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 'Current Anaesthesia and Critical Care' source. Fri, 19 Mar 2010 13:45:17 +0100 http://www.medworm.com/index.php?rid=3366905&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120900132X%2Fabstract%3Frss%3Dyes ‘Essentials of Cardiac Anesthesia’ is the first edition of this title which has been added to the ‘Essentials in Anaesthesia and Critical Care’ series by the Saunders Elsevier publishing house. The book is a new publication written by a distinguished list of North American experts, and edited by Joel A Kaplan, well known for his established textbook ‘Cardiac Anesthesia’, now in its 5th edition. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366905 Tue, 16 Mar 2010 13:42:26 +0100 3366905 http://www.medworm.com/index.php?rid=3366904&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001173%2Fabstract%3Frss%3Dyes The intended reader of this book is the new anaesthetic trainee who, with little or no previous anaesthetic experience, expects a basic yet comprehensive insight into the principles of anaesthetic practice and a practical guide to clinical anaesthetic skills. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366904 Tue, 16 Mar 2010 13:42:26 +0100 3366904 http://www.medworm.com/index.php?rid=3366903&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001598%2Fabstract%3Frss%3Dyes We read with great interest the commentary of Durbgidge J, “Eclampsia a rare complication: A reminder that magnesium sulphate saves lives” on our case report “Posterior Reversible Encephalopathy Syndrome (PRES) in a patient of eclampsia with ‘partial’ HELLP-syndrome presenting with status-epilepticus”. We agree with you fully that there is a continuing gap between the availability of healthcare and access to drugs between the developed and developing countries. You have rightly pointed out the important role of magnesium sulphate in the management of preeclampsia and eclampsia and it is an indispensable drug in such a situation. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366903 Tue, 16 Mar 2010 13:42:25 +0100 3366903 http://www.medworm.com/index.php?rid=3366902&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711210000104%2Fabstract%3Frss%3Dyes Summary: This is a case report of a patient with Crohn's disease admitted to hospital with a typical flare. The main symptoms were abdominal pain and haemorrhagic diarrhoea. During the current admission she was commenced on her first course of Infliximab.The clinical benefits of monoclonal TNF-alpha inhibitors are described. The anxieties relating to infectious complications that may be, in part related to the TNF-alpha inhibition are also discussed. At present the impact of these agents on critical illness is unclear but as the use of these effective drugs increase it is inevitable there will be an increase in patients presenting with critical illness who are concurrently on this treatment. Some of the implications are outlined. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366902 Tue, 16 Mar 2010 13:42:25 +0100 3366902 http://www.medworm.com/index.php?rid=3366901&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001653%2Fabstract%3Frss%3Dyes We report a 60-year male in whom the attempted NGT insertion led to a near fatal complication. He was admitted to the medical intensive care-unit of our institute with dysphagia, cough with expectoration and breathlessness. In an un-cooperative patient with ineffective cough, the administration of sedation and multiple attempts to place the NGT resulted in an impacted tooth in the upper esophagus, and misplacement of the NGT. An urgent chest radiograph showed that the NGT had entered into the airway and its tip lay in the left main bronchus. A brief review of the complications associated with NGT insertion is presented. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366901 Tue, 16 Mar 2010 13:42:25 +0100 3366901 http://www.medworm.com/index.php?rid=3366900&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001288%2Fabstract%3Frss%3Dyes Summary: Platelets aggregate at the site of ruptured atherosclerotic plaques and have a key role in the pathophysiology of occlusive vascular events. Antiplatelet agents (APA) have proven efficacy in the primary and secondary prevention of ischaemic heart and cerebrovascular disease. The peri-operative management of patients taking such drugs is increasingly challenging and necessitates consideration of the risk of thrombosis following cessation of APA versus that of haemorrhage through continuation. We discuss the current and future role of platelet function tests in optimising clinical management of patients taking APA at the time of surgery. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366900 Tue, 16 Mar 2010 13:42:25 +0100 3366900 http://www.medworm.com/index.php?rid=3366899&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001185%2Fabstract%3Frss%3Dyes In this review article Bunker et al. present their approach to the clinical conundrum regarding the use of red cell transfusion triggers. The impetus to use numerical values of haemoglobin concentration as transfusion triggers has been driven by several factors that have been clearly outlined by the authors. Whilst public perception may differ, blood itself has never been safer and currently the most pressing problem associated with this pharmacological product is the reduction in the donor pool and the exponential rise in cost due to even more sensitive screening tools and pathogen inactivation methods. This has to be tempered with the fact that decisions at the bedside will depend ultimately on the rapidity of blood loss that leads to anaemia and the co morbidities of the patient that m... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366899 Tue, 16 Mar 2010 13:42:24 +0100 3366899 http://www.medworm.com/index.php?rid=3366898&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001197%2Fabstract%3Frss%3Dyes Summary: Transfusion triggers are increasingly accepted in surgery and in the critically ill. There is very little evidence to suggest a restrictive policy is harmful although higher levels might be sensible in those with cardiovascular disease. A considerable tranche of literature shows that blood is bad for a patient but to date no clear mechanism has emerged and there is an argument that needing blood, a surrogate for illness may be as relevant. The impact of anaemia in the postoperative phase has not been evaluated adequately. The triggers lend themselves to non-acute elective situations but where there is acute blood loss and haemodynamic instability a slightly higher threshold, nearer 10g/dl, allows a margin of safety. