Anaesthesia
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Review Meta Analysis Comparative Study
Comparative efficacy and safety of the Ambu(®) AuraOnce(™) laryngeal mask airway during general anaesthesia in adults: a systematic review and meta-analysis.
The Ambu AuraOnce™ laryngeal mask is a non-inferior alternative to the LMA Classic and the LMA Unique.
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Randomized Controlled Trial
Does individual experience affect performance during cardiopulmonary resuscitation with additional external distractors?
Cardiopulmonary resuscitation is perceived as a stressful task. Additional external distractors, such as noise and bystanders, may interfere with crucial tasks and might adversely influence patient outcome. We investigated the effects of external distractors on resuscitation performance of anaesthesia residents and consultants with different levels of experience. ⋯ No interaction was observed between additional distractors and experience level (p = 0.4480). External distractors markedly reduce the quality of cardiopulmonary resuscitation. This suggests that all team members, including senior healthcare providers, require training to improve performance under stressful conditions.
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As part of the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland concerning accidental awareness during general anaesthesia, we issued a questionnaire to every consultant anaesthetist in each of 46 public hospitals in Ireland, represented by 41 local co-ordinators. The survey ascertained the number of new cases of accidental awareness becoming known to them for patients under their care or supervision for a calendar year, as well as their career experience. Consultants from all hospitals responded, with an individual response rate of 87% (299 anaesthetists). ⋯ None of the 46 hospitals had a policy to prevent or manage awareness. Similar to the results of a larger survey in the UK, the disparity between the incidence of awareness as known to anaesthetists and that reported in trials warrants explanation. Compared with UK practice, there appears to be greater use of depth of anaesthesia monitoring in Ireland, although this is still infrequent.
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High-intensity renal replacement therapy protocols in intensive care patients with acute kidney injury have failed to translate to improved patient outcomes when compared with lower-intensity protocols. This retrospective study explored the clinical and economic impacts of switching from a 30-35 ml.kg(-1) .h(-1) (high-volume) to a 20 ml.kg(-1) .h(-1) (low-volume) protocol. ⋯ A 25% reduction in daily replacement fluid usage was observed, equating to a cost saving of over £27 000 per annum. In conclusion, a switch from high- to low-volume continuous haemodiafiltration had minimal effects on clinical outcomes and resulted in marked cost savings.