Anaesthesia and Intensive Care back issues from February 2006:
Case Reports or Correspondence?
Feb 01, 2006; ... An important function of medical journals is to publish cases that describe novel approaches to diagnosis or management, or provide warnings about potential hazards or complications. While publications of this type rank very low in the hierarchy of evidence-based medicine1, they nevertheless ...
Muscle Relaxants-Suxamethonium and THA
Feb 01, 2006; ... In 1984, Stanley Fcldman wrote this about suxamethonium: "In spite of its many disadvantages and some potential lethal dangers, it remains the only drug presently available that will produce a rapid, complete ncuromuscular block of about 5-10 minutes duration." Twenty years later, the same ...
Prediction of Successful Epidural Catheter Placement by a 'Cold Test'
Feb 01, 2006; ... SUMMARY We tested the hypothesis that the patients' feeling of cold sensation down the back during epidural drug administration through the epidural catheter was a reliable predictor of correct epidural catheter placement. In a prospective study of 80 patients, an epidural catheter was ...
The Yield of Lumbar Puncture to Exclude Nosocomial Meningitis as Aetiology for Mental Status Changes in the Medical Intensive Care Unit
Feb 01, 2006; ... SUMMARY We aimed to evaluate the diagnostic value of lumbar puncture in excluding nosocomial meningitis as the cause of mental status changes in medical intensive care unit patients. We retrospectively reviewed the records of all patients admitted to the medical intensive care unit at ...
The Use of Recombinant Activated Factor VII for Refractory Bleeding Post Complex Cardiothoracic Surgery
Feb 01, 2006; ... SUMMARY We reviewed the outcome following use of recombinant activated factor VII (rVIIa) in patients with major bleeding post cardiothoracic surgery in our unit between January 2002 and July 2004. The unit consists of 16 cardiothoracic intensive care beds in a public metropolitan ...
Effectiveness of 3-in-1 Continuous Femoral Block of Differing Concentrations Compared to Patient Controlled Intravenous Morphine for Post Total Knee Arthroplasty Analgesia and Knee Rehabilitation
Feb 01, 2006; ... SUMMARY We assessed the effectiveness of the 3-in-1 continuous femoral block as a form of postoperative pain relief for unilateral total knee arthroplasty (TKA). Sixty patients undergoing elective unilateral TKA under subarachnoid block were randomized into three groups. Postoperative ...
Prospective Randomized Comparison of Progressive Dilational vs Forceps Dilational Percutaneous Tracheostomy
Feb 01, 2006; ... SUMMARY This trial prospectively compares two methods of percutaneous tracheostomy, both routinely used in ICU: the Ciaglia progressive dilational tracheostomy and the Griggs forceps dilational tracheostomy. One hundred patients were randomized using a single-blinded envelope method to ...
Malignant Hyperthermia and Day Stay Surgery
Feb 01, 2006; ... SUMMARY Patients who are malignant hyperthermia susceptible are often admitted overnight for observation, even after minor surgery. They may be declined care in a stand-alone day stay unit. This prospective audit set out to investigate whether patients susceptible to malignant ...
Performance of Three Systems for Warming Intravenous Fluids at Different Flow Rates
Feb 01, 2006; ... SUMMARY This study compared the intravenous fluid warming capabilities of three systems at different flow rates. The devices studied were a water-bath warmer, a dry-heat plate warmer, and an intravenous fluid tube warmer. Ambient temperature was controlled at 22° to 24°C. Normal saline ...
Effect of Tramadol on Bispectral Index During Intravenous Anaesthesia with Propofol and Remifentanil
Feb 01, 2006; ... SUMMARY The aim of this study was to investigate the effects of tramadol on the Bispectral Index (BIS) during total intravenous propofol-remifentanil anaesthesia. Forty-four adult ASA Physical status I-II patients, scheduled for elective general surgical procedures were included in a ...
The Performance and Safety of a Pleural Drainage Unit Under Hyperbaric Conditions
Feb 01, 2006; ... SUMMARY The performance of a proprietary dry suction pleural drainage unit was measured under hyperbaric oxygenation conditions. The test pleural drainage unit was connected to pressure gauges that allowed the pressures created in the suction and collection chambers to be measured as ...
Pulmonary Arteriovenous Malformation Causing Massive Haemoptysis and Complicated by Coronary Air Embolism
Feb 01, 2006; ... SUMMARY We report the case of a 20-year-old man with possible Osler-Rendu-Weber syndrome (hereditary haemorrhagic telangiectasia) who developed an episode of massive haemoptysis from a bleeding pulmonary arteriovenous malformation in the left lower lobe of his lung. During the acute ...
The Impact of an ICU Liaison Nurse on Discharge Delay in Patients after Prolonged ICU Stay
Feb 01, 2006; ... SUMMARY The mismatch between intensive care unit (ICU) bed availability and demand may be improved with timely patient discharges, however little is known about the nature and contributing factors of discharge delays. This study investigated the impact of a specific intervention-the ICU ...