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366898 Tue, 16 Mar 2010 13:42:24 +0100 3366898 http://www.medworm.com/index.php?rid=3366897&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711210000049%2Fabstract%3Frss%3Dyes True. Pre-existing chronic kidney disease is a risk factor for acute kidney injury (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366897 Tue, 16 Mar 2010 13:42:24 +0100 3366897 http://www.medworm.com/index.php?rid=3366896&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711210000050%2Fabstract%3Frss%3Dyes 1. Risk factors for acute kidney injury include Pre-existing chronic kidney disease (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366896 Tue, 16 Mar 2010 13:42:24 +0100 3366896 http://www.medworm.com/index.php?rid=3366895&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001604%2Fabstract%3Frss%3Dyes Summary: Recipients of successful renal transplants experience a markedly improved quality of life and almost certainly improved survival compared to patients treated with dialysis. Haemodialysis treatment in the immediate period prior to transplantation is associated with a poorer outcome including a higher rate of delayed graft function (DGF). Individuals undergoing renal transplantation require close intra-operative monitoring with optimisation of intravascular fluid volume to maximise renal transplant perfusion. Whether mannitol, loop diuretics, dopamine or other therapies influence the rate of DGF is not possible to decide. For renal transplant recipients admitted immediately post-procedure to intensive care unit (ICU) the prognosis is good. This is in contrast to those admitted usual... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366895 Tue, 16 Mar 2010 13:42:24 +0100 3366895 http://www.medworm.com/index.php?rid=3366894&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001616%2Fabstract%3Frss%3Dyes This article explores the techniques available for renal replacement and support in the intensive care unit, discussing vascular access, choice of technique, choice of membrane, choice of dialysis buffer and strategies for maintaining circuit patency. It examines the techniques in common use in the United Kingdom and the outcome following renal replacement therapy, discussing some of the controversies surrounding renal replacement in terms of timing and dose. It also discusses some future development in technologies for renal replacement. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366894 Tue, 16 Mar 2010 13:42:23 +0100 3366894 http://www.medworm.com/index.php?rid=3366893&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120900163X%2Fabstract%3Frss%3Dyes Summary: Acute Kidney injury (AKI) is a relatively common condition in the intensive care unit and is associated with an increase in mortality. Whilst it can be treated by the use of renal replacement therapies an independent increase in mortality still exists. It is therefore seems intuitive that the prevention of AKI should be associated with a reduction in both mortality and morbidity and an improvement in patient care for this reason there has been many attempts to develop strategies to reduce the incidence of AKI. These strategies involve the use of therapeutic agents to prevent renal failure, the avoidance of nephrotoxic agents and the maintenance of normal hydration and renal perfusion. More recently there has been focus on the early recognition of patients at risk of developing AKI... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366893 Tue, 16 Mar 2010 13:42:23 +0100 3366893 http://www.medworm.com/index.php?rid=3366892&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001641%2Fabstract%3Frss%3Dyes Abstract: The stage at which acute kidney injury (AKI) is detected is dependent upon the definition used. More recently it has been demonstrated that even relatively small increments of serum creatinine portend a worse outcome. This has prompted the development of new definitions based on small rises in serum creatinine or decreases in urine output. Acute kidney injury on the intensive care unit (ICU) is usually multifactorial secondary to hypovolaemia and sepsis resulting in hypoperfusion of the kidneys. In patients with good baseline kidney function the condition is generally reversible if the patient regains health. However it has been recognised that kidney function does not always completely recover. An episode of AKI may represent an antecedent to the development of chronic kidney di... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366892 Tue, 16 Mar 2010 13:42:23 +0100 3366892 http://www.medworm.com/index.php?rid=3366891&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001628%2Fabstract%3Frss%3Dyes Over the last few years there has been an increased interest in acute renal failure now termed acute kidney injury (AKI) particularly in relation to its association with increased patient morbidity, mortality and length of hospital stay. The term AKI encompasses all types of acute renal failure (ARF). The National Service Framework (NSF) for Renal Services has recommended that patients at risk of suffering from AKI should be identified promptly, with hospital services delivering high-quality, clinically appropriate care in partnership with specialised teams. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366891 Tue, 16 Mar 2010 13:42:23 +0100 3366891 http://www.medworm.com/index.php?rid=3366890&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711210000177%2Fabstract%3Frss%3Dyes (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3366890 Tue, 16 Mar 2010 13:42:23 +0100 3366890 http://www.medworm.com/index.php?rid=3173049&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001318%2Fabstract%3Frss%3Dyes The publisher regrets that the link as a commentary to the following article “Posterior reversible encephalopathy syndrome (PRES) in a patient of eclampsia with ‘partial’ HELLP syndrome presenting with status-epilepticus” was missed. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173049 Fri, 15 Jan 2010 13:41:38 +0100 3173049 http://www.medworm.com/index.php?rid=3173048&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001306%2Fabstract%3Frss%3Dyes The publisher regrets that the link as a commentary to the following article “Adjunctive therapy of severe sepsis and septic shock in adults” was missed. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173048 Fri, 15 Jan 2010 13:41:38 +0100 3173048 http://www.medworm.com/index.php?rid=3173047&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120900129X%2Fabstract%3Frss%3Dyes The publisher regrets that the link as a commentary to the following article “Sodium bicarbonate–the bicarbonate challenge test in metabolic acidosis: A practical consideration” was missed. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173047 Fri, 15 Jan 2010 13:41:38 +0100 3173047 http://www.medworm.com/index.php?rid=3173046&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001094%2Fabstract%3Frss%3Dyes I wholeheartedly recommend this elegantly presented paperback. The book opens with a beautifully concise and excellently illustrated synopsis of the structure and function of the brain and spinal cord, and continues with a clear and logical progression of short chapters through sections on neurophysiology and pharmacology before entering the clinical arena. The format makes it easy to find specific topics of interest. Each chapter ends with a useful list of key points and recommended further reading, and although the authors are drawn from America, Canada, Australia and the UK there is surprisingly little overlap of content, and a uniformity of style for which I congratulate the editors. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173046 Fri, 15 Jan 2010 13:41:37 +0100 3173046 http://www.medworm.com/index.php?rid=3173045&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000891%2Fabstract%3Frss%3Dyes Summary: Local anaesthetic toxicity has been a known complication of local anaesthetics since use began in 1884 and it continues to be a problem in modern medical practice.Local anaesthetic toxicity occurs due to raised plasma concentrations following high doses or inadvertent intravenous administration.The clinical manifestations of toxicity are generally neurological, cardiac or both in origin.Prevention is the best approach for toxicity, but in the event of its occurrence, lipid emulsion infusion has been recommended as part of the treatment algorithm. