Abstract:
:An unplanned intensive care unit admission within 24 hours of a procedure with an anaesthetist in attendance (UIA) is a recommended clinical indicator It is designed to identify preventable iatrogenic complications. Often understood as a specific anaesthetic outcome, its value has been repeatedly questioned. Iatrogenic complications however often result from successive mishaps. In the specific context of an UIA these complications can be related both to anaesthesia and surgery. UIA is therefore probably more a global indicator of the safety of surgical care (anaesthetic and surgical) rather than a specific anaesthetic outcome. Its utility as such is however unknown. The purpose of this study was to assess the value of UIA as a global measure of avoidable iatrogenic complications in surgical patients. Using computerised patient records and medical charts, all patients with an UIA over a study period of five years were identified. The proportion, cause and preventability of iatrogenic complications amongst these patients were assessed. A total of 188 UIA patients were identified by peer reviewers. Of these, 87% to 92% had a complication caused by anaesthesia and/or surgery. Anaesthesia was found to be responsible for 24% to 31% of iatrogenic complications. All other cases related to the combination of anaesthesia and surgery or surgery alone. Of these, 74% to 92% of complications were found to be preventable. Despite intrinsic limitations of the retrospective chart review method, UIA can be considered as a valuable tool to detect avoidable iatrogenic complications related to both surgical and anaesthetic care.
journal_name
Anaesth Intensive Carejournal_title
Anaesthesia and intensive careauthors
Haller G,Myles PS,Langley M,Stoelwinder J,McNeil Jdoi
10.1177/0310057X0803600209subject
Has Abstractpub_date
2008-03-01 00:00:00pages
190-200issue
2eissn
0310-057Xissn
1448-0271pii
2007342journal_volume
36pub_type
杂志文章abstract::The strong ion gap (SIG) is under evaluation as a scanning tool for unmeasured ions. SIG is calculated by subtracting [buffer base], which is ([A-]+[HCO3-), from the apparent strong ion difference, which is ([Na+]+[K+]+[Ca++]+[Mg++]-[Cl-]-[L-lactate]). A- is the negative charge on albumin and phosphate. We compared th...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0703500308
更新日期:2007-06-01 00:00:00
abstract::This narrative review aims to describe the role of peripheral and central immune responses to tissue and nerve damage in animal models, and to discuss the use of immunomodulatory agents in clinical practice and their perioperative implications. Animal models of pain have demonstrated that nerve injury activates immune...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,评审
doi:10.1177/0310057X20902774
更新日期:2020-05-01 00:00:00
abstract::Electroconvulsive therapy (ECT) under propofol anaesthesia induces relatively shorter seizures compared to barbiturate anaesthesia. Since significant correlation between seizure duration and bispectral index (BIS) value immediately before electrical stimulus has been reported among patients, adjustment of anaesthesia ...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章
doi:10.1177/0310057X0403200509
更新日期:2004-10-01 00:00:00
abstract::Hepatic cryotherapy is a relatively new technique, currently employed in the treatment of unresectable liver malignancy, which involves direct freezing of tumour deposits with liquid nitrogen. In a review of 26 patients undergoing this procedure, the anaesthetic considerations are defined. The total operation time ran...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9202000418
更新日期:1992-11-01 00:00:00
abstract::Predicting unexpected intensive care unit (ICU) re-admission and mortality after critical illness is difficult. This study assessed the associations between eosinopenia on the day of ICU discharge and outcomes after critical illness. This retrospective cohort study involved a total of 1446 critically ill patients who ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1304100130
更新日期:2013-03-01 00:00:00
abstract::Seven out of eight piglets which were susceptible to malignant hyperthermia (MHS) died when subjected to a heat challenge which was well tolerated by controls. The piglets which succumbed developed the classical clinical and biochemical changes of malignant hyperthermia before they died. These results show that overhe...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章
doi:10.1177/0310057X9602400308
更新日期:1996-06-01 00:00:00
abstract::Unnecessary pathology tests performed in intensive care units (ICU) might lead to increased costs of care and potential patient harm due to unnecessary phlebotomy. We hypothesised that a multimodal intervention program could result in a safe and effective reduction in the pathology tests ordered in our ICU. We conduct...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1804600309
更新日期:2018-05-01 00:00:00
abstract::Breathing through an endotracheal tube, connector, and ventilator demand valve imposes an added load on the respiratory muscles. As respiratory muscle fatigue is thought to be a frequent cause of ventilator dependence, we sought to examine the efficacy of five different ventilators in reducing this imposed work throug...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9302100116
更新日期:1993-02-01 00:00:00
abstract::In this case report, the course of arginine vasopressin and copeptin, the stable C-terminal part of the arginine vasopressin precursor, is described during the period of critical illness in a septic shock patient. Arginine vasopressin and copeptin concentrations were substantially increased during the initial 36 hours...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0603400415
更新日期:2006-08-01 00:00:00
abstract::Colloid infusions can cause metabolic acidosis. Mechanisms and relative severity with different colloids are incompletely understood. We compared haemodilution acid-base effects of 4% albumin, 3.5% polygeline, 4% succinylated gelatin (all weak acid colloids, strong ion difference 12 mEq/l, 17.6 mEq/l and 34 mEq/l resp...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0903700304
更新日期:2009-05-01 00:00:00
abstract::Venous thromboembolism is an important complication after general and cardiac surgery. Using transthoracic echocardiography, this study assessed the incidence of inferior vena cava (IVC) thrombosis among a total of 395 and 289 cardiac surgical and major surgical patients in the immediate postoperative period after car...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1304100614
更新日期:2013-11-01 00:00:00
abstract::The objective of this study was to assess the outcome of Jehovah's Witness (JW) patients admitted to a major Australasian ICU and to review the literature regarding the management of critically ill Jehovah's Witness patients. All Jehovah's Witness patients admitted to the ICU between January 1999 and September 2003 we...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0403200611