Motor Neurone Disease Presenting as Postoperative Respiratory Failure
Feb 01, 2006; ... SUMMARY We present the case of a woman who developed respiratory failure in the postoperative period secondary to previously unsuspected motor neurone disease. This case highlights the difficulty in detecting subtle neuromuscular weakness during anaesthetic pre-assessment. Key ...
Anaesthesia for a Patient with Congenital Methaemoglobinaemia and Temporomandibular Joint Ankylosis
Feb 01, 2006; ... SUMMARY We report a 10-year-old child with congenital methaemoglobinaemia and temporomandibular joint ankylosis who presented for ophthalmic surgery. He had had two previous anaesthetics in another institution. The first was short and uneventful, and no abnormality was noted. During the ...
A National Survey of Infection Control Practice by New Zealand Anaesthetists
Feb 01, 2006; ... SUMMARY Anaesthetists have an important role in preventing nosocomial infection. Failures in this role have resulted in critical reports in the media. We ascertained the current practices of New Zealand anaesthetists relating to infection control, by distributing a questionnaire to all ...
An Unusual Presentation of a Pituitary Tumour in the Early Postpartum Period
Feb 01, 2006; ... SUMMARY The case of a parturient, who first presented with a partial oculomotor nerve palsy shortly after caesarean delivery while participating in a clinical trial, is presented. The anaesthesia for the caesarean delivery involved a combined spinal-epidural with intrathecal bupivacaine ...
Refractory Hypotension During Combined General and Epidural Anaesthesia in a Patient on Tricyclic Antidepressants
Feb 01, 2006; ... SUMMARY We report a case of refractory hypotension that occurred after epidural injection of local anaesthetic, in a patient who was receiving tricyclic antidepressant therapy and was under general anaesthesia. The patient failed to respond to repeated injections of appropriate doses of ...
Anaesthesia for Major Orthopaedic Surgery in a Child with an Acute Tracheobronchial Injury
Feb 01, 2006; ... SUMMARY A 12-year-old boy presented after a motorbike accident with mediastinal and cervical emphysema but no pneumothorax, minor head injury and several fractures including a comminuted open leg fracture. The child had no signs of respiratory compromise and was stable. The presumed ...
Post-traumatic Severe Fat Embolism Syndrome with Uncommon CT Findings
Feb 01, 2006; ... SUMMARY Although the diagnosis of fat embolism syndrome is usually based on clinical findings, we describe ill-defined centrilobular and subpleural nodules in addition to ground-glass opacities and consolidation on a computed tomography scan of the chest in a trauma patient with fat ...
Perioperative Pulse Contour Cardiac Output Analysis in a Patient with Severe Cardiac Dysfunction
Feb 01, 2006; ... SUMMARY We describe a patient with severe left ventricular dysfunction simultaneously monitored with pulse contour cardiac output (PiCCO) analysis, a continuous cardiac output pulmonary artery catheter (continuous COPAC) and intraoperative transoesophageal echocardiography ...
Laryngotracheal Hypoplasia-A Rare Cause of Difficult Intubation
Feb 01, 2006; ... SUMMARY Generalized hypoplasia of the larynx and trachea is a very rare condition with only one case reported in the literature. A pregnant woman presented for an emergency laparotomy under general anaesthesia. Endotracheal intubation with conventional sizes of tracheal tubes failed, ...
Retained throat packs represent a potentially catastrophic airway hazard
Feb 01, 2006; ... In accordance with accepted practice both worldwide and in our institution, a throat pack was inserted into the pharynx of a nine-year-old boy undergoing surgical removal of six teeth under general anaesthesia. Following oral intubation of the trachea, a foam pad (Defries Industries, ...
ERRATA
Feb 01, 2006; ... Pfitzner J, Pfitzner L. The theoretical basis for using apnoeic oxygenation via the non-ventilated lung during one-lung ventilation to delay the onset of arterial hypoxaemia. Anaesth Intensive Care 2005; 33: 794 - 800. Page 796, paragraph 7, line 3: 'P^sub A^O^sub 2^' should read 'P^sub ...
Two cases of heparin induced thrombocytopenia type II post cardiopulmonary bypass
Feb 01, 2006; ... Heparin-induced thrombocytopenia (HIT) type II is an uncommon but serious complication of heparin therapy. It usually begins between 5 and 15 days following the initiation of heparin therapy. It is known to be immune-mediated. We recently encountered two cases of HIT type II, which began ...
A novel approach to locate the suprascapular nerve in a patient with a shoulder tumour: The specular symmetry technique
Feb 01, 2006; ... The suprascapular nerve provides sensory fibres to about 70% of the shoulder joint, including the superior and postero-superior regions and capsule and some of the surrounding soft tissues'. The suprascapular nerve block is used in the diagnosis and the treatment of shoulder pain conditions2 4 ....