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173045 Fri, 15 Jan 2010 13:41:37 +0100 3173045 http://www.medworm.com/index.php?rid=3173044&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001161%2Fabstract%3Frss%3Dyes Steinmetz has published a very good review updating current information on cardiac arrest, related to actual recommendations and guidelines on this subject, and possible cognitive impairment after surgery. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173044 Fri, 15 Jan 2010 13:41:37 +0100 3173044 http://www.medworm.com/index.php?rid=3173043&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120900115X%2Fabstract%3Frss%3Dyes This is a timely review, documenting the important subject of trace element measurement and replacement in the critically ill population. As stated in this review, they are rarely considered in the day-to-day management of the critically ill patient. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173043 Fri, 15 Jan 2010 13:41:37 +0100 3173043 http://www.medworm.com/index.php?rid=3173042&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001148%2Fabstract%3Frss%3Dyes This article reviews those trace elements relevant to critical care and the research that has been performed on them to date. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173042 Fri, 15 Jan 2010 13:41:37 +0100 3173042 http://www.medworm.com/index.php?rid=3173041&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001240%2Fabstract%3Frss%3Dyes Answers a b c d (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173041 Fri, 15 Jan 2010 13:41:37 +0100 3173041 http://www.medworm.com/index.php?rid=3173040&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001203%2Fabstract%3Frss%3Dyes Contraindications to bariatric surgery include; (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173040 Fri, 15 Jan 2010 13:41:37 +0100 3173040 http://www.medworm.com/index.php?rid=3173039&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001215%2Fabstract%3Frss%3Dyes Summary: Bariatric or weight loss surgery is the only treatment for morbid obesity that confers definitive weight loss at long-term follow-up. In addition to weight reduction there is a strong possibility of amelioration or even cure of various co-morbid conditions associated with obesity such as Type II diabetes mellitus, obstructive sleep apnoea, hypertension, asthma, osteoarthritis and gastro-oesophageal reflux disease.Laparoscopic bariatric surgery is now the gold standard technique in weight loss surgery with the Roux-en-Y Gastric Bypass, Adjustable Gastric Band and Sleeve Gastrectomy being the commonly performed surgeries in Europe, United States and Australia.This review aims to outline the technique, efficacy and complications of these procedures as well as outline the less commonl... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173039 Fri, 15 Jan 2010 13:41:37 +0100 3173039 http://www.medworm.com/index.php?rid=3173038&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001276%2Fabstract%3Frss%3Dyes This article will focus on the common types of sleep-disordered breathing and investigation of these patients. It will discuss the issues around anaesthetising patients with these conditions, and suggest solutions to the problems that these patients present. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173038 Fri, 15 Jan 2010 13:41:36 +0100 3173038 http://www.medworm.com/index.php?rid=3173037&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001239%2Fabstract%3Frss%3Dyes This article addresses key issues relevant to pre-operative assessment, and anaesthetic management of morbidly obese patients presenting for bariatric surgery. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173037 Fri, 15 Jan 2010 13:41:36 +0100 3173037 http://www.medworm.com/index.php?rid=3173036&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001264%2Fabstract%3Frss%3Dyes This article aims to improve understanding of the term ‘difficult airway’ in the obese population and focuses primarily on evidence related to pre-operative airway assessment and intra-operative airway management in the obese patient. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173036 Fri, 15 Jan 2010 13:41:36 +0100 3173036 http://www.medworm.com/index.php?rid=3173035&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001227%2Fabstract%3Frss%3Dyes Summary: The number of patients being referred for bariatric surgery is set to rise, due to the increasing prevalence of morbid obesity and the establishment of bariatric centres. The following review provides a pragmatic approach to the medical assessment and management of such patients, focusing on exclusion of endocrinopathy, adequate exploration of non-surgical treatment options and optimal management of diabetes and hypertension. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173035 Fri, 15 Jan 2010 13:41:36 +0100 3173035 http://www.medworm.com/index.php?rid=3173034&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001252%2Fabstract%3Frss%3Dyes We are all too aware that the obesity epidemic has arrived, and in the absence of any pharmacological breakthrough, it is undoubtedly here to stay for the foreseeable future. With one quarter of the UK adult population currently estimated to be obese, and predictions for this to rise to over 50% by 2050, the involvement of most healthcare professionals in some form of obesity management seems a certainty. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173034 Fri, 15 Jan 2010 13:41:36 +0100 3173034 http://www.medworm.com/index.php?rid=3173033&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209001409%2Fabstract%3Frss%3Dyes (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=3173033 Fri, 15 Jan 2010 13:41:35 +0100 3173033 http://www.medworm.com/index.php?rid=2775936&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000751%2Fabstract%3Frss%3Dyes Posterior Reversible Encephalopathy Syndrome (PRES) in a patient of eclampsia with ‘partial’ HELLP-syndrome presenting with status-epilepticus The case highlights a rare but interesting condition; posterior reversible encephalopathy syndrome (PRES) a clinicoradiological syndrome associated with hypertensive disorders, which has only been recognised since 1996. There have been several other obstetric cases of PRES reported, all of which seem to have a similarly good neurological outcome. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775936 Wed, 09 Sep 2009 16:07:37 +0100 2775936 http://www.medworm.com/index.php?rid=2775935&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000799%2Fabstract%3Frss%3Dyes Disturbances of acid–base homeostasis are a well recognised and clinically significant element of acute illness and physiological derangements. Over many decades, there have been high profile changes in perspectives of the interpretation, clinical effects, diagnostic significance and management of such metabolic alterations. One of the side-effects of these challenges has been to place a shroud of confusion over many aspects of understanding in acid–base physiology, and this decade is no different from others in adding further to this state. More importantly perhaps, is that the more the academic arguments reign over the minutia of this topic, the less accessible it becomes to clinicians and the more distant it moves from practical clinical medicine. One of the major challenges for man... