Anaesthesia
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Poor wellbeing and stress in UK anaesthetic trainees impacts significantly on clinical performance, workforce retention and patient care. This study aimed to provide an overview of the evidence in this field and to explore the factors affecting wellbeing and stress in UK anaesthetic trainees. ⋯ The wide scope of phenomena of interest and measurement tools emphasises the challenge of defining and researching the concept of wellbeing. Despite these limitations, we have created a novel conceptual model of individual and external factors affecting UK anaesthetic trainees' wellbeing and stress. This supports an increased awareness and understanding of these factors, so that improvements can be made to practice and policy.
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Observational Study
Associations between pre-operative iron deficiency and postoperative infection in patients undergoing major surgery (CARIPO): a prospective observational study.
Iron deficiency, with or without anaemia, is common during the peri-operative period. It has been hypothesised that pre-operative iron deficiency is associated with an increased incidence of postoperative infection. We designed the CARIPO prospective observational study to assess the incidence of postoperative infection in patients with and without iron deficiency undergoing a variety of major surgeries. ⋯ Iron deficiency was not associated with a higher rate of postoperative infection relative to an iron replete state. While iron deficiency was associated with a higher rate of surgical site infection, this result is hypothesis-generating, and further prospective studies are required.
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Review
Mechanisms underlying neurocognitive dysfunction following critical illness: a systematic review.
Cognitive impairment is a significant healthcare problem globally and its prevalence is projected to affect over 150 million people worldwide. Survivors of critical illness are impacted frequently by long-term neurocognitive dysfunction regardless of presenting illness, but the mechanisms are poorly understood. The goal of this review was to synthesise the existing evidence regarding potential mechanisms underlying neurocognitive dysfunction following critical illness in order to guide potential avenues for future research. ⋯ The underlying pathophysiology of neurocognitive decline after critical illness is not yet understood fully. The mechanisms implicated in other neurodegenerative conditions suggest that this may represent an accelerated version of the same processes. Large scale studies are required to further elucidate the cause of this significant problem for survivors of critical illness.