Anaesthesia and intensive care
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Anaesth Intensive Care · Jan 2016
Characteristics of sepsis-induced cardiac dysfunction using speckle-tracking echocardiography: a feasibility study.
Septic cardiomyopathy is commonly encountered in patients with severe sepsis and septic shock. This study explores whether novel global and segmental echocardiographic markers of myocardial deformation, using two-dimensional speckle tracking, are associated with adverse sepsis outcomes. We conducted a retrospective observational feasibility study, at a tertiary care centre, of patients admitted to the ICU with a diagnosis of sepsis who underwent an echocardiogram within the first week of sepsis diagnosis. ⋯ Speckle-tracking echocardiography can be performed feasibly in patients in sepsis. Global and segmental left ventricular deformation indices are associated with ejection fraction. Further studies need to evaluate the ability of these new indices to predict sepsis outcomes.
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Anaesth Intensive Care · Jan 2016
Procedural pain does not raise plasma levels of cortisol or catecholamines in adult intensive care patients after cardiac surgery.
The gold standard for quantification of pain is a person's self-report. However, we need objective parameters for pain measurement when intensive care patients, for example, are not able to report pain themselves. An increase in pain is currently thought to coincide with an increase in stress hormones. ⋯ There was no statistically significant association between numeric rating scale scores and change in cortisol, adrenaline, and noradrenaline plasma levels during the procedure. Despite current convictions that pain coincides with an increase in stress hormones, procedural pain was not associated with a significant increase in plasma stress hormone levels in patients who had undergone cardiac surgery. Thus, plasma levels of cortisol, adrenaline, and noradrenaline seem unsuitable for further research on the measurement of procedural pain.
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Anaesth Intensive Care · Jan 2016
Activities of a Medical Emergency Team: a prospective observational study of 795 calls.
Relatively few papers have examined specific causes for Medical Emergency Team (MET) review and the assessment and management undertaken by the MET. The aim of our study was to describe the type of patients who require MET review, the reasons such reviews are requested and the subsequent immediate management of these patients. Our prospective single-centre observational study was conducted in a university-affiliated tertiary hospital in New Zealand between October 2012 and September 2013. ⋯ This may guide education and training of ward staff to improve detection of deteriorating patients and prevent or pre-emptively manage causes of such deterioration prior to MET criteria being reached. The association between time of day and crisis recognition suggests the hospital system does not reliably detect deteriorating patients. This questions the adequacy of monitoring of deteriorating patients on hospital wards.