Pub Date : 2022-04-01DOI: 10.1016/j.bja.2022.04.004
Charles Mcfadyen, B. Garfield, J. Mancio, C. Ridge, T. Semple, Archie G M Keeling, S. Ledot, Brijesh Patel, C. Samaranayake, C. McCabe, S. Wort, S. Price, L. Price
{"title":"Use of sildenafil in patients with severe COVID-19 pneumonitis","authors":"Charles Mcfadyen, B. Garfield, J. Mancio, C. Ridge, T. Semple, Archie G M Keeling, S. Ledot, Brijesh Patel, C. Samaranayake, C. McCabe, S. Wort, S. Price, L. Price","doi":"10.1016/j.bja.2022.04.004","DOIUrl":"https://doi.org/10.1016/j.bja.2022.04.004","url":null,"abstract":"","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"53 1","pages":"e18 - e21"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88064958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-01DOI: 10.1016/j.bja.2022.04.003
V. Athanassoglou, H. Zhong, J. Poeran, Jiabin Liu, C. Cozowicz, A. Illescas, S. Memtsoudis
{"title":"Anaesthesia practice in the first wave of the COVID-19 outbreak in the United States: a population-based cohort study","authors":"V. Athanassoglou, H. Zhong, J. Poeran, Jiabin Liu, C. Cozowicz, A. Illescas, S. Memtsoudis","doi":"10.1016/j.bja.2022.04.003","DOIUrl":"https://doi.org/10.1016/j.bja.2022.04.003","url":null,"abstract":"","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"61 1","pages":"e16 - e18"},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85077966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-23DOI: 10.1016/j.bja.2022.03.012
T. Stephens, E. Vail, J. Billings
{"title":"Silver linings: will the COVID-19 pandemic instigate long overdue mental health support services for healthcare workers?","authors":"T. Stephens, E. Vail, J. Billings","doi":"10.1016/j.bja.2022.03.012","DOIUrl":"https://doi.org/10.1016/j.bja.2022.03.012","url":null,"abstract":"","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"49 1","pages":"912 - 914"},"PeriodicalIF":0.0,"publicationDate":"2022-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88148659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-24DOI: 10.1016/j.bja.2021.12.026
Leah R Hughes, B. Shelley, J. McPeake
{"title":"Absent visitors: the wider implications of COVID-19 on cardiothoracic ICU staff: the VINCI Study","authors":"Leah R Hughes, B. Shelley, J. McPeake","doi":"10.1016/j.bja.2021.12.026","DOIUrl":"https://doi.org/10.1016/j.bja.2021.12.026","url":null,"abstract":"","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"56 1","pages":"e253 - e254"},"PeriodicalIF":0.0,"publicationDate":"2022-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84957178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-02DOI: 10.1101/2020.07.01.20144436
Patients with Coronavirus disease 2019 (COVID-19) who require invasive mechanical ventilation frequently meet the acute respiratory distress syndrome (ARDS) diagnostic criteria. Hospitals based in the United States have been incorporating prone positioning (PP) into the COVID-19-related ARDS treatment plan at a higher rate than normal. Here, we describe 11 patients admitted to a single inpatient rehabilitation hospital who were subsequently diagnosed with acquired focal/multifocal peripheral nerve injury (PNI) in association with the use of PP for COVID-19-related ARDS. The reason for the high rate of PNI associated with PP in COVID-19 ARDS is likely multifactorial, but may include an underlying state of hyperinflammation and hypercoagulability already linked to other the neurological sequelae of COVID-19. Physicians must be aware of this elevated susceptibility to PNI in severe COVID-19 and refined standard PP protocols in order to reduce the risk.
