British journal of anaesthesia
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Observational Study
Intraoperative venous congestion and acute kidney injury in cardiac surgery: an observational cohort study.
Increased intravascular volume has been associated with protection from acute kidney injury (AKI), but in patients with congestive heart failure, venous congestion is associated with increased AKI. We tested the hypothesis that intraoperative venous congestion is associated with AKI after cardiac surgery. ⋯ Intraoperative venous congestion was independently associated with increased AKI after cardiac surgery.
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Observational Study
Observational study of anaesthesia workflow to evaluate physical workspace design and layout.
The safety and efficiency of anaesthesia care depend on the design of the physical workspace. However, little is known about the influence that workspace design has on the ability to perform complex operating theatre (OT) work. The aim of this study was to observe the relationship between task switching and physical layout, and then use the data collected to design and assess different anaesthesia workspace layouts. ⋯ Our study showed that current operating theatre layouts do not fit work demands. We report a simple method that facilitates a quick layout design assessment and showed that the anaesthesia workspace can be improved to better suit workflow and patient care. Overall, this arrangement could reduce anaesthesia workload while improving task flow efficiency and potentially the safety of care.
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Observational Study
Socioeconomic deprivation and long-term outcomes after elective surgery: analysis of prospective data from two observational studies.
Socioeconomic deprivation is associated with health inequalities. We explored relationships between socioeconomic group and outcomes after elective surgery in the UK National Health Service (NHS). ⋯ Socioeconomic deprivation is associated with worse long-term outcomes after elective surgery. This risk factor should be considered when planning perioperative care for patients from deprived areas.
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With the increasing prevalence of children who are overweight and with obesity, anaesthesiologists must determine the optimal dosing of medications given the altered pharmacokinetics and pharmacodynamics in this population. We therefore determined the single dose of dexmedetomidine that provided sufficient sedation in 95% (ED95) of children with and without obesity as measured by a minimum Ramsay sedation score (RSS) of 4. ⋯ ChiCTR1800014266.