Anaesthesia and intensive care
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Anaesth Intensive Care · Dec 1993
A survey of cardiopulmonary bypass perfusion practices in Australia in 1992.
Twenty-four cardiopulmonary bypass (CPB) perfusion units around Australia were surveyed to determine the characteristics of CPB perfusion as practised in Australia in 1992. Twenty completed survey forms were received. Findings were compared with those of a similar study performed by one of the authors for the year 1986. ⋯ A range of minimum perfusion pressures for CPB is noted, whereas most units employ similar minimum perfusion flows. Methods of central nervous system and renal protection are mainly hypothermia and diuretics, respectively, with a scattering of other techniques. Staffing of CPB perfusion units is essentially unchanged since 1986 and at least five units had no medical perfusionist appointed in 1992.
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Anaesth Intensive Care · Dec 1993
Cytokines in plasma and ultrafiltrate during continuous arteriovenous haemofiltration.
Cytokines are considered to be important mediators in the pathophysiology of sepsis and septic shock. We investigated if continuous arteriovenous haemofiltration (CAVH) could be used to remove excessive amounts of the cytokines tumour necrosis factor-alpha (TNF alpha), interleukin (IL)-1 alpha and IL-6 from peripheral blood in critically ill patients. Nine septic patients with renal failure were treated with CAVH. ⋯ IL-1 alpha was detectable in both plasma and ultrafiltrate in four patients. All patients developed multi-organ failure and septic shock and seven died. It is concluded that TNF alpha and IL-1 alpha but not IL-6 can be removed by CAVH in patients with sepsis.
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The collective experience of 187 patients who suffered awareness during general anaesthesia is presented. This has been collated from letters solicited in September 1992 by a women's magazine widely distributed throughout Australia and New Zealand. ⋯ The findings show a disturbing symptomatology ranging over all modalities of sensation and of postoperative psychological and psychiatric disturbances. The letters also reveal that in most cases understanding of awareness and its proper management by medical personnel was poor or totally lacking.
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Anaesth Intensive Care · Dec 1993
The Training/Examination Programme in Intensive Care, Australian and New Zealand College of Anaesthetists. 1. Training.
Unlike training for programmes in other countries which have published details of training programmes for Intensive Care Medicine, the training programme of the Australian and New Zealand College of Anaesthetists does not require certification in a primary specialty, although it is possible to combine training in Intensive Care and Anaesthetics. The lynchpin of the programme is the requirement that training can be undertaken in recognised posts in intensive care units which are approved by the College. ⋯ The Units are assessed by physical inspection by assessors appointed by the College. The programme includes a Final Examination in Intensive Care.