbidity and mortality. The intensive care management of TBI requires a coordinated and comprehensive approach to treatment, including strategies to prevent secondary brain injury by avoidance of systemic physiological disturbances, such as hypotension and hypoxaemia, and maintenance of adequate cerebral perfusion and oxygenation. There have been marked improvements in the treatment of patients with severe TBI over the last decade and management advances in the pre-hospital setting and emergency department have recently been extended into the intensive care unit. The management of head injury has undergone extensive revision as evidence accumulates that established practices are not as effective or innocuous as previo... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805318 Sat, 30 Apr 2011 23:00:00 +0100 4805318 http://www.medworm.com/index.php?rid=4805317&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000361%2Fabstract%3Frss%3Dyes Abstract: The monitoring of critically ill brain-injured patients has become increasingly complex. Several techniques are now available for global and regional brain monitoring that provide early warning of impending brain ischaemia and allow optimization of cerebral haemodynamics, oxygenation and metabolism. Developments in multimodality monitoring have enabled a move away from rigid physiological target setting to an individually tailored, patient-specific approach. Multimodal monitoring generates large and complex datasets, and systems that analyse and present information in a user-friendly format at the bedside are essential to maximize its clinical relevance. This review describes current neuromonitoring techniques used during the intensive care management of brain injury. (Source: An... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805317 Sat, 30 Apr 2011 23:00:00 +0100 4805317 http://www.medworm.com/index.php?rid=4805316&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000324%2Fabstract%3Frss%3Dyes Abstract: The external bony characteristics of the skull are described in this article, with emphasis on surface anatomical features, bony landmarks and relationships to nervous and vascular structures. Common fractures are described, together with their associated complications and diagnostic features. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805316 Sat, 30 Apr 2011 23:00:00 +0100 4805316 http://www.medworm.com/index.php?rid=4805315&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000312%2Fabstract%3Frss%3Dyes Abstract: Cardiovascular events are an important group of critical incidents in anaesthetic practice. Generic manifestations of cardiovascular disturbance include hypotension, hypertension, myocardial ischaemia/infarction, arrhythmias, and cardiac arrest. These incidents require prompt recognition and effective management to minimize the potential for patient harm. (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805315 Sat, 30 Apr 2011 23:00:00 +0100 4805315 http://www.medworm.com/index.php?rid=4805314&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000907%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805314 Sat, 30 Apr 2011 23:00:00 +0100 4805314 http://www.medworm.com/index.php?rid=4805313&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000889%2Fabstract%3Frss%3Dyes (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4805313 Sat, 30 Apr 2011 23:00:00 +0100 4805313 http://www.medworm.com/index.php?rid=4664535&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000464%2Fabstract%3Frss%3Dyes [Drugs affecting coagulation. Anaesthesia and Intensive Care Medicine 2010; 11(6): 247–253] The dose of bivalirudin given in Table 1 on page 248 of the above article should be: (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4664535 Thu, 31 Mar 2011 23:00:00 +0100 4664535 http://www.medworm.com/index.php?rid=4664534&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029911000038%2Fabstract%3Frss%3Dyes (pp 166–169) Which of the following are the side-effects and drug interactions of lithium? (Source: Anaesthesia and intensive care medicine) Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4664534 Thu, 31 Mar 2011 23:00:00 +0100 4664534 http://www.medworm.com/index.php?rid=4664533&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029910003188%2Fabstract%3Frss%3Dyes Abstract: Carbohydrate and fat form the immediate and long-term energy stores of the body, and protein constitutes the active (functional) cell mass and is also an energy source but, normally, a relatively minor one. All three macronutrients are interrelated. Proteins are synthesized from amino acids derived from ingested protein. Glucose and fat provide energy via adenosine triphosphate. The brain and red cells can only obtain their energy from glucose. Glucose is oxidized via the glycolytic and the tricarboxylic acid (Krebs) cycle pathways. Fatty acids are metabolized by the process of β-oxidation, whereby two carbon fragments are cleaved from the fatty acid chain and enter the Krebs cycle. Amino acids are deaminated to keto acids and the nitrogen moiety excreted in the urine mostly as ... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4664533 Thu, 31 Mar 2011 23:00:00 +0100 4664533 http://www.medworm.com/index.php?rid=4664532&cid=s_33863_5_f&fid=33863&url=http%3A%2F%2Fwww.anaesthesiajournal.co.uk%2Farticle%2FPIIS1472029910003176%2Fabstract%3Frss%3Dyes Abstract: Carbohydrates have the general formula Cn(H2O)n. Monosaccharides have between three and six carbon atoms and exist as chains or ring structures. As rings, they link with other monosaccharide rings. The major carbohydrate in humans is glucose, which is stored as glycogen: branching chains of glucose molecules. Fat (triglyceride), which makes up adipose tissue, consists of three fatty acids bonded to glycerol, but other lipids include phospholipids and steroids. Proteins are composed of chains of amino acids linked by amide bonds folded on each other to form protein structures. Vitamins and minerals are obtained from the diet and are required in varying quantities for a variety of metabolic processes. Energy is derived from the oxidation of carbohydrate, fat and protein. Energy exp... Anaesthesia and intensive care medicine journals http://www.medworm.com/rss/comments.php?id=4664532 Thu, 31 Mar 2011 23:00:00 +0100 4664532