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  • 1
    Electronic Resource
    Electronic Resource
    Monitoring of hypoxaemic episodes in the late postoperative period (1998)
    Oxford : Blackwell Science Ltd
    Anaesthesia 53 (1998), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.1998.0584g.x
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  • 2
    Electronic Resource
    Electronic Resource
    Comparison of heart rate variability in supine, and left and right lateral positions (2003)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 58 (2003), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Summary In order to determine whether differences exist in cardiac autonomic tone between different body positions that may be used in unconscious subjects, we examined beat-to-beat heart rate variability (HRV) in volunteers lying supine, and in left lateral and right lateral positions. We studied 24 subjects, aged 20–35 years in each of the three positions on one study day, and 6 subjects in each of the three positions on each of six different study days. In both groups of subjects we observed no difference in heart rate, respiratory frequency, total power (0.02–0.45 Hz) of HRV or the proportion of power in the high (0.15–0.45 Hz), low (0.08–0.15 Hz) or very low (0.02–0.08Hz) frequency bands among the three positions. These results suggest that there are no cardiac autonomic tone advantages to be gained by placing a person in the recovery position on one side compared with the other.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2044.2003.03145.x
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  • 3
    Electronic Resource
    Electronic Resource
    Psychometric characteristics of simulation-based assessment in anaesthesia and accuracy of self-assessed scores (2005)
    Oxford, UK : Blackwell Science Ltd
    Anaesthesia 60 (2005), S. 0 
    Details
    ISSN: 1365-2044
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: The purpose of this study was to define the psychometric properties of a simulation-based assessment of anaesthetists. Twenty-one anaesthetic trainees took part in three highly standardised simulations of anaesthetic emergencies. Scenarios were videotaped and rated independently by four judges. Trainees also assessed their own performance in the simulations. Results were analysed using generalisability theory to determine the influence of subject, case and judge on the variance in judges' scores and to determine the number of cases and judges required to produce a reliable result. Self-assessed scores were compared to the mean score of the judges. The results suggest that 12–15 cases are required to rank trainees reliably on their ability to manage simulated crises. Greater reliability is gained by increasing the number of cases than by increasing the number of judges. There was modest but significant correlation between self-assessed scores and external assessors' scores (rho = 0.321; p = 0.01). At the lower levels of performance, trainees consistently overrated their performance compared to those performing at higher levels (p = 0.0001).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2044.2004.04073.x
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  • 4
    Electronic Resource
    Electronic Resource
    Central venous catheter-related bloodstream infections: an analysis of incidence and risk factors in a cohort of 400 patients (1998)
    Springer
    Intensive care medicine 24 (1998), S. 1034-1039 
    Details
    ISSN: 1432-1238
    Keywords: Key words Central venous catheters ; Infection ; Diagnosis ; Intensive care
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To determine the incidence of central catheter-related bloodstream infection (CR-BSI) and to compare patient and catheter characteristics of those with and without CR-BSI from a clinically suspected subgroup. Secondly, to assess the efficacy of the acridine orange leucocyte cytospin test (AOLC) as a rapid in situ method of detecting central venous catheter (CVC) infection. Design: One-year prospective audit. Setting: Intensive care unit/high dependency unit (ICU/HDU) and general wards of a tertiary referral hospital. Patients and participants: 400 patients with non-tunnelled CVCs. Interventions: Daily surveillance, blood culture from peripheral venepuncture, blood sample from the CVC for assessment of the AOLC test and removal of suspected CVCs were carried out on patients clinically suspected of having CR-BSI. Measurements and results: CR-BSI was diagnosed using well defined criteria. Infection rate was calculated by dividing the number of definitive catheter associated infections by the total number of appropriate catheter in situ days. The AOLC test was performed on all those with suspected CR-BSI. A total of 499 CVCs in 400 patients were assessed, representing 3014 catheter in situ days. Over 80 % of patients were from our ICU/HDU, representing 404 CVCs and 1901 catheter in situ days. A total of 49/499 (9.8 %) CVCs in the same number of patients were suspected of being infected subsequently 12/499 (2.4 %) CVCs [95 % confidence interval (CI) 1.25 to 4.16] in 12 separate patients were demonstrated to be the direct cause of the patient's BSI. Rates of CR-BSI per 1000 catheter days were 3.98 (95 % CI 2.06 to 6.96) for the whole cohort and 4.20 (95 % CI 1.81 to 8.29) for the ICU/HDU subgroup. In the group suspected of having CR-BSI, CVCs were removed unnecessarily in 55 %, and no patient or catheter variables measured were predictive of the development of CR-BSI. The AOLC test was negative in all 12 catheters subsequently shown to be the definitive cause of BSI. Conclusions: We have defined the incidence of CR-BSI in a cohort of patients from a tertiary referral hospital, the rates comparing favourably with those reported for similar populations. We were unable to demonstrate significant differences in any patient or catheter variables between those with and without CR-BSI. The AOLC test used alone was unhelpful as a method to diagnose in situ CVC infection in this patient population.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050712
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  • 5
    Electronic Resource
    Electronic Resource
    Glasgow Coma Scale: variation in mortality among permutations of specific total scores (2000)
    Springer
    Intensive care medicine 26 (2000), S. 157-161 
    Details
    ISSN: 1432-1238
    Keywords: Key words Glasgow Coma Scale ; Outcome ; Permutation
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: The objective of this study was to determine whether different score permutations of the Glasgow Coma Scale (GCS) giving the same GCS total score were associated with significantly different mortality.¶Design: For each GCS total we compared the mortality associated with each of the different GCS permutations using a Fisher's exact test. The relationship between components of the GCS score and mortality was also examined using uni- and multivariate logistic regression.¶Setting: Data were collected from the intensive care unit at Wellington Hospital, a multidisciplinary, tertiary referral unit.¶Patients: We analysed the GCS and mortality data from all admissions over a 4 year period (January 1994–January 1998). Patients with GCS scores of 3 or 15 were excluded, since these two total scores do not have multiple permutations, leaving 1390 patients with GCS scores of 4–14 for analysis.¶Results: The incidence of mortality was significantly different for the different permutations for total GCS scores of 7, 9, 11 and 14.¶Conclusions. It is possible for patients to have the same total GCS score, but significantly different risks of mortality due to differences in the GCS profile making up that score. This suggests that GCS scores may be more useful reported in terms of profiles rather than totals. This could also have implications for the use of other scoring systems such as Acute Physiology and Chronic Health Evaluation and Simplified Acute Physiology Score.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050039
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  • 6
    Electronic Resource
    Electronic Resource
    Cardioventilatory coupling in the anaesthetised rabbit, rat and guinea-pig (1999)
    Springer
    Pflügers Archiv 437 (1999), S. 910-916 
    Details
    ISSN: 1432-2013
    Keywords: Key words Cardiorespiratory system ; Anaesthesia ; Rat ; Rabbit ; Guinea-pig
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Cardioventilatory coupling is a temporal coherence of respiratory and cardiac rhythms, seen in humans at rest, and during sleep and anaesthesia. In this study we compared the cardioventilatory coupling of anaesthetised rabbits, rats and guinea-pigs. Breathing two successive anaesthetic concentrations (1 or 2% isoflurane) we compared the effect of anaesthetic depth and species on (1) heart rate, (2) heart rate variability, (3) ventilatory rate (f), (4) ventilatory variability, (5) ratio HR/f, (6) degree of coupling (Shannon entropy of the distribution of intervals between inspiration and the preceding electrocardiographic R wave – the RI interval) and (7) coupling pattern, classified into four sub-patterns (I-IV) based upon inspection of the RI interval time series. Rabbits exhibited significantly less ventilatory variability and coupling than rats or guinea-pigs. The sub-pattern of coupling also differed between the three species. Rabbits showed coupling only when HR and f were close to integer ratios whereas other species coupled at non-integer ratios. Ventilatory variability in the rat and guinea-pig differed according to the pattern of coupling observed. Of the three species studied, the rat and guinea-pig demonstrated coupling most similar to that of anaesthetised human subjects. Anaesthetic concentration did not influence the pattern or degree of coupling.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004240050862
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