Anaesthesia and intensive care
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Anaesth Intensive Care · Feb 1982
Pulmonary artery catheterisation. An assessment of risks and benefits in 220 surgical patients.
The benefits and risks of pulmonary artery catheterisation were assessed in 220 patients having cardiac or vascular surgery. Prior to induction of anaesthesia 20% of patients had pulmonary artery wedge pressure measurements which indicated the need for blood volume support, vasodilator therapy or modification of the anaesthetic induction technique. Of those patients for cardiac surgery, 38% had important changes before cardiopulmonary bypass requiring blood volume support or vasodilator therapy. ⋯ Minor complications occurred in 25% of patients (transient arrhythmias) and more serious complications occurred in 3.6% of patients. There was no mortality or long-term sequelae. We conclude that the benefits of pulmonary artery catheterisation outweigh its risks in patients having major cardiac and vascular surgery.
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Anaesth Intensive Care · Feb 1982
Biography Historical ArticleThe Yorkshire Connection--Priestley and Waterton. Ellis Gillespie Lecture 1981.
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Anaesth Intensive Care · Nov 1981
ReviewFactors affecting an anaesthetist's work: some findings on vigilance and performance.
This paper reviews factors which may influence the vigilance tasks of an anaesthetist during an anaesthetic. Vigilance tasks are found to be unlike any other automatic, repetitive or monotonous tasks. ⋯ We suggest, however, that there are many parallels between findings related to vigilance in general and the type of work done by anaesthetists. Implications of major factors are discussed, and recommendations for further study are proposed.
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Anaesth Intensive Care · Nov 1981
ReviewPathophysiology and management of raised intracranial pressure.
The mechanism of cerebral homeostasis is reviewed, paying particular attention to the way blood-brain barrier, cerebrospinal fluid and cerebral blood flow contribute to the maintenance of normal intracranial pressure. The pathophysiology of raised intracranial pressure is outlined delineating the different types of cerebral oedema. Guidelines for the management of patients with raised intracranial pressure are presented as well as the techniques of intracranial pressure monitoring.
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Anaesth Intensive Care · Nov 1981
Randomized Controlled Trial Clinical TrialSpinal anaesthesia or general anaesthesia for emergency hip surgery in elderly patients.
One hundred and thirty-two elderly patients undergoing emergency hip surgery were randomly allocated to receive subarachnoid block (SAB) or general anaesthesia (GA). Using the 125. I fibrinogen uptake test, deep vein thrombosis was found to occur in 17 of 37 patients in the SAB group and 30 of 39 patients in the GA group (P 0.05). ⋯ At 24 hours postoperatively the fall in PaO2 was similar in both groups and recovered only slowly during the first week. Twelve patients died, three in the SAB group and nine in the GA group. This difference in mortality was not statistically significant.