Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 2012
A pilot study of short-term high-pressure support ventilation in persistent sudden-onset rapid breathing.
Sudden-onset rapid breathing commonly occurs in previously calm, invasively-ventilated patients. In most cases it can be resolved easily by traditional management techniques, but other cases can be very challenging. We enrolled 40 patients who failed traditional interventions and performed short-term high-pressure support ventilation (HPSV). ⋯ The age and Glasgow Coma Scale also had high predicted ability (both with areas under the curve of ≥0.8). In conclusion, short-term HPSV relieved persistent sudden-onset rapid breathing. However, it was not effective in the relatively young and conscious patients with relatively high support pressure, peak pressure, minute ventilation and heart rate.
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Anaesth Intensive Care · Nov 2012
Approaching families for organ donation-intensivists' perspectives.
In Australia the initial approach to families for organ donation is almost always undertaken by intensivists. There is, however, a paucity of literature on intensivists' views on this approach and how their approach compares with recommendations in published literature on this subject. This study consisted of a survey of the views of intensive care consultants and senior intensive care registrars in the four major teaching hospitals in Perth, Western Australia, on how they approached families for organ donation. ⋯ The survey results indicate that most intensive care consultants felt adequately trained to approach families for organ donation, but almost half of the group surveyed would prefer a collaborative approach with either a donor co-ordinator or a colleague with additional training on this subject. Despite recommendations in the literature and from the Australian and New Zealand Intensive Care Society to determine the registration status of potential donors on the Australian Organ Donation Registry prior to discussions with families, this was not always undertaken. In addition, the benefits of organ donation were not always discussed with families, nor were the reasons for refusal of consent sensitively explored.
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Anaesth Intensive Care · Nov 2012
The self-pressurising air-Q® Intubating Laryngeal Airway for airway maintenance during anaesthesia in adults: a report of the first 100 uses.
The self-pressurising air-Q® Intubating Laryngeal Airway is a new, commercially available, supraglottic airway device that incorporates a self-regulating periglottic cuff. In this retrospective review, we describe our initial clinical experience using the device in 100 patients. The ease and number of insertion attempts, airway seal pressure, device positioning, intubation success and oropharyngeal morbidity were recorded. ⋯ Eleven percent of patients complained of sore throat postoperatively before discharge. In our series, the air-Q Intubating Laryngeal Airway performed adequately as a primary airway during anaesthesia with respect to ease of insertion, adequacy of airway maintenance and as a conduit for intubation in both anticipated and unanticipated difficult airways. Although our initial experience is positive, further investigation with larger numbers of observations are needed as the upper limits of the 95% confidence intervals for device failure (the worst failure rate the clinician could expect) are still high.