European journal of anaesthesiology
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The Modified Early Warning Score is a validated assessment tool for detecting risk of deterioration in patients at risk on medical and surgical wards. ⋯ This study shows that the Modified Early Warning Score is a useful predictor of mortality in the ICU, 30-day mortality and length of stay in the ICU.
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Randomized Controlled Trial Comparative Study
Labour analgesia: a randomised, controlled trial comparing intravenous remifentanil and epidural analgesia with ropivacaine and fentanyl.
To compare the analgesic efficacy and side-effects of remifentanil intravenous patient-controlled analgesia (IVPCA) with walking epidural analgesia (EDA) during labour. ⋯ Remifentanil IVPCA and epidural provided effective analgesia, with high maternal satisfaction scores and reassuring neonatal outcome. Remifentanil produced more maternal sedation and oxygen desaturation. Close monitoring is, therefore, mandatory.
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A unifying hypothesis which satisfactorily explains the clinical syndrome of heart failure has proved elusive. A deeper understanding of the underlying pathophysiology has led to the development of more complex models and, as a result, the evolution of new treatment strategies. ⋯ Although vasodilators undoubtedly play a major role in the management of patients with heart failure, the relative importance of venodilatation remains unclear. The purpose of this article is to discuss the clinical evidence supporting the use of drugs with venodilating properties in surgical patients with heart failure.
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Cardiac dysfunction following open heart surgery is a major determinant of subsequent morbidity and mortality. ⋯ The preoperative model including variables obtained easily in routine clinical work performed well and was improved only slightly by inclusion of intraoperative variables. Performance was better than those of the five previously published risk scores.
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This study is the first attempt in the UK to establish the views of senior anaesthetic trainees in relation to acquiring the attributes of an 'ideal' anaesthetist, and how these could be met by a simulation course. ⋯ This study on the training needs of senior anaesthetic trainees, who have described the behavioural characteristics of an 'ideal anaesthetist'. Some of these attributes can be taught by simulation training. Our results should be used in the design of future simulation courses.