'Safe' methaemoglobin concentrations are a mortality risk factor in patients receiving inhaled nitric oxide.

Abstract:

:Inhaled nitric oxide (iNO) can reduce pulmonary arterial hypertension and improve oxygenation in some patients with severe respiratory or heart failure. Despite this, iNO has not been found to improve survival. This study aimed to perform a local practice audit to assess the mortality predictors of critically ill patients who had received iNO as therapy for pulmonary hypertension and respiratory or heart failure. A retrospective audit in a single tertiary centre intensive care unit of patients receiving iNO was conducted between 2004 and 2009. The indications for iNO use, comorbidities, severity of illness, organ function, oxygenation, Sequential Organ Failure Assessment scores, patterns of iNO use, adverse events and outcomes were reviewed. In 215 patients receiving iNO, improvement in oxygenation after one hour from iNO commencement did not predict either intensive care unit (P = 0.36) or hospital (P = 0.72) mortality. The independent risk factors for intensive care unit mortality were worsening Sequential Organ Failure Assessment scores within 24 hours of commencing iNO (adjusted odds ratio 1.07, 95% confidence interval 1.05 to 1.18), the Charlson Comorbidity Score (adjusted odds ratio 1.49, 95% confidence interval 1.16 to 1.91) and the peak methaemoglobin concentration in arterial blood while receiving iNO (adjusted odds ratio 2.67, 95% confidence interval 1.42 to 4.96). Inhaled nitric oxide as salvage therapy for severe respiratory failure in critically ill patients is not routinely justified. Increased methaemoglobin concentration during iNO therapy, even when predominantly less than 3%, is associated with increased mortality.

journal_name

Anaesth Intensive Care

authors

Rolley L,Bandeshe H,Boots RJ

doi

10.1177/0310057X1103900519

subject

Has Abstract

pub_date

2011-09-01 00:00:00

pages

919-25

issue

5

eissn

0310-057X

issn

1448-0271

pii

20110027

journal_volume

39

pub_type

杂志文章
  • The effect of increasing operating room capacity on day-of-surgery cancellation.

    abstract::Several studies have been conducted to evaluate the utilisation of the operating room, a fixed resource, in terms of conditions that prevent day-of-surgery cancellation due to deficient operative capacity. In this study, we surveyed the causes and overall rates of elective surgery cancellation and then compared the nu...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0903700203

    authors: Yoon SZ,Lee SI,Lee HW,Lim HJ,Yoon SM,Chang SH

    更新日期:2009-03-01 00:00:00

  • Anaphylactic reactions to gallamine triethiodide.

    abstract::Three cases of severe anaphylaxis to gallamine triethiodide are described. All reported cases of anaphylaxis to gallamine have occurred in women, and all the confirmed cases in Australasia. There is evidnece that women may be exposed to some substance which leaves them sensitive to gallamine triethiodide. ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X7800600110

    authors: Fisher MM

    更新日期:1978-02-01 00:00:00

  • Comparison of remifentanil and fentanyl in anaesthesia for elective cardioversion.

    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

    authors: Maltepe F,Kocaayan E,Ugurlu BS,Akdeniz B,Guneri S

    更新日期:2006-06-01 00:00:00

  • Strategies to reduce inappropriate laboratory blood test orders in intensive care are effective and safe: a before-and-after quality improvement study.

    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

    authors: Dhanani JA,Barnett AG,Lipman J,Reade MC

    更新日期:2018-05-01 00:00:00

  • Myasthenia gravis in children and its anaesthetic implications.

    abstract::Myasthenia gravis, a rare disease in children, occurs in a variety of forms. The aetiology and clinical presentations are reviewed. Eight patients who were studied with electromyography are presented. The results show that, in general, patients with the usual pattern of disease are resistant to suxamethonium (ED95 3-4...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,评审

    doi:10.1177/0310057X9001800408

    authors: Brown TC,Gebert R,Meretoja OA,Shield LK

    更新日期:1990-11-01 00:00:00

  • Impact of increasing overnight intensive care unit registrar staffing on duration of intubation of elective cardiac surgery patients.