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775935 Wed, 09 Sep 2009 16:07:37 +0100 2775935 http://www.medworm.com/index.php?rid=2775934&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000763%2Fabstract%3Frss%3Dyes This is a very interesting and timely discussion of some controversial and not so controversial aspects of treatment adjuncts in sepsis. Critical care medicine is in a mild confusional state at present with surviving sepsis recommendations falling from grace and seemingly robust studies being unrepeatable or contradicted by further studies. None of the adjunct treatments described is the magic bullet but might they be sufficient to gain an edge in the treatment of this devastating and costly disease? (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775934 Wed, 09 Sep 2009 16:07:35 +0100 2775934 http://www.medworm.com/index.php?rid=2775933&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000787%2Fabstract%3Frss%3Dyes This article explores the combination of a bicarbonate challenge test with defined endpoints of haemodynamic resuscitation as a semi-quantitative method for differentiating between simultaneous reasons for severe metabolic acidosis. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775933 Wed, 09 Sep 2009 16:07:35 +0100 2775933 http://www.medworm.com/index.php?rid=2775932&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000775%2Fabstract%3Frss%3Dyes Summary: Sepsis continues to be a major unresolved medical challenge of the present. Despite earlier diagnosis and treatment initiation, source control, improvements in the standard of care and attempts at standardization of treatment and resuscitation protocols intensive care unit mortality rates for severe sepsis is 32.2% and 54.1% for septic shock. Further reduction in mortality may be achievable through knowledge and use of the expanding field of adjunctive therapy: a supplement to optimal, supportive, intensive therapy and antibiotic treatment.Numerous and unsuccessful trials targeted at inhibiting various essential inflammatory mediators and receptors involved in the sepsis syndrome have failed to show a reduction in mortality, raising the question whether mortality in sepsis actuall... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775932 Wed, 09 Sep 2009 16:07:34 +0100 2775932 http://www.medworm.com/index.php?rid=2775931&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120900074X%2Fabstract%3Frss%3Dyes We report the management of a 21y-female with peripartum eclampsia and ‘partial’ HELLP syndrome (haemolysis, elevated liver enzymes and low-platelets) presenting with status-epilepticus. She had neurological, cardiovascular, hepatic, renal and hematological involvement along with electrolyte abnormalities. Early diagnosis along with timely supportive therapy resulted in the successful management of this challenging case. Recent understanding on the pathophysiology of this uncommon condition is discussed. We highlight the importance to obstetricians, intensive-care physicians and anesthesiologists of recognizing such cases. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775931 Wed, 09 Sep 2009 16:07:34 +0100 2775931 http://www.medworm.com/index.php?rid=2775930&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000714%2Fabstract%3Frss%3Dyes This article had the aim to give an overview on problems associated to the spread of GRE and to provide some recommendation about the management of infected or colonized patients. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775930 Wed, 09 Sep 2009 16:07:34 +0100 2775930 http://www.medworm.com/index.php?rid=2775929&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000726%2Fabstract%3Frss%3Dyes Summary: AMPA receptors are one of the major excitatory receptors within the CNS with many of their functional effects being mediated by alterations in their trafficking to the cell surface and targeting into the synapse. Integral to these functions, and consequently, AMPA receptor activity is a class of proteins termed transmembrane AMPA receptor regulatory proteins (TARPs) which also possess diverse effects on AMPA receptor pharmacology. Incredibly, despite the evident importance of TARPs in AMPA receptor function, very few studies even allude to the potential significance of their potential role within the glutamatergic pathology of neurological disorder. This review brushes upon the importance of these proteins as potential targets for therapeutic agents in several psychological disord... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775929 Wed, 09 Sep 2009 16:07:34 +0100 2775929 http://www.medworm.com/index.php?rid=2775928&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000805%2Fabstract%3Frss%3Dyes Abstract: Schizophrenia is a psychiatric disorder involving the impairment of normal thinking, emotion, and everyday behaviours. Characteristics of schizophrenia can be divided into positive, negative and cognitive symptoms. Contributory factors of the disorder include genetics, early environmental factors and neuropsychological factors. Many years of research has investigated the dopamine hypothesis and glutamate hypothesis of schizophrenia, but more recently the field is scrutinizing the combined interactions of the glutamatergic and dopaminergic systems. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775928 Wed, 09 Sep 2009 16:07:34 +0100 2775928 http://www.medworm.com/index.php?rid=2775927&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000817%2Fabstract%3Frss%3Dyes Abstract: Motor Neuron Disease is a term defining a group of neurodegenerative diseases, in which motor neurons degenerate, leading to muscle wasting, paralysis and ultimately death. Here I review the current understanding of Amyotrophic Lateral Sclerosis (ALS), the most common form of MND, looking particularly at the causative factors, and the available treatments for the disease. Familial ALS can be caused by a mutation in SOD1; research into the effects of this mutation has given an insight into the mechanisms by which MND progresses. Mutant SOD1 causes the initiation and progression of MND via protein aggregation, disrupted axonal transport, and oxidative stress within motor neurons. There is currently only one drug available for the treatment of motor neuron disease; Riluzole. I exami... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775927 Wed, 09 Sep 2009 16:07:34 +0100 2775927 http://www.medworm.com/index.php?rid=2775926&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000829%2Fabstract%3Frss%3Dyes Summary: Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by selective degeneration of upper and lower motor neurons. To date, glutamate modulator riluzole is the only drug that has proved effective against disease progression. Based on this evidence, it has been proposed that glutamate excitotoxicity contributes to the neurodegeneration observed in ALS, with α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate receptors (AMPARs) emerging as a likely candidate for glutamate receptor-mediated excitotoxicity. The calcium (Ca2+) conductance of AMPARs is determined by the presence of the edited GluR2 subunit, which renders the AMPAR Ca2+ impermeable. Of particular significance, reduced GluR2 editing at the Q/R site of AMPARs has been reported in spinal moto... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775926 Wed, 09 Sep 2009 16:07:34 +0100 2775926 http://www.medworm.com/index.php?rid=2775925&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000842%2Fabstract%3Frss%3Dyes The neuropharmacology focus in this double issue includes a number of reviews with a common thread, namely the glutamatergic system, including aspects of glutamate receptor regulation, molecular RNA editing and excitotoxicity, with therapeutic implications in Motor neuron disease, schizophrenia and clinical depression, a highly debilitating spectrum of diseases and disorders which affect, in the main, relatively young adults. Exciting new insights through basic research have provided new therapeutic targets and rationale strategies which are reviewed in this focus. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775925 Wed, 09 Sep 2009 16:07:34 +0100 2775925 http://www.medworm.com/index.php?rid=2775924&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000878%2Fabstract%3Frss%3Dyes (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775924 Wed, 09 Sep 2009 16:07:34 +0100 2775924 http://www.medworm.com/index.php?rid=2775923&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120900088X%2Fabstract%3Frss%3Dyes (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775923 Wed, 09 Sep 2009 16:07:34 +0100 2775923 http://www.medworm.com/index.php?rid=2775922&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000738%2Fabstract%3Frss%3Dyes Pain is fundamentally important to the human condition. It is the most common symptom experienced by patients in critical care and all those in the health care service should have a basic understanding of the mechanisms underlying pain and how best to treat patients in the clinical setting. Based on this basic understanding, it is thus essential to identify and understand the rational for pain relief and the strategies available. This excellent and timely publication brings together a collection of academics, clinical directors, consultants, specialist registrars and even a final year medical student, each contributing a chapter pertaining to their specialities and experience. The book benefits from valuable sections listing key abbreviations and definitions. The first four chapters set th... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775922 Wed, 09 Sep 2009 16:07:34 +0100 2775922 http://www.medworm.com/index.php?rid=2775921&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000854%2Fabstract%3Frss%3Dyes We describe the role of pharmacovigilance in detecting and evaluating emerging evidence of adverse drug reactions, i.e. “signals” using the New Zealand Pharmacovigilance Centre as an example. The benefits to individual patient safety through a medical warning system are of particular relevance to anaesthetic practice. Effective and holistic pharmacovigilance relies on voluntary reporting systems for all therapeutic products, prescription or cohort event monitoring of selected medicines and vaccines, and specific monitoring of medication error. Ongoing development of computational methods for data-mining in the voluntary reporting databases for signal detection and the application of these methods to electronic longitudinal health care databases such as general practice records in order... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775921 Wed, 09 Sep 2009 16:07:33 +0100 2775921 http://www.medworm.com/index.php?rid=2775920&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000830%2Fabstract%3Frss%3Dyes This article explores an interdisciplinary setting with comprehensive approach (pharmacological, interventional, and psychological in conjunction with rehabilitation pathway) as the protocol for the practical management of CRPS. Insight in predisposing factors may facilitate early diagnosis and elucidate underlying mechanisms that could provide targets for pharmacotherapy. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775920 Wed, 09 Sep 2009 16:07:33 +0100 2775920 http://www.medworm.com/index.php?rid=2775919&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000696%2Fabstract%3Frss%3Dyes Summary: Voltage-gated sodium channels are important in the pathophysiology of chronic neuropathic pain and as targets for analgesic drugs. This review will cover the molecular structure and signalling roles for this ion channel super-family with a focus on the channels thought to be involved in nociception. We highlight the mode of action of current analgesic drugs and the difficulty of treating chronic inflammatory or neuropathic pain states. The discovery of key channel classes, or familial mutations, associated with chronic pain syndromes has resulted in intensive drug discovery programmes. The quest for selective drugs or toxins which safely and effectively block diseased channels without interfering with normal conduction in the central or peripheral nervous system has been frustrati... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775919 Wed, 09 Sep 2009 16:07:33 +0100 2775919 http://www.medworm.com/index.php?rid=2775918&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000866%2Fabstract%3Frss%3Dyes Summary: The prevalence of neuropathic pain is rising, and is expected to further increase in aging populations. However, drug treatment for neuropathic pain remains inadequate, with the best available treatments having limited efficacy and dose-limiting side effects. Cannabinoids have been shown in clinical trials to be moderately effective at reducing neuropathic pain, but doses of cannabinoids currently in use are severely curtailed by psychoactive side effects through actions on the cannabinoid CB1 receptor. A relatively new class of drugs, selective cannabinoid CB2 receptor agonists, have shown considerable efficacy in a variety of animal models of neuropathic pain. Importantly, these drugs lack the psychoactivity of non-selective cannabinoid receptor agonists. The mechanisms by whic... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775918 Wed, 09 Sep 2009 16:07:33 +0100 2775918 http://www.medworm.com/index.php?rid=2775917&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000702%2Fabstract%3Frss%3Dyes This issue of current anaesthesia and critical care covers two long standing problems in pharmacology: (i) how important it is to appraise drug safety objectively beyond clinical trials (using a combination of spontaneous and longitudinal reporting) and (ii) how difficult it is to treat patients in the chronic pain clinic effectively with currently available drugs. All of the contributing authors are experts in these fields in New Zealand. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775917 Wed, 09 Sep 2009 16:07:33 +0100 2775917 http://www.medworm.com/index.php?rid=2775916&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120900091X%2Fabstract%3Frss%3Dyes (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2775916 Wed, 09 Sep 2009 16:07:33 +0100 2775916 http://www.medworm.com/index.php?rid=2474881&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000283%2Fabstract%3Frss%3Dyes Summary: Inadequate postoperative pain management is an international problem and the need to improve its management is well documented. This review outlines some of the commonly used treatments such as multimodal analgesia, patient controlled analgesia, epidurals, perineural infusions and adjuvant drugs. Barriers to improvement including inaccurate pain assessment, communication issues, knowledge deficits, difficulties integrating evidence into practice and the challenges in the modern healthcare environment will be discussed. Following this, some options for the way forward will be outlined. A continued focus on improving the basics including accurate pain assessment and prompt treatment with appropriate analgesic regimes would make a considerable difference for many patients. Although t... