Abstract:
:Sepsis and respiratory dysfunction leading to multiple system organ failure remains the leading cause of postoperative morbidity and mortality following major surgical procedures. It has been suggested the oxygen free radicals might play a pivotal role in this process. The aim of this study was to investigate whether short-term infusion of N-acetylcysteine (N-acetylcysteine), a potent antioxidant, administered before and during extensive abdominal surgery, could ameliorate the progression of early postoperative organ dysfunction and improve oxygenation. Out of the 93 patients, 47 received N-acetylcysteine and 46 were given placebo in a randomized, controlled, double-blinded fashion. Patients received N-acetylcysteine (150 mg.kg-1 bolus followed by a continuous infusion of 12 mg.kg-1.h-1) or the same volume of placebo (5% dextrose) during surgery. Treatment effect on organ function was assessed by organ dysfunction scores according to physiological parameters of six main organ systems: respiratory, cardiovascular, renal, hepatic, haematological and central nervous system. The scores were obtained on admission, then daily during the first three postoperative days. For statistical analysis Mann-Whitney U and Chi-squared tests were used. There was no significant difference between the two groups in any of the six organ dysfunction parameters, length of intensive care stay, days of mechanical ventilation and mortality. Our results do not support the routine use of N-acetylcysteine as a prophylactic measure during surgery, and reinforce previous evidence which challenges the indication of N-acetylcysteine in the critically ill.
journal_name
Anaesth Intensive Carejournal_title
Anaesthesia and intensive careauthors
Szakmany T,Marton S,Molnar Zdoi
10.1177/0310057X0303100304keywords:
subject
Has Abstractpub_date
2003-06-01 00:00:00pages
267-71issue
3eissn
0310-057Xissn
1448-0271pii
2002406journal_volume
31pub_type
临床试验,杂志文章,随机对照试验abstract::A randomised prospective controlled study was conducted during a one-year period on patients scheduled for oesophagectomy via a right thoracotomy approach. Twenty-two patients received one-lung ventilation (OLV group) and twenty patients received high frequency positive pressure ventilation (HFPPV group). Episodic hyp...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/0310057X9101900209
更新日期:1991-05-01 00:00:00
abstract::Changes in local cerebral blood flow during sodium nitroprusside hypotension were measured using the hydrogen electrode technique. At mean arterial pressures from 90% to 50% of control values, local cerebral blood flow showed a significant decrease by 20%. When blood pressure was reduced below 50%, the local cerebral ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X7800600402
更新日期:1978-11-01 00:00:00
abstract::Frailty assessment in patients admitted to intensive care is often limited using traditional clinical frailty assessment tools. Opportunistic use of contemporary computed tomography (CT) can provide an objective estimate of low skeletal muscle mass (sarcopenia) as a proxy for frailty. The aim of this study was to esta...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X20922234
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abstract::Dobutamine 300 mg was administered orally to both healthy volunteers and to patients with circulatory failure. After the 300 mg dose of dobutamine, subjects were found to have a higher concentration of the drug in their plasma than the effective levels of 37.5 (SD 2.9) ng/ml (n = 5) normally seen during intravenous in...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8801600311
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abstract::Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) has been shown to improve quality of life and survival rates in patients suffering from pseudomyxoma peritonei. The procedure is long and associated with significant intraoperative blood loss. As such, the anaesthetic management of pati...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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abstract::Minimally invasive oesophagectomy is a relatively new procedure that is performed by means of thoracoscopy and laparoscopy. One stage of the procedure involves creation of a peritoneo-pleural communication in the presence of a pneumoperitoneum. In the case presented, severe hypotension occurred at this point. We belie...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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abstract::The purpose of the study was to investigate the characteristics and outcomes of in-hospital cardiac arrests that occurred outside of the hospital critical care areas. A prospective register of adult in-hospital cardiac arrests occurring in non-critical care areas of Christchurch Hospital, Christchurch, New Zealand, fr...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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更新日期:2007-08-01 00:00:00
abstract::Saline tonometry has been replaced by automated air tonometry (TONOCAP). As with saline tonometry there are some pitfalls to consider. We investigated the influence of different filling handicaps to the tonometry catheter sampling balloon on measurement of regional PCO2 (PrCO2). In an in vitro set-up, PrCO2 was measur...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0203000613
更新日期:2002-12-01 00:00:00
abstract::The aim of this study was to review and describe indications for intraaortic balloon counterpulsation (IABP) use and identify the impact these have on outcomes at an Australian cardiothoracic tertiary referral hospital. A secondary aim was comparison of the Australian practice with a large multinational IABP data regi...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0703500101
更新日期:2007-02-01 00:00:00
abstract::Although the diagnosis of fat embolism syndrome is usually based on clinical findings, we describe ill-defined centrilobular and subpleural nodules in addition to ground-glass opacities and consolidation on a computed tomography scan of the chest in a trauma patient with fat embolism syndrome. The nodules presumably r...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,评审
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abstract::A 74-year-old man with cardiac failure and renal impairment was admitted to the cardiothoracic intensive care unit with metformin-induced lactic acidosis and shock. He was successfully treated with high-dose (80 ml/kg/hour) continuous venovenous haemodiafiltration. Lactic acidosis is a known complication of metformin ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700520
更新日期:2009-09-01 00:00:00
abstract::Three volatile anaesthetic agent monitors (Datex Normac Anesthetic Agent Monitor, Engstrom Emma Multigas Monitor and Penlon Halothane Meter) were evaluated for the effects of nitrous oxide or water vapour, and for their linearity, stability, and rate of response to a change in concentration of various anaesthetic agen...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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更新日期:1986-11-01 00:00:00
abstract::There were 160 incidents associated with regional anaesthesia amongst the first 2000 incidents reported to the Australian Incident Monitoring Study. They were categorised into 6 groups; epidural anaesthesia (83), spinal anaesthesia (42), brachial plexus blocks (14), intravenous local anaesthesia (4), ocular blocks (3)...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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abstract::This paper was commissioned to cover the beginning of anaesthesia: the transition from surgical operations with pain to those without. It reviews some previous pre-anaesthetic histories (Part I): it focuses upon attitudes to pain; and it seeks evidence from the one hundred years before the discovery of anaesthesia. Fi...