    abstract::It is unclear whether increases to overnight junior medical staffing levels can improve ICU patient outcomes. We conducted a retrospective cohort study before and after the introduction of a third overnight ICU registrar at a 24-bed metropolitan ICU in February 2012. We hypothesised that this change would be associate...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1504300508

    authors: Durie ML,Darvall JN,Rechnitzer T,Tacey MA

    更新日期:2015-09-01 00:00:00

  • Neural and neurochemical mechanisms of pain inhibition.

    abstract::Recent studies which suggest the existence of an endogenous neural substrate of pain inhibition are reviewed. Electrical stimulation of some areas of the medial brain stem in laboratory rats has produced a dramatic degree of analgesia. Such stimulation-produced analgesia is partially blocked by an opiate antagonist dr...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8201000209

    authors: Liebeskind JC,Sherman JE,Cannon T

    更新日期:1982-05-01 00:00:00

  • Postoperative epidural morphine analgesia in Papua New Guinea.

    abstract::In order to introduce the technique of epidural narcotics for pain relief in Papua New Guinea, fifty patients were given low doses of epidural morphine and thereupon the quality of analgesia and morbidity evaluated. The lowest effective epidural morphine dose was determined by considering the patient's characteristics...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8901700315

    authors: Oberoi GS,Yaubihi N

    更新日期:1989-08-01 00:00:00

  • Control of imported and acquired methicillin-resistant Staphylococcus aureus (MRSA) in mechanically ventilated patients: a dose-response study of enteral vancomycin to reduce absolute carriage and infection.

    abstract::This study aimed to quantify the animate source provided by the patients using the concept of "absolute carriage" by multiplying the carrier rate by the level of carriage; and to compare the impact of a low and high dose of an oropharyngeal vancomycin gel on the absolute MRSA carriage and infection. In all, 265 patien...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0503300312

    authors: Viviani M,van Saene HK,Dezzoni R,Silvestri L,Di Lenarda R,Berlot G,Gullo A

    更新日期:2005-06-01 00:00:00

  • Continuous infusion of subcutaneous compared to intravenous insulin for tight glycaemic control in medical intensive care unit patients.

    abstract::The aim of this randomised controlled study was to compare continuous subcutaneous insulin infusion using an insulin pump with the traditional continuous intravenous infusion method for tight glycaemic control. Sixty patients admitted to our University Hospital medical intensive care unit with an initial blood glucose...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0310057X0803600421

    authors: Bodur HA,Saygili F,Saygili S,Doganay LH,Yesil S

    更新日期:2008-07-01 00:00:00

  • Anaesthesia for adults with cystic fibrosis.

    abstract::Cystic fibrosis is an autosomal recessive disorder which affects one in 2500 live births. It is a multisystem disease and has a variety of presentations. The major clinical features affect the gastrointestinal and respiratory tracts. Severe respiratory disease, diabetes and gastroesophageal reflux are common features ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9502300310

    authors: Weeks AM,Buckland MR

    更新日期:1995-06-01 00:00:00

  • A patient with intractable posthypoxic myoclonus (Lance-Adams syndrome) treated with sodium oxybate.

    abstract::Posthypoxic myoclonus is a rare and devastating complication of near-fatal cardiopulmonary arrest. Despite treatment with available anti-myoclonic agents, some patients may recover cognitively but remain completely disabled by severe myoclonus. We report a 16-year-old patient with severe treatment-refractory posthypox...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0903700214

    authors: Arpesella R,Dallocchio C,Arbasino C,Imberti R,Martinotti R,Frucht SJ

    更新日期:2009-03-01 00:00:00

  • Human serum albumin induced hypotension in the postoperative phase of cardiac surgery.

    abstract::Hypotension associated with the rapid infusion of human serum albumin products was first recognised in Australasia in the early 1970s. An association with the angiotensin converting enzyme inhibitor class of drugs (ACE-I) followed, leading to a proposed mechanism involving bradykinin generation through pre-kallikrein ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0102900604

    authors: Howard G,Downward G,Bowie D

    更新日期:2001-12-01 00:00:00

  • Autotransfusion: an impossible dream?