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474881 Sun, 14 Jun 2009 23:09:40 +0100 2474881 http://www.medworm.com/index.php?rid=2474880&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000064%2Fabstract%3Frss%3Dyes Summary: There are many conditions accompanied by muscle pain/hyperalgesia. Despite the large number of people who are suffering from musculoskeletal pain, understanding of its mechanism is quite limited. Many muscle pain conditions are considered to be somehow related to muscle exertion, in the presence or absence of muscle ischemia, therefore, this review introduces recent results obtained from delayed onset muscle soreness model by lengthening contraction (eccentric contraction), together with recent advances in muscle pain research with a focus on topics such as temporomandibular joint disorders and glutamate, nerve growth factor (NGF) and inflammatory pain, the role of protons and lactic acid in ischemic muscular pain, myofascial pain syndrome and trigger points, and fibromyalgia. (So... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474880 Sun, 14 Jun 2009 23:09:36 +0100 2474880 http://www.medworm.com/index.php?rid=2474879&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000040%2Fabstract%3Frss%3Dyes Summary: Healthcare-associated infections (HAIs) are a hugely topical issue, attracting unprecedented public and political interest.With regards to the ICU, both the ward environment and susceptible population make the patients particularly vulnerable to a range of infections. The causative organisms are often different to those causing disease in the community, or even for the rest of the hospital. Therefore management of the infected ICU patient is complicated and requires careful consideration. In addition, the emergence of multi-drug resistant organisms further complicates treating such patients as they tend to be more susceptible to infections with less physiological reserve and therapeutic options are frequently reduced. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474879 Sun, 14 Jun 2009 23:09:31 +0100 2474879 http://www.medworm.com/index.php?rid=2474878&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000519%2Fabstract%3Frss%3Dyes a, c, e (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474878 Sun, 14 Jun 2009 23:09:31 +0100 2474878 http://www.medworm.com/index.php?rid=2474877&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000507%2Fabstract%3Frss%3Dyes Complications of angioplasty include (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474877 Sun, 14 Jun 2009 23:09:31 +0100 2474877 http://www.medworm.com/index.php?rid=2474876&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000556%2Fabstract%3Frss%3Dyes Summary: Echocardiography or cardiac ultrasound has long been established as an important cardiac imaging technique for acquiring real-time information about cardiac anatomy and function. The technological aspect of this cardiac ultrasound platform continues to evolve, recent developments such as real-time 3D scanning are currently being assimilated into clinical practice first in transthoracic scanning and now in transoesophageal scanning. Echocardiography use is migrating across patient populations and different specialities – there is currently much discussion on how best to adopt the technique for the general intensive care unit. Cardiac assessment and monitoring have always been an essential part of the management of the patient undergoing cardiac surgery and cardiothoracic intensiv... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474876 Sun, 14 Jun 2009 23:09:30 +0100 2474876 http://www.medworm.com/index.php?rid=2474875&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000532%2Fabstract%3Frss%3Dyes Summary: There is an increasing use of large airway stents for non-malignant disease processes. As advances in stent development and manufacture are made, there are more patients being treated with airway stents. Stenting can be short term or long term and can be used for the management of large airway obstruction where surgery carries both morbidity and mortality.Pre-operative assessment is particularly important and may determine which of the wide range of techniques that have been used is most appropriate for the individual case.The anaesthetic management of patients with stents already in situ is becoming more important as the number of patients with stents increases. There are some specific pitfalls and problems associated with anaesthesia and these are reviewed. (Source: Current Anae... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474875 Sun, 14 Jun 2009 23:09:28 +0100 2474875 http://www.medworm.com/index.php?rid=2474874&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000076%2Fabstract%3Frss%3Dyes Summary: Standard treatment for valvular heart diseases such as aortic stenosis and mitral regurgitation includes replacement or repair of the valve. This will require median sternotomy and cardiopulmonary by-pass. In elderly patients with co-morbidity the risks from surgery increase and some patients may be classified as too high risk for surgery.Developments in percutaneous catheter delivered systems make it feasible that non-invasive valve repair and replacement can be performed. Those patients unsuitable for surgical treatment can be offered these procedures. We review the procedures available and the outcome data. We discuss the implications for anaesthesia and intensive care. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474874 Sun, 14 Jun 2009 23:09:26 +0100 2474874 http://www.medworm.com/index.php?rid=2474873&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000520%2Fabstract%3Frss%3Dyes This article will explain the differences between types of coronary artery stent, their different issues, and discuss the current evidence for the perioperative management of these patients. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474873 Sun, 14 Jun 2009 23:09:24 +0100 2474873 http://www.medworm.com/index.php?rid=2474872&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000544%2Fabstract%3Frss%3Dyes This issue of the journal is devoted to cardiothoracic topics. The contributors all come from a single unit – the Cardiothoracic Unit of St George's Hospital in London. The face of cardiology, cardiothoracic surgery and anaesthesia is changing relatively quickly, reflecting the fast advances and innovations in these fields. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474872 Sun, 14 Jun 2009 23:09:23 +0100 2474872 http://www.medworm.com/index.php?rid=2474871&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120900057X%2Fabstract%3Frss%3Dyes (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2474871 Sun, 14 Jun 2009 23:09:23 +0100 2474871 http://www.medworm.com/index.php?rid=2399481&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000039%2Fabstract%3Frss%3Dyes Steinmetz has published a very good review updating current information on cardiac arrest, related to actual recommendations and guidelines on this subject. We will focus our commentaries about the effects of hypoxia and ischemia on the brain after cardiac arrest. The human brain uses approximately 20% of the cardiac in a way that cerebral blood flow (CBF) is tightly regulated to meet the brain's metabolic demands. The CBF dropping to less than 20mL/100gm/min produces ischemic neuronal activity reduction, but still reversible neuronal changes. CBF values less than 10mL/100gm/min result in irreversible ischemic neuronal damage within minutes, as reflected by membrane failure. That's why the CBF values between 10 and 20mL/100gm/min are considered the ischemic penumbra, and represent neurona... