British journal of anaesthesia
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Several physiological scoring systems (PSS) have been proposed for identifying those at risk of deterioration. However, the chosen specific physiological values chosen and the scores allocated have not been prospectively validated. In this study, we investigate the relative contributions of the ventilatory frequency, heart rate, arterial pressure, temperature, oxygen saturation, and conscious level to mortality in order to devise a robust scoring system. All data were collected on admission to the emergency unit. Precise 'intervention-calling scores' could then be derived to trigger interventions. ⋯ A simple validated scoring system to predict mortality in medical patients with precise 'intervention-calling scores' has been developed.
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Comparative Study
Multi-level approach to anaesthetic effects produced by sevoflurane or propofol in humans: 1. BIS and blink reflex.
The relative roles of forebrain and brainstem in producing adequate anaesthesia are unclear. ⋯ The blink reflex (brainstem function) is more sensitive to sevoflurane or propofol than BIS (forebrain function). Sevoflurane suppresses the blink reflex more than propofol. Different k(e0)s for blink reflex vs BIS indicate different effect sites.
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Anatomical dead space is usually measured using the Fowler equal area method. Alternative methods include the Hatch, Cumming, and Bowes methods, in which first, second, and third order polynomials, respectively, fitted to an expired CO2 volume vs expired volume curve, intercept the x-axis at the anatomical dead space. This study assessed systematic errors and susceptibility to noise of the Fowler, Hatch, Cumming, and Bowes dead spaces calculated over 40-80% of the CO2 expirogram. ⋯ The Fowler method shows greatest susceptibility to measurement noise and the Hatch method exhibits the largest systematic error. The Cumming method, which exhibits both low bias and low noise susceptibility, is preferred for estimating anatomical dead space from CO2 expirograms.
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Neuropathic pain is associated with significant co-morbidity, including anxiety and depression, which impact considerably on the overall patient experience. However, pain co-morbidity symptoms are rarely assessed in animal models of neuropathic pain. To improve the clinical validity of a widely used rodent model of traumatic peripheral neuropathy, we have investigated fear-avoidance- and depression-related behaviours in nerve-injured and sham-operated mice over a 4 week period. ⋯ These data demonstrate that pain behaviour in nerve-injured C57BL/6J mice was not associated with alterations in emotion-related behaviours.