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Self-assessment
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2025-01-01 DOI: 10.1016/j.mpaic.2024.11.012
Vijayanand Nadella
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引用次数: 0
Physiology of haemostasis
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2025-01-01 DOI: 10.1016/j.mpaic.2024.09.015
Abbas Zaidi, Laura Green
Haemostasis is a complex process that ensures the maintenance of blood flow under normal physiological conditions and prevents major blood loss following vascular injury. The process is tightly regulated to prevent pathological thrombosis. Normal haemostasis relies on the delicate balance of prothrombotic and anticoagulant processes, where five components play a significant role in maintaining the haemostasis, these include: (i) endothelial cells; (ii) platelets which are key to platelet plug formation; (iii) coagulation factors that are essential to formation of insoluble fibrin clot; (iv) coagulation inhibitors; and (v) fibrinolysis. This article will provide an overview of the current concepts of haemostasis, and through this we will explain how antiplatelets and antithrombotic drugs work, as well as provide a basic understanding of how to interpret clotting tests used to measure coagulation disorders.
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引用次数: 0
Cardiac output monitoring
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2025-01-01 DOI: 10.1016/j.mpaic.2024.09.013
Nathan Betteridge, Fiona Armstrong
Cardiac output monitoring has become commonplace amongst the standard monitoring in anaesthesia for major surgery and in intensive care. Multiple techniques are used, employing different models to calculate flow, which cannot be directly measured. Each method has differing advantage and disadvantage profiles and so the choice of device should consider a balance of invasiveness, usability, reliability and validity. Trend monitoring is generally emphasized over absolute values.
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引用次数: 0
Pharmacokinetic variation
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2024-12-01 DOI: 10.1016/j.mpaic.2024.09.010
Alexander T Vidouris, Craig Carroll
Pharmacokinetics is the study of how a drug is handled by the body, including absorption, distribution, metabolism and excretion. Pharmacokinetic variation is variability in the effector site concentration after a standard dose. This means there is potential for dosing to be ineffective for one patient but potentially toxic with increased side effects for another. This article aims to review some of the causes of variation by looking at physiological, pathological and pharmacological factors.
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引用次数: 0
Patient selection for day surgery
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2024-12-01 DOI: 10.1016/j.mpaic.2024.09.007
Tsz Ying Apple Lo, Man Ting Chan
Day surgery allows surgery to be delivered in a more efficient and convenient manner. Inclusion criteria and protocols have evolved and expanded in recent decades. It represents a modern and patient-centred approach to surgical care, bringing numerous advantages to patients’ postoperative recovery. For safer outcomes and lower risk of complications, it is crucial for clinicians to have clear patient selection criteria and enhanced recovery protocols. We discuss the benefits of day surgery, explore factors in patient selection and methods to help smooth recovery.
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引用次数: 0
Intravenous anaesthetic agents
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2024-12-01 DOI: 10.1016/j.mpaic.2024.09.008
Swarnendu Dey, Kenichi Ode
This article gives an overview of drugs frequently used for intravenous anaesthetic induction, as well as a brief overview of total intravenous anaesthesia.
The physio-chemical properties of intravenous anaesthetic drugs, their clinical and adverse effects are summarized.
The article also discusses the historical context on the introduction of intravenous anaesthetic agents and highlights developments of novel agents.
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引用次数: 0
Postoperative analgesia
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2024-12-01 DOI: 10.1016/j.mpaic.2024.09.005
Katharine C Ireland, Abdul G Lalkhen
Pain is a complex experience consisting of sensory, affective, behavioural and physiological components. The management of pain is therefore best achieved with an approach which acknowledges that the experience of pain is produced through the interaction of biological, psychological and sociocultural factors. Effective pain management requires preoperative patient engagement and education to manage expectations regarding pain relief and an inpatient pain service to coordinate the implementation of evidence-based postoperative pain management protocols and facilitate continuous staff education. Multimodal postoperative analgesia, built on an opioid-sparing ethos, is an essential component of perioperative pain management. Effective pain management enhances recovery after surgery by facilitating early patient mobilization, a reduction in respiratory and cardiac complications and amelioration of the stress response to surgery with consequent improved wound healing. Inadequate pain control can contribute to prolonged hospitalization and the development of chronic postsurgical pain.
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引用次数: 0
Principles of the anaesthetic machine
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2024-12-01 DOI: 10.1016/j.mpaic.2024.09.006
Michaela J van der Walt, Leo G Kevin
Anaesthetic machines are designed to accurately mix and deliver medical gases and anaesthetic vapours. Although these machines have evolved greatly from the original Boyle's Trolley, and they are now sophisticated computer-controlled interfaces with integrated measurement tools and controls, the fundamental principles have remained broadly unchanged. An understanding of the structure, function and safety features of the anaesthetic machine is essential to the practising anaesthetist.
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引用次数: 0
Self-assessment
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2024-12-01 DOI: 10.1016/j.mpaic.2024.10.003
Vijayanand Nadella
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引用次数: 0
The principles of anaesthetic vaporizers
IF 0.2 Q4 ANESTHESIOLOGY
Anaesthesia and Intensive Care Medicine
Pub Date : 2024-12-01 DOI: 10.1016/j.mpaic.2024.09.001
Ravi Anandampillai
Fluorinated hydrocarbons have transformed inhalational anaesthesia, and vaporizers are essential for safe and accurate delivery of these agents. The modern-day vaporizers have evolved considerably since the ether inhaler invented by John Snow in 1847 and are robust, precise and efficient. For an anaesthetist to administer safe inhalational anaesthetic, it is important to understand the physical principles of the various inhalational anaesthetic agents along with the working principles of the vaporizers. Almost all modern vaporizers are located outside the circle system and the have multiple safety mechanisms in place.
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引用次数: 0
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