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399481 Sun, 10 May 2009 15:16:29 +0100 2399481 http://www.medworm.com/index.php?rid=2399480&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001610%2Fabstract%3Frss%3Dyes Summary: Microglia are uniformly distributed throughout the central nervous system. The number of microglia is thought to make up 5–20% of the entire glial cell population. Origin of microglia has been discussed for several decades. Recently, microglia are widely considered to originate from mesodermal monocyte/macrophage cell lineage, because of similarities in cell surface molecular phenotype. In normal adult brain, microglia have finely branched and ramified cell processes that extend in all directions, and survey the brain microenvironment. When the brain is injured by trauma, stroke and other neurodegenerative disorders, microglia transform their morphology into an activated phenotype, and accumulate in the affected sites. Activation of microglia has been believed to lead to neuroto... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399480 Sun, 10 May 2009 15:16:26 +0100 2399480 http://www.medworm.com/index.php?rid=2399479&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000325%2Fabstract%3Frss%3Dyes Question 1. True: a, c, e (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399479 Sun, 10 May 2009 15:16:26 +0100 2399479 http://www.medworm.com/index.php?rid=2399478&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000313%2Fabstract%3Frss%3Dyes Hypoxaemia occurs much more rapidly if airway obstruction appears in (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399478 Sun, 10 May 2009 15:16:26 +0100 2399478 http://www.medworm.com/index.php?rid=2399477&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000349%2Fabstract%3Frss%3Dyes Summary: Traumatic brain injury (TBI) is one of the major causes of disability, death and health related cost to our society. An organized trauma system from the site of accident to the Intensive Care Unit is the cornerstone of treatment of TBI patients. Treatment in the emergency room must focus on swift normalization of blood pressure and oxygenation. During tracheal intubation cervical spine protection and the risk of aspiration, must be balanced against the risk of hypotension and hypercapnia. Both hyper- and hypoventilation can be deleterious in TBI patients, and consequently, they should be normoventilated as guided by end-tidal CO2. A neurosurgeon should be consulted before a TBI patient is taken directly from the emergency room to emergency surgery for non-life threatening injuries... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399477 Sun, 10 May 2009 15:16:22 +0100 2399477 http://www.medworm.com/index.php?rid=2399476&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000350%2Fabstract%3Frss%3Dyes Summary: Severe sepsis is a leading cause of death and characterised by infection-induced endothelial and cardiac dysfunction leading to hypovolaemia, maldistribution of flow, tissue ischaemia and organ failure. A clinical approach with focus on cardiovascular diagnostics and rational goal-directed therapy is likely to reduce the high mortality. The treatment involves focus control, broad-spectrum antibiotics, target-oriented fluid therapy and vasopressor and inotropic agents guided by frequent reassessments of the patients' response to intervention. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399476 Sun, 10 May 2009 15:16:21 +0100 2399476 http://www.medworm.com/index.php?rid=2399475&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000337%2Fabstract%3Frss%3Dyes This article outlines different techniques for gaining peripheral, central and intraosseus access. We go through some of the vast amount of evidence supporting the use of real-time ultrasonography and describe its use and common pitfalls. Ultrasound equipment is readily available in almost every hospital but is often not used. Our hope is that this article can give physicians and nurses some means to increase their success rates and decrease the amount of time they spend on gaining intravenous access. Hopefully patient satisfaction will increase at the same time. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399475 Sun, 10 May 2009 15:16:18 +0100 2399475 http://www.medworm.com/index.php?rid=2399474&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001403%2Fabstract%3Frss%3Dyes Summary: Cardiac arrest is singly one of the most important conditions to recognize and treat well. In order to ensure the optimal treatment and uniform implementation worldwide, guidelines are published every fifth year. A considerable amount of research is done, and although there have been advances, there is always room for improvement. Prospective studies of cardiac arrest in humans are extremely difficult to conduct, especially randomised studies, and the number of patients involved in the studies is sparse. This paper provides updated available information on cardiac arrest, as well as a discussion of recommendations, based on the guidelines published in November 2005 by the International Liaison Committee on Resuscitation. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399474 Sun, 10 May 2009 15:16:08 +0100 2399474 http://www.medworm.com/index.php?rid=2399473&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000295%2Fabstract%3Frss%3Dyes This article provides an overview of the anatomy, physiology and causes of airway obstruction. Algorithms used in its management are described, and the possibilities for future training for this rare event will be considered. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399473 Sun, 10 May 2009 15:15:59 +0100 2399473 http://www.medworm.com/index.php?rid=2399471&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000301%2Fabstract%3Frss%3Dyes The management of emergency patients is a major challenge. Time is the limiting factor and any delay in treatment must be carefully balanced against the risk of further deterioration in patient condition. The patient history is commonly incomplete and previous medical records may not be available. Anaesthesiologists are key players in the team taking care of emergency patients because we have the skills to assess and support vital functions no matter if the patient is undergoing surgery or not. The initial evaluation of any emergency patient is based on the traditional algorithm looking at airway, breathing, and circulation in that order. An accurate diagnosis may not be attainable but the most important aspect during the first few minutes is to ensure that life threatening conditions are ... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399471 Sun, 10 May 2009 15:15:45 +0100 2399471 http://www.medworm.com/index.php?rid=2399470&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000374%2Fabstract%3Frss%3Dyes (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2399470 Sun, 10 May 2009 15:15:42 +0100 2399470 http://www.medworm.com/index.php?rid=2349974&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000027%2Fabstract%3Frss%3Dyes Summary: The aim of this article is to describe the rationale and principles of bioequivalence and non-inferiority analysis and describe some recent applications in extending equivalence techniques to simple physiological measures in anaesthetic research. