Anaesthesia and intensive care
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Early evidence suggests that checklists are one way of ensuring required processes of care are delivered to intensive care unit patients. Evidence to date however, has not explicitly detailed methods of checklist validation in these settings. This study aimed to test the validity of a 'process-of-care' checklist for measuring and ensuring daily care delivery in an intensive care unit. ⋯ The two forms of documentation were significantly correlated (P=0.01) for all but one of the checklist items (pain). Findings provided support for the concurrent validity of an intensive care unit process-of-care checklist. Further research is required for checklist validity and reliability testing prior to, or in conjunction with, a planned prospective intervention study.
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Major burns have previously been considered a contraindication to solid organ donation. We present two cases of successful organ donation and transplantation, after Maastricht category III cardiac death in adult patients with non-survivable burns injury. The implications of the outcome of these cases are that major burns should not be considered a contraindication to organ donation, and that cardiac death provides opportunity for patients with non-survivable burns to contribute to the pool of potential organ donors.
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Anaesth Intensive Care · May 2013
Randomized Controlled TrialEffects of dexmedetomidine infusion on laryngeal mask airway removal and postoperative recovery in children anaesthetised with sevoflurane.
We investigated the effects of dexmedetomidine infusion on the end-tidal concentration of sevoflurane required for smooth removal of the laryngeal mask airway (LMA) and on the incidence of respiratory complications during postoperative recovery in paediatric patients anaesthetised with sevoflurane. Eighty-seven patients (ASA 1 or 2, aged 3-7 years) were randomly allocated to receive saline (Group C), 0.5 µg/kg dexmedetomidine (Group D(1)), or 1 µg/kg dexmedetomidine (Group D(2)) after LMA insertion. A predetermined end-tidal sevoflurane concentration for each patient was determined using the Dixon's up-and-down method (starting at 2.2% and step was 0.2%). ⋯ The incidence of breath-holding was significantly lower in Group D(2) (3%) than in Group C (27%; P=0.009), but comparable between Groups D(1) (17%) and C (P=0.385). The incidence of severe coughing was significantly lower in Groups D(1) (14%) and D(2) (6%) as compared to Group C (39%; P=0.005), but comparable between Groups D(1) and D(2) (P=0.323). In conclusion, dexmedetomidine infusion produced a dose-dependent decrease in the end-tidal concentration of sevoflurane required for smooth LMA removal in children and was associated less agitation in the post-anaesthetic care unit.
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Anaesth Intensive Care · May 2013
Letter Case ReportsDelirium and Takotsubo cardiomyopathy following cardiac surgery.