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  • 1
    Electronic Resource
    Electronic Resource
    Improvements in anaesthetic care resulting from a critical incident reporting programme (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 51 (1996), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The rôle of an anaesthetic incident reporting programme in improving anaesthetic safety was studied. The programme had been running for 4 to 5 years in three large hospitals in Hong Kong and more than 1000 incidents have been reported. The number of reports being made and frequency of the various categories of incident reported, did not alter during the study period. Sixty nine percent of incidents were considered to be preventable. Human error contributed to 76% of incidents and violations of standard practice to 30% of incidents. The programme was effective in its ability to detect latent errors in the anaesthesia system and when these were corrected, incidents did not recur. The frequency with which various contributing factors were cited did not decrease with time. With the exception of problems dealt with by specific protocol development, the study found no evidence that an increasing awareness of the problem of human error was effective in reducing this kind of problem.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1996.tb07841.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Pressure support ventilation during isoflurane anaesthesia (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 50 (1995), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We have studied the respiratory effects of 5and 10cmH2O pressure support ventilation during anaesthesia with 1.5% end-tidal concentration of isoflurane in nine healthy, spontaneously breathing, adult patients. Some of the patients demonstrated an irregular respiratory pattern with periods of apnoea and we therefore went on to study a further seven patients with a continuous 500 s recording of airflow. Pressure support ventilation augmented mean (SD) tidal volume from 212 (56) ml to 360 (88) ml at 5 cmH2O and to 509 (108)ml at 10cmH2O (n = 16, p 〈 0.05). Mean (SD) respiratory rate decreased from 26 (6)min-1 to 22 (6)min-1 at 5cmH2O and 17(5)min-1 at 10 cmH2O pressure support (n = 16, p 〈 0.05). Mean (SD) inspiratory work of breathing decreased from 1.77 (0.70) J.min-1 to 0.31 (0.36) J.min-1 at 5 cmH2O and 0.16 (0.26) J.min-1 at 10cmH2O pressure support ventilation (n = 9, p 〈 0.05). Analysis of the respiratory rhythm in the second group of seven patients revealed an oscillating respiratory pattern in four patients at 5cmH2O and six of the seven patients at 10 cmH2O pressure support ventilation. The metabolic advantage of the decreased work of breathing during pressure support ventilation during anaesthesia is unlikely to balance the disadvantage of an oscillating respiratory rhythm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1995.tb05944.x
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    The respiratory depressant effect of morphine (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 49 (1994), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The respiratory response to carbon dioxide was measured in 130 ASA 1 adult male patients from three ethnic groups, European, Nepalese, and Chinese, both before and after premedication with intramuscular morphine sulphate (200 μg.kg-1 body weight). Satisfactory results were obtained from 125 patients. Overall, there was no ethnic difference in the effect of morphine on the respiratory response to carbon dioxide, but initially the Chinese group appeared to be more sensitive in their response to carbon dioxide than the Europeans and Nepalese. However, there was a significant correlation between respiratory response to carbon dioxide and pulse rate and on restricting analysis to those patients with a pulse rate equal to or less than 72 beat.min-1, the ethnic difference in carbon dioxide response disappeared. It was concluded that there were no ethnic differences in the respiratory response to carbon dioxide before or after morphine in male Europeans, Nepalese and Chinese but that the respiratory response to carbon dioxide may be influenced by long term physical training.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1994.tb03420.x
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  • 4
    Electronic Resource
    Electronic Resource
    A comparison of omeprazole and ranitidine for prophylaxis against aspiration pneumonitis in emergency Caesarean section (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: One hundred and sixty-two Chinese women undergoing emergency Caesarean section were allocated at random on admission to the labour ward to receive one of three regimens for orally administered chemoprophylaxis against acid aspiration: ranitidine 150 mg 6 hourly with sodium citrate at induction of anaesthesia, omeprazole 40 mg 12 hourly with sodium citrate, or omeprazole 40 mg 12 hourly alone. Intragastric pH and volume were measured immediately after induction of anaesthesia. Ten patients (17%) in the omeprazole-only group, three (6%) in the omeprazole and citrate group and one (2%) in the ranitidine group had an intragastric pH 〈 2.5 and volume 〉 25 ml (p 〈 0.05). The use of sodium citrate resulted in higher intragastric pH but larger intragastric volumes (p 〈 0.05). The sodium citrate and ranitidine regimen was the most cost-effective among the three.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1992.tb02002.x
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  • 5
    Electronic Resource
    Electronic Resource
