Anaesthesia
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Haemorrhage remains an important cause of maternal mortality worldwide. Cell salvage carries a theoretical risk of amniotic fluid embolus syndrome and is too expensive for use in many parts of the world. To explore cheaper options, we investigated whether a leucocyte depletion filter alone removes components of pure amniotic fluid. ⋯ Lamellar bodies and fetal squames were almost completely removed (filtration efficacy 96.6% and 99.9%, respectively; p<0.0001 and <0.0004), and hair was completely removed (p=0.002). Filtration had no effect on concentrations of α-fetoprotein, tissue factor or endothelin-1, or on the presence of meconium or vernix. Additional work is required to evaluate whether cell salvage using filtration alone may be useful in maternal haemorrhage in the developing world.
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Alcohol-related disease adversely affects the outcome of critically ill patients. The burden of this in Scotland is higher than elsewhere in the United Kingdom. In a prospective observational study of all patients admitted to the 24 intensive care units in Scotland we assessed the proportion of admissions in which alcohol-related disease was implicated. ⋯ The alcohol-related group had a significantly longer period of ventilation with a median (IQR [range]) of 2 (1-6 [0-176]) vs 1 (0-4 [0-136]) days (p<0.005). Admissions from an area of deprivation were more likely to be related to alcohol. Alcohol-related admissions have a significant impact on Scottish intensive care services, with an extrapolated cost of £8.9 million per year.