British journal of anaesthesia
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The transpulmonary thermodilution (TPTD) technique for measuring cardiac output (CO) has never been validated in the presence of a left-to-right shunt. ⋯ The TPTD technique is a feasible method of measuring CO in paediatric animals with a left-to-right shunt.
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Cell salvage is used in obstetric surgery as part of a blood conservation strategy in our Trust. This carries a theoretical risk of amniotic fluid embolism and also a risk of fetal red cells being present in the re-infusion, resulting in alloimmunization. In this study, we attempted to quantify the risk of antibody formation from re-infusion of autologous blood after Caesarean section. ⋯ The implementation of a blood conservation strategy which includes the use of intraoperative cell salvage appears safe and can contribute to a reduction in the number of blood transfusions to the obstetric population. We remain uncertain of the significance of fetal red cell contamination.
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The aim of this study was to explore anaesthetists' perceptions and experience of the implementation of multi-source feedback (MSF) for their performance review. ⋯ The anaesthetists interviewed in this study accepted performance review and the role of MSF in it. Anaesthetists thought anonymity an important feature of MSF, and viewed the process as an opportunity for self-improvement. To the extent that MSF was viewed by the anaesthetists as surveillance by management, this was seen as being largely benign. Rather a view of the acceptance of self-responsibility for using the information gathered to improve their own performance was held by the majority of those interviewed. While broad sampling of sources within and outside anaesthesia was desired, most value was placed on feedback from both nurses and trainees within anaesthesia. The value of feedback from surgeons was contentious, and this may reflect underlying issues with this important relationship that are yet to be explored.
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Editorial Comment
What should we be doing about fungal infections in intensive care?