Latest Articles
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Anaesth Intensive Care · Jan 2025
Culprit allergen prevalence in polyreactive individuals reflects prescription trends: A tool for estimating comparative anaphylaxis risk using the example of neuromuscular blocking agents.
Prescription-event monitoring (PEM) is the current gold standard for determining the risk of rare drug side-effects and comparing the risk between agents; however, spontaneous or prompted reporting schemes have low case-detection rates and exposure may be difficult to estimate. A novel method is described that allows a comparative adverse event rate between two drugs to be estimated-based on patterns of cross-reactivity-requiring only a sample of cases and no direct knowledge of drug exposure rates. Agreement was compared between the novel method and historical estimates of risk using PEM for comparative risk of rocuronium versus vecuronium anaphylaxis. ⋯ The median risk from historical estimates was 4.7 times, while the previous PEM estimate in Western Australian was 3.0 times. Using a subgroup of patients susceptible to the same side-effect of two drugs, the relative exposure rate and corrected comparative risk of an adverse effect can be estimated for a population. Using this technique, which requires assessment only of cases to estimate relative exposure rates, we have estimated that the risk of anaphylaxis from rocuronium to be 2.2 times that of vecuronium in Western Australia.
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Letter
EXPRESS: Pharmacokinetic advantages of lipophilic statins over rosuvastatin in COVID-19 management.
Not applicable.
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Anaesth Intensive Care · Jan 2025
Association of medical emergency team activation in the 24-hour postoperative period with length of stay and in-hospital mortality.
Medical emergency team (MET) activations were designed to improve patient safety and outcomes by providing timely and specialised care to patients experiencing clinical deterioration. The primary objective of this study was to describe the association between MET events in the early (24-h) postoperative period and in-hospital mortality as well as length of stay. A retrospective data linkage study was performed of prospectively collected data from patient administrative data and the MET database at Launceston General Hospital located in Tasmania, Australia. ⋯ Notably, staff concern as a trigger for MET activation was associated with a hazard nearly as great as chest pain. Other MET triggers that reached statistical significance were bleeding, respiratory rate more than 36/min, peripheral oxygen saturations less than 84% and systolic blood pressure less than 80 mmHg. Despite being frequent, MET events should be regarded as a serious marker of an adverse patient journey that may warrant higher resource allocation.