{"title":"Injury-prone: peripheral nerve injuries associated with prone positioning for COVID-19-related acute respiratory distress syndrome","authors":"","doi":"10.1101/2020.07.01.20144436","DOIUrl":"https://doi.org/10.1101/2020.07.01.20144436","url":null,"abstract":"Patients with Coronavirus disease 2019 (COVID-19) who require invasive mechanical ventilation frequently meet the acute respiratory distress syndrome (ARDS) diagnostic criteria. Hospitals based in the United States have been incorporating prone positioning (PP) into the COVID-19-related ARDS treatment plan at a higher rate than normal. Here, we describe 11 patients admitted to a single inpatient rehabilitation hospital who were subsequently diagnosed with acquired focal/multifocal peripheral nerve injury (PNI) in association with the use of PP for COVID-19-related ARDS. The reason for the high rate of PNI associated with PP in COVID-19 ARDS is likely multifactorial, but may include an underlying state of hyperinflammation and hypercoagulability already linked to other the neurological sequelae of COVID-19. Physicians must be aware of this elevated susceptibility to PNI in severe COVID-19 and refined standard PP protocols in order to reduce the risk.","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"33 1","pages":"e478 - e480"},"PeriodicalIF":0.0,"publicationDate":"2020-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83105289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.bja.2020.04.028
J. Samuels, T. Dill, R. Greif, S. Perera, B. Mcguire, C. Hagberg
{"title":"Second victim response in anaesthesiologists after difficult airway management: an international survey","authors":"J. Samuels, T. Dill, R. Greif, S. Perera, B. Mcguire, C. Hagberg","doi":"10.1016/j.bja.2020.04.028","DOIUrl":"https://doi.org/10.1016/j.bja.2020.04.028","url":null,"abstract":"","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87952448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-07-01DOI: 10.1016/j.bja.2020.04.045
F. Mir, K. Horner, A. Fong, S. Hammond, P. Waikar, Anil K Patel, S. Nouraei
{"title":"High-flow nasal oxygen reduces the incidence of hypoxaemia and intra-procedural interruptions during gastrointestinal endoscopy","authors":"F. Mir, K. Horner, A. Fong, S. Hammond, P. Waikar, Anil K Patel, S. Nouraei","doi":"10.1016/j.bja.2020.04.045","DOIUrl":"https://doi.org/10.1016/j.bja.2020.04.045","url":null,"abstract":"","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85344382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-11-15DOI: 10.11648/J.AJEP.20180704.11
B. Sørensen, Henrik Grüttner
The introduction of single-use alternatives has stressed the need for environmental comparisons between reusable and single-use devises in the healthcare sector. Discarding of single-use devices intuitively causes concern among staff in hospitals, other users and people with environmental concerns as to whether the single use is environmentally friendly. This study aims to compare carbon dioxide (CO2)-equivalent emissions and resource consumption from a single-use bronchoscope (Ambu® aScopeTM 4) to a reusable flexible bronchoscope. The comparison is made using a simplified life-cycle-assessment methodology. The analysis shows that the materials used for the cleaning operations of the reusable scopes are a key factor affecting the impact factors assessed; energy consumption, emission of CO2-equivalent and consumption of scarce resources. Initially, it is assumed that each reusable scope is cleaned using one set of personal protective equipment (PPE) per cleaning operation, but since cleaning practice may vary the consequence of cleaning more scopes with one set of PPE is also assessed. Using one set of protective wear per operation and the materials for cleaning and disinfection determine that reusable scopes have comparable or higher material and energy consumption as well as higher emissions of CO2-equivalents and values of resource consumption. Cleaning two or more reusable scopes per set of PPE makes the impacts fairly comparable. Other aspects that may impact the results are also assessed, including energy consumption for washing and drying units, differences in use of PPE and differences in the disposal of PPE or single-use scopes. As the three assessed parameters are highly dependent on cleaning procedures and the use of protective equipment, it cannot be concluded from these results which type of bronchoscope affects the environmental factors investigated here the most.
{"title":"Comparative Study on Environmental Impacts of Reusable and Single-use Bronchoscopes","authors":"B. Sørensen, Henrik Grüttner","doi":"10.11648/J.AJEP.20180704.11","DOIUrl":"https://doi.org/10.11648/J.AJEP.20180704.11","url":null,"abstract":"The introduction of single-use alternatives has stressed the need for environmental comparisons between reusable and single-use devises in the healthcare sector. Discarding of single-use devices intuitively causes concern among staff in hospitals, other users and people with environmental concerns as to whether the single use is environmentally friendly. This study aims to compare carbon dioxide (CO2)-equivalent emissions and resource consumption from a single-use bronchoscope (Ambu® aScopeTM 4) to a reusable flexible bronchoscope. The comparison is made using a simplified life-cycle-assessment methodology. The analysis shows that the materials used for the cleaning operations of the reusable scopes are a key factor affecting the impact factors assessed; energy consumption, emission of CO2-equivalent and consumption of scarce resources. Initially, it is assumed that each reusable scope is cleaned using one set of personal protective equipment (PPE) per cleaning operation, but since cleaning practice may vary the consequence of cleaning more scopes with one set of PPE is also assessed. Using one set of protective wear per operation and the materials for cleaning and disinfection determine that reusable scopes have comparable or higher material and energy consumption as well as higher emissions of CO2-equivalents and values of resource consumption. Cleaning two or more reusable scopes per set of PPE makes the impacts fairly comparable. Other aspects that may impact the results are also assessed, including energy consumption for washing and drying units, differences in use of PPE and differences in the disposal of PPE or single-use scopes. As the three assessed parameters are highly dependent on cleaning procedures and the use of protective equipment, it cannot be concluded from these results which type of bronchoscope affects the environmental factors investigated here the most.","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"30 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90798174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Groeben, B. J. Nottebaum, P. Alesina, A. Traut, H. Neumann, M. Walz
Background. Mortality associated with surgery for phaeochromocytoma has dramatically decreased over the last decades. Many factors contributed to the dramatic decline of the mortality rate, and the influence of an &agr;-receptor blockade is unclear and has never been tested in a randomized trial. We evaluated intraoperative haemodynamic conditions and the incidence of complications in patients with and without &agr;-receptor blockade undergoing surgery for catecholamine producing tumours. Methods. Haemodynamic conditions and perioperative complications were assessed in 110 patients with (B) and 166 without (N) &agr;-receptor blockade. Data were analysed as a consecutive case series of 303 cases and subsequently via propensity score matching, and presented as mean and confidence interval (CI). Results. No difference in maximal intraoperative systolic arterial pressures (B = 178 mm Hg (CI 169-187) vs N = 185 mm Hg (CI 177-193; P = 0.2542) and hypertensive episodes above 250 mm Hg were found (P = 0.7474) for the closed case series. No major complications occurred. Propensity score matching (75 pairs) revealed a significant difference of 17 mm Hg in maximal intraoperative systolic bp for these selected pairs (P = 0.024). Conclusions. Only a slight difference in mean maximal systolic arterial pressure was detected between patients with or without an &agr;-receptor blockade. There was no difference in the incidence of excessive hypertensive episodes between groups and no major complications occurred. The basis for the general recommendation of perioperative &agr;- receptor blockade for phaeochromocytoma surgery demands further study.