Postoperative coagulopathy after liver resection-implications for epidural analgesia
Feb 01, 2006; ... Postoperative coagulopathy has been previously reported after liver resection1. For this reason, we conducted a retrospective audit of liver resections performed in our hospital to look at the postoperative coagulation profile of the patients and its influence on epidural catheter removal. The ...
R-Hirudin for cardiopulmonary bypass/R-Hirudin for cardiopulmonary bypass-Reply
Feb 01, 2006; ... I read with interest the recent case report of r-hirudin use for cardiopulmonary bypass by Manikappa et al published in the June 2005 issue of the Journal1. The authors are to be congratulated for their successful outcome and their detailed description of the modified ecarin clotting ...
Clinical Manual and Review of Transesophageal Echocardiography
Feb 01, 2006; ... Clinical Manual and Review of Transesophageal Echocardiography. Edited by Joseph P. Matthew and Chakib M. Ayoub; McGraw-Hill Australia Pty Ltd, Locked Bag 2233 North Ryde, BC N.S. W. 1670; $214.95; 235x190 mm; pp. 427; ISBN 0-07-142230-7. Transoesophageal echocardiography has achieved a ...
Further reason for maintaining a positive CVP during neurosurgery in the sitting position/Further reason for maintaining a positive CVP during neurosurgery in the sitting position-Reply
Feb 01, 2006; ... The 'Practical Approach' review and accompanying 'Case Series' on neurosurgery in the sitting position by Dr Domaingue1 are useful additions to the previous reports and studies on the subject. To maintain a positive central venous pressure (CVP) and reduce the risk of intraoperative hypotension, ...
Anesthesia for Congenital Heart Disease
Feb 01, 2006; ... Anesthesia for Congenital Heart Disease. D. B. Andropoulos, S. A. Stayer, I. A. Russell; Blackwell Publishing, 550 Swanston Street, PO Box 378, Carlton South, Victoria; $481.00, 280×220 mm, pp. 498, ISBN 1-4051-2060-6. This book draws contributions from a number of the renowned ...
Year Book of Critical Care Medicine 2005
Feb 01, 2006; ... Year Book of Critical Care Medicine 2005. R. P. Dellinger, J. E. Parrillo, R. A. Balk, C. Bekes, T. Dorman, D. J. Dries; Elsevier Australia, 30-52 Smidmore Street, Marrickville, N.S.W. 2204; $188.00, 235×150 mm; pp. 377; ISBN 0-323-02104-2. Year Book Of Critical Care Medicine 2005 aims ...
iPOD, iSAW, iCONQUERED operating theatre-essential anaesthetic equipment?
Feb 01, 2006; ... How many so far have suffered the slings and arrows of outrageous operating theatre CD collections? We all know the contents of said collections ... all three CDs are scratched, in wrongly labelled cases and your invidious 'choice' is between Kenny G's Christmas Hits, Val Doonican and Nana ...
A design fault of the Dräger Cato anaesthesia workstation/A design fault of the Dräger Cato anaesthesia workstation-Reply
Feb 01, 2006; ... Recently there have been reports of some newer anaesthetic machines not alarming when there was discontinuation of the breathing circuit1-3. The breathing circuit was opened to air, resulting in progressive decline in the inspired concentration of anaesthetic agents. This places patients at risk ...
Recovery from Bispectral Index-guided Anaesthesia/Recovery from Bispectral Index-guided anaesthesia-Reply
Feb 01, 2006; ... I have read with interest the trial results by Leslie et al on recovery from Bispectral Index-guided anaesthesia1. I note that the use of this monitoring reduced the time to being ready for post-anaesthesia care unit discharge by three minutes. Of course the relevant finding is the total ...
Critical Care Toxicology: Diagnosis and Management of the Critically Poisoned Patient
Feb 01, 2006; ... Critical Care Toxicology: Diagnosis and Management of the Critically Poisoned Patient. J. Brent, K. L. Wallace, K. K. Burkhart, S. D. Phillips, J. W. Donovan; Elsevier Australia, 30-52 Smidmore Street, Marrickville, N.S.W. 2204; $321.20; 280× 220 mm; pp. 1690; ISBN 0-8151-4387-7. When ...
Mentor to a Profession
Feb 01, 2006; ... Mentor to a Profession. L. E. Morris, M. E. Schroeder, M. E. Warner; Wood Library-Museum of Anesthesiology, 520 N Northwest Highway, Park Ridge, Illinois 6006, U.S.A.; $US45.00; 260×185 mm; pp. 260; ISBN 1-889595-13-6. Ralph Milton Waters was a significant figure in the development of ...
Future Meetings
Feb 01, 2006; ... 2006 February 8-10, Leura, Blue Mountains, New South Wales: Critical Care Echocardiography Advanced Course. Venue: Nepean Hospital, Penrith, New South Wales. Information: Ms Leanne Meyn, Intensive Care Unit, Nepean Hospital, P O Box 63, Penrith, N.S.W. 2751. Tel: 02 4734 2490. Website: ...