Anaesthesia and intensive care
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Anaesth Intensive Care · Jul 2023
Dynamic three-dimensional printing: The future of bronchoscopic simulation training?
High-fidelity models are required for technical mastery of bronchoscopic procedures in the fields of anaesthesia, intensive care, surgery and respiratory medicine. Our group has created a three-dimensional (3D) airway model prototype to emulate physiological and pathological movement. Developed from the concepts of our previously described 3D printed paediatric trachea for airway management training, this model produces movements created by injection of air or saline through a side Luer Lock port. ⋯ For surgical training, the model has high tissue realism and allows for rigid bronchoscopy. The novel and high-fidelity 3D printed airway model with dynamic pathologies represents capability to provide both generic and patient-specific advancement for all modes of anatomical representation. The prototype illustrates the potential of combining the fields of industrial design with clinical anaesthesia.
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Anaesth Intensive Care · Jul 2023
Triggers for medical emergency team activation after non-cardiac surgery.
Deterioration after major surgery is common, with many patients experiencing a medical emergency team (MET) activation. Understanding the triggers for MET calls may help design interventions to prevent deterioration. We aimed to identify triggers for MET activation in non-cardiac surgical patients. ⋯ Hypotension was the most common trigger for MET calls after non-cardiac surgery. Deterioration frequently occurred within 24 h of PACU discharge. Future research should focus on prevention of hypotension and tachycardia after surgery.
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Anaesth Intensive Care · Jul 2023
Prophylactic cannula cricothyroidotomy and percutaneous oxygen insufflation with the Rapid-O2®: A simple and effective tool for enhancing safety in difficult airway management.
Prophylactic cannula cricothyroidotomy is a recognised technique for actual or potential difficult airway management, where it confers a number of technical and non-technical benefits. Oxygenation with this technique is traditionally achieved by way of pressure-regulated, high flow jet ventilation and requires specialised equipment and considerable expertise for safe use, neither of which are always readily available. As an alternative, we describe the management of two patients with progressive upper airway obstruction in whom prophylactic cannula cricothyroidotomy and oxygen insufflation were performed using equipment which we consider is safer, widely available and already familiar to most anaesthetists throughout Australia.
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Anaesth Intensive Care · Jul 2023
ReviewIncidence of postoperative delirium in surgical patients: An observational retrospective cohort study.
SummaryPerioperative neurocognitive disorders including postoperative delirium (POD) are common complications of anaesthesia and surgery, associated with morbidity, mortality and a large economic cost. Currently, limited data are available on the incidence of POD in the New Zealand population. The objective of this study was to utilise New Zealand national level datasets to identify the incidence of POD. ⋯ A diagnosis of POD was associated with increased mortality and hospital length of stay. Our results highlight potential risk factors of POD and disparities in health outcomes in New Zealand. Additionally, these findings suggest systemic under-reporting of POD in national level datasets.