背景。在过去的几十年里，与嗜铬细胞瘤手术相关的死亡率急剧下降。许多因素导致了死亡率的急剧下降，而受体阻断的影响尚不清楚，从未在随机试验中进行过测试。我们评估了术中血流动力学条件和并发症的发生率，这些患者在接受儿茶酚胺产生肿瘤的手术时，有和没有&agr;受体阻断。方法。对110例(B)和166例(N) &agr -受体阻断患者的血流动力学状况和围手术期并发症进行了评估。数据作为303例的连续病例序列进行分析，随后通过倾向评分匹配，并以平均值和置信区间(CI)表示。结果。术中最大收缩压(B = 178 mm Hg (CI 169-187) vs N = 185 mm Hg (CI 177-193;P = 0.2542)和250 mm Hg以上的高血压发作(P = 0.7474)。无重大并发症发生。倾向评分匹配(75对)显示，这些选择的夫妇的最大术中收缩压相差17 mm Hg (P = 0.024)。结论。在有或没有受体阻断的患者中，平均最大收缩压只有轻微的差异。两组间高血压过度发作发生率无差异，无重大并发症发生。嗜铬细胞瘤手术围手术期普遍推荐&agr;受体阻断的依据有待进一步研究。
{"title":"Perioperative &agr;-receptor blockade in phaeochromocytoma surgery: an observational case series†","authors":"H. Groeben, B. J. Nottebaum, P. Alesina, A. Traut, H. Neumann, M. Walz","doi":"10.1093/bja/aew392","DOIUrl":"https://doi.org/10.1093/bja/aew392","url":null,"abstract":"Background. Mortality associated with surgery for phaeochromocytoma has dramatically decreased over the last decades. Many factors contributed to the dramatic decline of the mortality rate, and the influence of an &agr;-receptor blockade is unclear and has never been tested in a randomized trial. We evaluated intraoperative haemodynamic conditions and the incidence of complications in patients with and without &agr;-receptor blockade undergoing surgery for catecholamine producing tumours. Methods. Haemodynamic conditions and perioperative complications were assessed in 110 patients with (B) and 166 without (N) &agr;-receptor blockade. Data were analysed as a consecutive case series of 303 cases and subsequently via propensity score matching, and presented as mean and confidence interval (CI). Results. No difference in maximal intraoperative systolic arterial pressures (B = 178 mm Hg (CI 169-187) vs N = 185 mm Hg (CI 177-193; P = 0.2542) and hypertensive episodes above 250 mm Hg were found (P = 0.7474) for the closed case series. No major complications occurred. Propensity score matching (75 pairs) revealed a significant difference of 17 mm Hg in maximal intraoperative systolic bp for these selected pairs (P = 0.024). Conclusions. Only a slight difference in mean maximal systolic arterial pressure was detected between patients with or without an &agr;-receptor blockade. There was no difference in the incidence of excessive hypertensive episodes between groups and no major complications occurred. The basis for the general recommendation of perioperative &agr;- receptor blockade for phaeochromocytoma surgery demands further study.","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"9 1","pages":"182–189"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75727824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Association between the availability of videolaryngoscopes and the incidence of emergency surgical airway in the perioperative setting of a large academic medical centre: a retrospective observational study","authors":"M. Fei, J. Wanderer, Y. Jiang, P. S. Jacques","doi":"10.1093/BJA/AEW374","DOIUrl":"https://doi.org/10.1093/BJA/AEW374","url":null,"abstract":"","PeriodicalId":8987,"journal":{"name":"BJA: British Journal of Anaesthesia","volume":"49 1","pages":"824-826"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91150146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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