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349974 Wed, 01 Apr 2009 04:00:00 +0100 2349974 http://www.medworm.com/index.php?rid=2349973&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711209000052%2Fabstract%3Frss%3Dyes Summary: Transfusion related lung injury is almost certainly related to the administration of blood products containing antibodies in the plasma. Those antibodies may have developed during pregnancy or following blood transfusion. They react with specific ‘cognate’ antigens in the recipient and in some patients, but not all, this results in an acute lung injury pattern. The problem resides in the plasma, so the incidence with FFP is far higher than with red cells.Blood transfusion services have adopted several ways of reducing risk such as using untransfused male donors. Leucodepletion may also have a benefit.Diagnosis is an issue as it is easily confused with transfusion associated circulatory overload TACO and often the right preconditions exist for both. Although most sources agree ... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349973 Wed, 01 Apr 2009 04:00:00 +0100 2349973 http://www.medworm.com/index.php?rid=2349972&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001336%2Fabstract%3Frss%3Dyes Summary: The Mental Capacity Act 2005 has considerable implications for critical care practitioners and particularly in relation to treatment of elderly patients. The full Act came into force on 1st October 2007. The Act sets down decision specific criteria for the assessment of capacity, and “best interests” principles to enhance decision making for patients without capacity. Patients undergoing serious treatment must have an Independent Mental Capacity Advocate appointed if there is no one appropriate to consult in determining the patient's interests. A person may be appointed as personal attorney under a Lasting Power of Attorney to make decisions on the patient's behalf. Advance Decisions about the refusal of life-sustaining treatment are regulated statutorily for the first time. T... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349972 Wed, 01 Apr 2009 04:00:00 +0100 2349972 http://www.medworm.com/index.php?rid=2349971&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001634%2Fabstract%3Frss%3Dyes Spinal anaesthesia; the following increase the likelihood of spread. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349971 Wed, 01 Apr 2009 04:00:00 +0100 2349971 http://www.medworm.com/index.php?rid=2349970&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001622%2Fabstract%3Frss%3Dyes Spinal anaesthesia; the following increase the likelihood of spread. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349970 Wed, 01 Apr 2009 04:00:00 +0100 2349970 http://www.medworm.com/index.php?rid=2349969&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001646%2Fabstract%3Frss%3Dyes Summary: The practice of regional anaesthesia has evolved from mechanically stimulating a nerve with a needle and thereby eliciting paraesthesia to the fine art of using state-of-the art electrolocation using peripheral nerve stimulators and insulated needles. The stimulating nerve catheter is a very useful addition to the armamentarium of the regional anaesthesia practitioner. The stimulating nerve catheter makes it possible to verify the perineural location before delivering targeted continuous infusion of local anaesthetic for extended pain relief. The increasing use of ultrasound in echolocation of neural structures has added a new dimension to the popularity of peripheral nerve blocks. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349969 Wed, 01 Apr 2009 04:00:00 +0100 2349969 http://www.medworm.com/index.php?rid=2349968&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001397%2Fabstract%3Frss%3Dyes Summary: Regional anaesthesia is an important part of paediatric anaesthesia and plays a key role in peri-operative multimodal analgesic regimens. In recent years, the popularity of ultrasound-guided nerve blocks has significantly increased out of the recognition of its higher efficacy and safety. Its importance is further enhanced in paediatrics and especially in neonates as there are restrictions in the volume and maximum dosage of local anaesthetic that can be used. Ultrasound has allowed the usage of significantly smaller doses and concentrations by direct deposition of the drug around the nerve. It also allows the dynamic visualisation of the advancement of the block needle, adjacent anatomical structures and allows dynamic vision of local anaesthetic spread. (Source: Current Anaesthe... Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349968 Wed, 01 Apr 2009 04:00:00 +0100 2349968 http://www.medworm.com/index.php?rid=2349967&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001385%2Fabstract%3Frss%3Dyes Summary: The aim of any regional anaesthesia technique is to locate target nerves and deposit local anaesthetic around them. Nerve stimulation using anatomical landmarks has been conventional method of nerve localisation. With the advance in technology, the use of ultrasound in regional anaesthesia has been steadily increasing. In addition to localisation of nerves and other structures under direct visualisation, ultrasound has the potential to reduce complications and minimise the local anaesthetic toxicity by injecting right dose at the right site. The principles, advantages, disadvantages and applications of ultrasound have been reviewed in this article. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349967 Wed, 01 Apr 2009 04:00:00 +0100 2349967 http://www.medworm.com/index.php?rid=2349966&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001373%2Fabstract%3Frss%3Dyes This article reviews the techniques, applications and complications of thoracic and upper lumbar PVB in adult patients. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349966 Wed, 01 Apr 2009 04:00:00 +0100 2349966 http://www.medworm.com/index.php?rid=2349965&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS0953711208001361%2Fabstract%3Frss%3Dyes This article describes how to use the technique of CSA in high risks patients undergoing laparotomy, potential problems that might be encountered and how they can be treated and prevented. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349965 Wed, 01 Apr 2009 04:00:00 +0100 2349965 http://www.medworm.com/index.php?rid=2349964&cid=s_38457_5_f&fid=38457&url=http%3A%2F%2Fwww.currentanaesthesia.com%2Farticle%2FPIIS095371120800135X%2Fabstract%3Frss%3Dyes Summary: Arterial tourniquets are commonly used in orthopaedic anaesthesia to provide a bloodless field for better operating conditions. It is also used in intravenous regional blocks both for upper and lower limbs. Complications can be either local to the affected limb or systemic. Systemic effects can occur during inflation and deflation of the tourniquet. General guidelines should be followed in order to minimize such complications. (Source: Current Anaesthesia and Critical Care) Current Anaesthesia and Critical Care journals http://www.medworm.com/rss/comments.php?id=2349964 Wed, 01 Apr 2009 04:00:00 +0100 2349964