    A comparison of the effects of omeprazole and ranitidine on gastric secretion in women undergoing elective Caesarean section (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 45 (1990), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This study compares the efficacy of omeprazole and ranitidine at reducing gastric secretion in obstetric patients. Sixty-five women scheduled to undergo elective Caesarean section under general anaesthesia were randomly allocated to receive either omeprazole 40 mg or ranitidine 150 mg orally at 2200 hours the night before and at 0600 hours on the morning of surgery. Intragastric pH and volume were measured immediately after induction of anaesthesia and on completion of surgery. All patients had gastric aspirates less than 25 ml. None of the omeprazole group had an aspirate of pH less than 3.5. Six patients (19%) in the ranitidine group had aspirates of pH less than 3.5, a significant difference from the omeprazole group (p 〈 0.05). Of these six, two (6%) had aspirates of pH less than 2.5. Hence this study showed that omeprazole was more effective and consistent than ranitidine at maintaining gastric pH greater than 3.5.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1990.tb14823.x
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  • 6
    Electronic Resource
    Electronic Resource
    Gastric tonometry and prediction of outcome in the critically ill#Arterial to intramucosal pH gradient and carbon dioxide gradient (1997)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 52 (1997), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Splanchnic ischaemia is thought to be of central importance in the development of multi-organ failure and hence death in critically ill patients. It has been suggested that the arterial to gastric intramucosal pH gradient and the difference in partial pressure of carbon dioxide between gastric mucosa and arterial blood are more sensitive markers of splanchnic ischaemia than gastric intramucosal pH itself and thus should be predictors of mortality in the critically ill. We studied 62 critically ill patients within 6 h of admission to the intensive care unit and found no significant difference at 0, 12 or 24 h after admission to the study in either the arterial to gastric intramucosal pH gradient or the difference in partial pressure of carbon dioxide between gastric mucosa and arterial blood between survivors and nonsurvivors. We conclude that in contrast to gastric intramucosal pH neither the arterial to gastric intramucosal pH gradient nor the difference in partial pressure of carbon dioxide between gastric mucosa and arterial blood distinguish survivors from nonsurvivors.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1997.146-az0150.x
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  • 7
    Electronic Resource
    Electronic Resource
    Severe hyperventilation and respiratory alkalosis during pressure-support ventilation: report of a hazard (1995)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 50 (1995), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A 53-year-old woman with a flaccid quadriparesis developed severe hyperventilation and respiratory alkalosis during pressure-support ventilation. A gas leak in the ventilator system caused a loss of positive end-expiratory pressure and autocycling of the ventilator. Large ventilator breaths were then delivered because a high level of pressure support was set in a patient with low respiratory impedance. The complication is rare and its occurrence requires a combination of patient and equipment factors. Awareness of the responsible factors will promote detection and prevention of the hazard.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1995.tb05932.x
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  • 8
    Electronic Resource
    Electronic Resource
    Resistance and additional inspiratory work imposed by the laryngeal mask airway (1992)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 47 (1992), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Laryngeal mask airways and tracheal tubes were studied to determine both their resistance to constant gas flows and additional inspiratory work during simulated inspiration. Laryngeal mask airways imposed less resistance and required lower additional inspiratory work compared with the corresponding sized tracheal tubes. If inspiratory loading during anaesthesia is an important consideration, then the laryngeal mask airway may be preferable to a tracheal tube.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1992.tb02179.x
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  • 9
    Electronic Resource
    Electronic Resource
    Propofol for induction and maintenance of anaesthesia at Caesarean section A comparison with thiopentone/enflurane (1991)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 46 (1991), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A propofol infusion regimen and a standard general anaesthetic were compared in 40 Chinese women undergoing elective Caesarean section. Twenty patients received propofol 2 mg/kg for induction of anaesthesia followed by propofol 6 mg/kg/hour, while 20 patients received thiopentone 4 mg/kg with enflurane 1% for maintenance of anaesthesia. All patients were given atracurium and their lungs ventilated with nitrous oxide 50% in oxygen until delivery of the neonate. The hypertensive response after intubation was of shorter duration in the propofol group compared with the thiopentone group. Induction to delivery times ranged from 5 to 14 minutes and neonates from both groups had similar and satisfactory Apgar scores, Neurologic and Adaptive Capacity Scores and umbilical cord blood gas analysis. However, a prolonged propofol infusion time before delivery may cause lower Neurologic and Adaptive Capacity Scores. There were no differences in maternal recovery times or psychomotor performance.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1991.tb09307.x
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  • 10
    Electronic Resource
    Electronic Resource
    The Dandy—Walker syndrome Relevance to anaesthesia and intensive care (1990)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 45 (1990), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A case of the Dandy-Walker syndrome and some of its attendant complications is described.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.1990.tb14389.x
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