更新日期:2004-12-01 00:00:00
abstract::We present the case of a 28-year-old female with a previous diagnosis of C1 esterase inhibitor deficiency presenting for dental extractions under general anaesthesia. Following prophylaxis with a new bradykinin receptor 2 antagonist (icatibant), surgery was carried out uneventfully with an unremarkable postoperative c...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1204000320
更新日期:2012-05-01 00:00:00
abstract::Patients with a presumptive diagnosis of an acute anaphylactoid reaction to anaesthesia were investigated to determine the cause of the reaction and the drug responsible by intradermal testing, patch and prick testing, sequential complement measurement, passive transfer testing and challenge. The most valuable informa...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8100900305
更新日期:1981-08-01 00:00:00
abstract::With a greater appreciation and understanding of reactions to homologous blood transfusion there has been a renewed interest in autologous blood transfusion. The techniques and indications for preoperative banked autologous blood, perioperative haemodilution and recycled salvaged autologous blood transfusion are descr...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X8000800212
更新日期:1980-05-01 00:00:00
abstract::The provision of optimal analgesia after caesarean section remains a challenge as satisfactory pain relief must be combined with patient satisfaction, including the ability to care for the newborn. In a prospective study of 132 patients, we have compared epidural analgesia with intravenous patient-controlled analgesia...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,更正并重新发布的文章,杂志文章,随机对照试验
doi:10.1177/0310057X9302100537
更新日期:1993-10-01 00:00:00
abstract::Catecholamine-resistant shock is not uncommon in intensive care. Bolus dose terlipressin (a vasopressin analogue) has been used successfully in this setting allowing cessation of other vasopressor agents. The relative vasopressin deficiency in combination with the restoration of the vascular tone (by blocking adenosin...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0303100532
更新日期:2003-10-01 00:00:00
abstract::We present a case of severe rigidity during emergence from general anaesthesia in a 64-year-old man who had suffered from Parkinson's disease for nine years. Controversy still exists over how to optimally manage these patients perioperatively. We successfully managed his Parkinsonism with administration of crushed Sin...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1103900623
更新日期:2011-11-01 00:00:00
abstract::Human error is a pervasive and normal part of everyday life and is of interest to the anaesthetist because errors may lead to accidents. Definitions of, and the relationships between, errors, incidents and accidents are provided as the basis to this introduction to the psychology of human error in the context of the w...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9302100506
更新日期:1993-10-01 00:00:00
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
doi:10.1177/0310057X0002800509
更新日期:2000-10-01 00:00:00
abstract::This prospective, randomized, double-blind study was designed to compare the recovery characteristics of remifentanil and fentanyl in combination with propofol for direct current cardioversion. Patients undergoing elective cardioversion received either intravenous fentanyl 1 microg/kg (n=33) or remifentanil 0.25 micro...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章,随机对照试验
doi:10.1177/0310057X0603400309
更新日期:2006-06-01 00:00:00
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
doi:10.1177/0310057X8601400419
更新日期:1986-11-01 00:00:00
abstract::Nineteen adult patients of either gender received intravenous infusions of propofol, scaled to estimated lean body mass (LBM), for 150 minutes as part of a balanced anaesthetic. Arterial blood was assayed for whole blood propofol. The first subject received propofol at a fixed rate of 0.058 mg x min(-1) x kg(LBM)(-1)....
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1003800305
更新日期:2010-05-01 00:00:00
abstract::The occurrence of ventricular fibrillation after aortic de-clamping during cardiac surgery is common, and if prolonged may contribute to myocardial ischaemia. The use of lignocaine cardioplegia to minimize reperfusion ventricular fibrillation was studied in 141 patients undergoing first time coronary artery surgery in...
journal_title:Anaesthesia and intensive care
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1177/0310057X9402200420
更新日期:1994-08-01 00:00:00
abstract::Although intraoperative transoesophageal echocardiography (TOE) has an established role in the management of some cardiac surgical procedures, there is little data on its impact on coronary artery bypass graft (CABG) cases that are stratified for clinical risk. This is a retrospective review of the surgical impact of ...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X0203000603
更新日期:2002-12-01 00:00:00
abstract::Epidural opioids provide high quality analgesia with no clinically apparent effect on the circulation or on specific organ blood flow. Little investigative data is available to support these impressions of circulatory stability. Ten patients presenting for thoracotomy were studied at rest preoperatively to determine i...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9101900105
更新日期:1991-02-01 00:00:00
abstract::The potential transmission of disease by anaesthetic and ventilator breathing circuits has resulted in the widespread use of filters. Convincing scientific evidence of their complete efficacy is lacking particularly in regard to viruses. In the past, practical difficulties precluded the use of new or autoclavable equi...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9602400207
更新日期:1996-04-01 00:00:00
abstract::Many deceased by neurologic criteria donors are administered inhalational agents during organ recovery surgery-a process that is characterised by warm and cold ischaemia followed by warm reperfusion. In certain settings, volatile anaesthetics (VA) are known to precondition organs to protect them from subsequent ischae...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X1804600206
更新日期:2018-03-01 00:00:00
abstract::A survey was conducted among 259 New Zealand specialist anaesthetists to assess attitudes and practices with regard to epidural or subarachnoid anaesthesia (ESA). Ninety-four per cent replied and virtually all of the respondents indicated that they performed ESA at some time. ESA was used by most anaesthetists for mos...
journal_title:Anaesthesia and intensive care
pub_type: 杂志文章
doi:10.1177/0310057X9602400114
更新日期:1996-02-01 00:00:00