journal_title:Anaesthesia and intensive care
pub_type: 传,历史文章,杂志文章
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更新日期:1986-05-01 00:00:00
abstract::This paper reports on the causes and preventability of primary anaesthetic deaths in Western Australia between 1985 and 2008. In Western Australia, it is a legal requirement to report all deaths that occur within 48 hours of an anaesthetic and later deaths if an anaesthetic complication is implicated. A committee asse...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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更新日期:2013-05-01 00:00:00
abstract::This paper describes four neonates having abdominal procedures with intraoperative and early postoperative analgesia provided by a transversus abdominis plane regional block. Analgesia for neonatal upper and mid-abdominal surgery usually involves regional anaesthesia and/or systemic opioid. All these analgesia techniq...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700303
更新日期:2009-05-01 00:00:00
abstract::We aimed to establish the frequency and nature of drug administration error in anaesthesia (a significant subset of error in medicine) at two hospitals. Anaesthetists were asked to return a study form anonymouslyfor every anaesthetic, indicating whether or not a drug administration error or pre-error (defined as any i...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,多中心研究
doi:10.1177/0310057X0102900508
更新日期:2001-10-01 00:00:00
abstract::This study was designed to compare the efficacy of subarachnoid morphine alone or in combination with bupivacaine and fentanyl for combined spinal-epidural analgesia in colorectal surgery. This is a prospective, randomised, double-blind clinical trial. Sixty patients undergoing low anterior resection were assigned to ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,随机对照试验
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更新日期:2009-07-01 00:00:00
abstract::The aim of this study was to assess the relationship between superior vena cava (SVC) diameter, collapsibility and central venous pressure (CVP) in cardiac surgical patients. SVC maximum and minimum diameters, plus collapsibility with ventilation, were measured with transoesophageal echocardiography in the mid-oesopha...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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abstract::There is little consensus on the definition or optimal constituents of fluid bolus therapy (FBT), and there is uncertainty regarding its physiological effects. The aims of this study were to determine clinician-reported definitions of FBT and to explore the physiological responses clinicians expect from such FBT. In J...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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abstract::Patients presenting for elective surgery in the Bay of Plenty area in New Zealand are increasingly elderly with significant medical comorbidities. For these patients the risk-benefit balance of undergoing surgery can be complex. We recognised the need for a robust shared decision-making pathway within our perioperativ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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abstract::We reviewed the clinical characteristics, required intervention and short- and long-term outcomes in obstructive sleep apnoea (OSA) patients requiring intensive care. A retrospective, single-centre, observational cohort study was undertaken in a multidisciplinary teaching medical and surgical intensive care unit. Adul...
journal_title:Anaesthesia and intensive care
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abstract::This trial prospectively compares two methods of percutaneous tracheostomy, both routinely used in ICU: the Ciaglia progressive dilational tracheostomy and the Griggs forceps dilational tracheostomy. One hundred patients were randomized using a single-blinded envelope method to receive progressive or forceps percutane...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,随机对照试验
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abstract::The efficacy of the McCoy laryngoscope, external laryngeal pressure, and their combination to improve the laryngoscopic view was evaluated in 219 patients and compared with the Macintosh laryngoscope. An experienced laryngoscopist performed laryngoscopy twice using the Macintosh laryngoscope and the McCoy laryngoscope...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章
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更新日期:2000-10-01 00:00:00
abstract::The first human infection with Chromobacterium violaceum was recorded in 1927, but since then there have been about 33 cases reported worldwide, including two from Australia. Chr. violaceum occurs in the tropics and subtropics and is generally considered to be nonpathogenic, but infection can occur in patients who are...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
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更新日期:1992-02-01 00:00:00
abstract::Chlormethiazole ethanedisulphonate (Hemineurin) was administered to provide light sedation in patients undergoing surgery with neural blockade. A two stage intravenous infusion system was used and consisted of a loading dose 1520 mg over 30 minutes followed by a maintenance rate of 10 mg/min for the desired period. Pa...
journal_title:Anaesthesia and intensive care
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abstract::Prophylaxis of acute upper gastrointestinal bleeding by control of gastric pH has been widely advocated for intensive care patients. H2-blockers and antacids have been used and demonstrated to be incompletely effective at maintaining gastric pH above 4. A study of 100 patients measured the efficacy of two-hourly gastr...
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abstract::The ultrasound software package Enhanced Needle Visualization (ENV) has been reported to provide improved ultrasound imaging of needles even at steep insertion angles. ENV has three settings: shallow, medium and steep. However, the angles are unknown. We examined the advantages and indications of ENV in an in vitro st...
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abstract::Modern near-infrared spectroscopy technology is increasingly adopted to measure cerebral tissue oxygen saturation. However, the normal range of cerebral tissue oxygen saturation in adults with such technology is unknown. We sought to measure cerebral tissue oxygen saturation in healthy volunteers using the novel O3 Re...
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abstract::Children undergoing anaesthesia are prone to hypothermia. Perioperative monitoring of patient temperature is, therefore, standard practice. Postoperative temperature is regarded as a key anaesthetic performance indicator in Australian hospitals. Many different methods and sites of temperature measurement are used peri...
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