Anaesthesia
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Letter Case Reports
Preventing confusion due to possibly retained long lines.
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We wished to investigate whether intensive care represents good value for money to the National Health Service in the UK using cost-effectiveness analysis. We developed a cost-effectiveness model using secondary data sources to estimate the incremental cost per quality adjusted life year gained of treatment in intensive care vs non-intensive care treatment in adults. Estimates of hospital mortality with and without intensive care were obtained from seven published studies and from data published by the Intensive Care National Audit and Research Centre. ⋯ This figure is sensitive to the mortality risk reduction associated with intensive care. Despite the high daily cost of intensive care, its cost-effectiveness is excellent and compares favourably with other commonly used health interventions. Our findings suggest that adult intensive care represents good value for money.
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This study was undertaken to investigate and calibrate the isoflurane output of an Oxford Miniature Vaporiser (OMV) draw-over vaporiser with reversed gas flows. Plenum or Boyles type machines have gas flowing left to right through the apparatus. Draw over anaesthesia systems, in contrast, traditionally have the carrier gas, air plus oxygen, flowing right to left through the vaporiser. ⋯ The predictable output of the OMV vaporiser assumes the correct direction of gas flows for the device. There are many second hand right to left OMV vaporisers for sale to developing countries where the nuances of vaporiser orientation add unnecessarily to the desired simplicity of anaesthesia. A simple calibration scale for reversed gas flows through the OMV vaporiser would be useful.