    abstract::Despite the many critics of autologous blood transfusion, there is virtually no literature to support such an attitude in relation to any form of premeditated autologous blood transfusion. It is only in relation to intraoperative blood scavenging that there have been complications. In contrast, there is considerable l...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8401200307

    authors: Isbister JP

    更新日期:1984-08-01 00:00:00

  • Difficulties with positioning Robertshaw double lumen tubes.

    abstract::Difficulties in positioning Robertshaw tubes have been reviewed in a retrospective and a prospective series. Pre-operative cheat X-rays did not help in predicting difficulties. The performance of the Robertshaw tube was carefully recorded for each malposition in the prospective series, and the relationship of the malp...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X7500300404

    authors: Black AM,Harrison GA

    更新日期:1975-11-01 00:00:00

  • Anaesthetic breathing circuit obstruction due to blockage of tracheal tube connector by a foreign body--two cases.

    abstract::Two cases are presented which illustrate the disastrous consequences possible when an anaesthetic breathing circuit is obstructed by a foreign body. Despite reports of previous similar cases, work practices and equipment manufacture or design continue to allow for such events to occur. The importance of both pre-anaes...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9902700116

    authors: Foreman MJ,Moyes DG

    更新日期:1999-02-01 00:00:00

  • Use of a Fogarty catheter as a bronchial blocker through a single-lumen endotracheal tube in patients with subglottic stenosis.

    abstract::One-lung ventilation can be achieved with a double-lumen tube or a bronchial blocker. However, the larger outer diameters of double-lumen or Univent tubes may prevent their passage through an area of subglottic stenosiss. We present five cases of subglottic stenosis in which a Fogarty catheter was used as a bronchial ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0303100215

    authors: Park HP,Bahk JH,Park JH,Oh YS

    更新日期:2003-04-01 00:00:00

  • Presentation of hemiplegic migraine--hemiplegia and hemi-sensory loss following general anaesthesia.

    abstract::We report a case of a 15-year-old male who developed severe left-sided hemiplegia and hemi-sensory loss 20 minutes after arrival in post anaesthetic care unit following an uneventful general anaesthesia for removal of a cannulated screw of left hip. Initial CT and MRI/MRA with diffusion-weighted imaging were unremarka...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X0703500318

    authors: Lin L,Adey C

    更新日期:2007-06-01 00:00:00

  • Low dose chlormethiazole infusion as a supplement to central neural blockade: blood concentrations and clinical effects.

    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

    pub_type: 杂志文章

    doi:10.1177/0310057X8000800405

    authors: Mather LE,Cousins MJ

    更新日期:1980-11-01 00:00:00

  • Left ventricular outflow tract obstruction-be prepared!

    abstract::The current trend to treat hypotension in critically ill patients is to place a greater emphasis on inotropic support and less on fluid resuscitation in order to limit the potential harm from fluid overload. This combination may trigger left ventricular outflow tract obstruction (LVOTO) in susceptible patients. Althou...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1704500103

    authors: Evans JS,Huang SJ,McLean AS,Nalos M

    更新日期:2017-01-01 00:00:00

  • Nerve blocks around the knee in children.

    abstract::Analgesia below the knee can be achieved by blocking the tibial nerve and the common peroneal nerve in the popliteal fossa, and the saphenous nerve adjacent to the knee. The anatomy and technique of nerve block in the popliteal fossa is described, the nerve being located prior to blockade using a peripheral nerve stim...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X8401200103

    authors: Kempthorne PM,Brown TC

    更新日期:1984-02-01 00:00:00

  • The effect of forced air warming on postoperative oxygen consumption and temperature in elective orthopaedic surgery.

    abstract::Actively warming patients during surgery is considered the best method of preventing inadvertent hypothermia. In order to investigate the effect of forced air warming on postoperative oxygen consumption, we studied 26 patients undergoing orthopaedic surgery using a prospective, randomized trial design. We measured oxy...

