Anaesthesia and intensive care
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Anaesth Intensive Care · Mar 2013
Effectiveness of a patient blood management data system in monitoring blood use in Western Australia.
The aim of this paper is to describe a linked patient blood management (PBM) data system and to demonstrate its usefulness by presenting the blood usage data obtained. Our existing datasets already collected much of the required information in relation to PBM. However, these datasets were not linked. ⋯ The post-transfusion haemoglobin in RBC transfusions exceeded 100 g/l in 33% of patients. Databases were successfully linked to produce a powerful tool to monitor blood utilisation and transfusion practices within a pilot PBM program. This will facilitate effective targeting of PBM strategies and ongoing monitoring of their impact.
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Anaesth Intensive Care · Mar 2013
Case ReportsSpontaneous coronary artery dissection in pregnancy requiring emergency caesarean delivery followed by coronary artery bypass grafting.
Spontaneous coronary artery dissection is a rare and often fatal condition of pregnancy. The long-term morbidity is unknown, but a small cohort of patients develop severe ventricular dysfunction as a consequence. ⋯ There is little information about the long-term outcomes and the specific anaesthesia management of combined emergency caesarean delivery and cardiac surgery in pregnancy for spontaneous coronary artery dissection. Therefore, we outline our multidisciplinary management of this critically ill pregnant woman.
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Anaesth Intensive Care · Mar 2013
Eosinopenia as a predictor of unexpected re-admission and mortality after intensive care unit discharge.
Predicting unexpected intensive care unit (ICU) re-admission and mortality after critical illness is difficult. This study assessed the associations between eosinopenia on the day of ICU discharge and outcomes after critical illness. This retrospective cohort study involved a total of 1446 critically ill patients who survived their first ICU admission between January 2009 and March 2010 in a multidisciplinary ICU in Western Australia. ⋯ Eosinopenia remained associated with ICU re-admission (odds ratio 2.50, 95% confidence interval 1.38-4.50; P=0.002) and post-ICU mortality (hazard ratio 2.65, 95% confidence interval 1.77-3.98; P=0.001) after adjusting for age, gender, nocturnal discharge, neutrophil count at ICU discharge, elective surgical admission, Sequential Organ Failure Assessment scores, Acute Physiology and Chronic Health Evaluation II predicted mortality and chronic medical diseases. Eosinopenia at ICU discharge explained about 8.4% of the variability and was the third most important factor in explaining the variability in survival after ICU discharge. In summary, eosinopenia at ICU discharge was associated with an increased risk of unexpected ICU re-admission and post-ICU mortality.