    journal_title:Anaesthesia and intensive care

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1177/0310057X9802600306

    authors: Wongprasartsuk P,Konstantatos A,McRae R

    更新日期:1998-06-01 00:00:00

  • The effects of prostaglandin E1 on interleukin-6, pulmonary function and postoperative recovery in oesophagectomised patients.

    abstract::The inflammatory reactions and tissue response after oesophagectomy are leading causes of postoperative morbidity and mortality. We evaluated the effects of intraoperative infusion of prostaglandin E1 (PGE1) on interleukin-6 (IL-6) levels, (A-a) DO2, pulmonary function and complications. This randomised double-blind c...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章,随机对照试验

    doi:10.1177/0310057X0903700618

    authors: Farrokhnia E,Makarem J,Khan ZH,Mohagheghi M,Maghsoudlou M,Abdollahi A

    更新日期:2009-11-01 00:00:00

  • Release of inflammatory mediators in association with collection of wound drainage blood during orthopaedic surgery.

    abstract::Ten patients undergoing hip replacement surgery were studied regarding activation of complement and leukocytes in association with collection of wound drainage blood. The blood was collected postoperatively but not reinfused due to the possible risks with reinfusion of blood containing inflammatory mediators. Blood sa...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9502300604

    authors: Arnold JP,Haeger M,Bengtson JP,Bengtsson A,Lisander B

    更新日期:1995-12-01 00:00:00

  • Use of inhaled nitric oxide in pulmonary embolism.

    abstract::Acute massive pulmonary embolism carries a high mortality with the majority of deaths occurring during the early phase. We describe a case of massive pulmonary embolism resulting in severe cardiovascular collapse and cardiac arrest which was treated successfully with inhaled nitric oxide. ...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9902700415

    authors: Crerar-Gilbert A,Boots R

    更新日期:1999-08-01 00:00:00

  • Successful use of rocuronium and sugammadex in an anticipated difficult airway scenario.

    abstract::Neuromuscular blocking agents are often avoided in anticipated difficult airway scenarios. However to facilitate jet ventilation, muscle relaxants are useful. We report a case of a potentially threatened airway in a 21-year-old with a large infraglottic pedunculated polyp. In this case rocuronium was used on induction...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X1003800226

    authors: McTernan CN,Rapeport DA,Ledowski T

    更新日期:2010-03-01 00:00:00

  • A comparison of parametric and non-parametric approaches to target-controlled infusion of propofol.

    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

    authors: Crankshaw DP,Brown MJ,Bjorksten AR

    更新日期:2010-05-01 00:00:00

  • Efficacy of pressure support in compensating for apparatus work.

    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

    authors: Bersten AD,Rutten AJ,Vedig AE

    更新日期:1993-02-01 00:00:00

  • Inhalational induction with sevoflurane in an adult with severe complex central airways obstruction.

    abstract::Sevoflurane is a newly available volatile anaesthetic agent which is suitable for inhalational induction of anaesthesia. Due to concerns about obstructing the upper airway as anaesthesia deepens, its use has until now been avoided in patients with upper airway obstruction. We used its smooth induction and recovery pro...

    journal_title:Anaesthesia and intensive care

    pub_type: 杂志文章

    doi:10.1177/0310057X9702500621

    authors: Watters MP,McKenzie JM

    更新日期:1997-12-01 00:00:00

  • Pioneers of laryngoscopy: indirect, direct and video laryngoscopy.

    abstract::Airway management is one of the core skills of the anaesthetist and various techniques of airway management have developed over many years. Initially, the only view of the glottis that could be obtained was an indirect view (indirect laryngoscopy). Late in the 19th century, a direct view of the glottis was obtained vi...

    journal_title:Anaesthesia and intensive care

    pub_type: 历史文章,杂志文章

    doi:10.1177/0310057X150430S103

    authors: Pieters BM,Eindhoven GB,Acott C,van Zundert AA

    更新日期:2015-07-01 00:00:00