Abstract:
:This case report outlines the clinical process whereby a patient with severe traumatic brain injury became a non-heartbeating organ donor after a withdrawal-of-care decision. This process raises a series of ethical questions regarding decision-making on grounds of futility, the role of the next of kin, informed consent, the accommodation of manoeuvres directed towards organ retrieval at maximal viability, and the timing and determination of death. Although many aspects of the process can be accommodated within fundamental ethical principles and a broad interpretation of the concept of the 'best interests', the variance with established law requires authoritative clarification if a need for transplantable organs is to be responded to without compromising the reputation of practitioners involved in this area of care. Therefore, this recruitment strategy warrants wide public and professional debate to achieve longer-term sustainability and ensure the protection of all parties.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Bell MDdoi
10.1093/bja/aei048subject
Has Abstractpub_date
2005-04-01 00:00:00pages
474-8issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35667-2journal_volume
94pub_type
杂志文章abstract::Arterial oxygenation was measured in patients being ventilated artificially for respiratory failure, initially at the FIO2 that had been selected clinically to achieve PaO2 at least normal, and then at each of two or three progressively increased FIO2 values up to about 0.9. Impairment of oxygen transfer was assessed ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/55.1.3
更新日期:1983-01-01 00:00:00
abstract::Ropivacaine is considered safer than bupivacaine, on the basis of experimental and human data that indicate a lower systemic toxicity. Here we report the occurrence of a single seizure after i.v. administration of ropivacaine 120 mg intended for extradural block in a patient having postpartum, tubal ligation. The only...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/80.6.843
更新日期:1998-06-01 00:00:00
abstract:BACKGROUND:The effect of anaesthesia on postoperative outcome is unclear. Cardioprotective properties of volatile anaesthetics have been demonstrated experimentally and in haemodynamically stable patients undergoing coronary artery bypass grafting. Their effects in patients undergoing high-risk cardiac surgery have not...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/bja/aeu290
更新日期:2014-12-01 00:00:00
abstract::Intrathecal midazolam causes antinociception by combining with spinal cord benzodiazepine receptors. This effect is reversible with doses of naloxone, suggesting involvement of spinal kappa or delta but not mu opioid receptors. The antinociceptive effects of intrathecally administered drugs in the spinal cord were dem...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.6.758
更新日期:1996-12-01 00:00:00
abstract::We present a case where rocuronium 80 mg (3 x ED95) was used in a rapid sequence induction in a 80-kg pregnant patient with an open eye injury. The patient was also receiving magnesium 2 g h-1 i.v. for preterm labour. The expected duration for neuromuscular block of rocuronium in the absence of magnesium would be appr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.5.669
更新日期:1996-11-01 00:00:00
abstract::Units for the investigation of susceptibility to malignant hyperthermia (MH) were set up in Denmark in 1977 and in Sweden in 1981. Two hundred and ten patients from 76 families have been investigated. The diagnosis of MH susceptibility (MHS) was made by in vitro exposure of muscle from vastus medialis to halothane and...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.11.1183
更新日期:1984-11-01 00:00:00
abstract::A new prototype of the laryngeal mask airway (LMA), the intubating laryngeal mask airway (ILMA), was used to facilitate tracheal intubation in 100 fasted patients presenting for elective surgery. Alignment of the ILMA with the larynx was assessed fibreoptically before intubation without the investigator performing the...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/79.6.710
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:The memory effect of dexmedetomidine has not been prospectively evaluated in children. We evaluated the feasibility of measuring memory and sedation responses in children during dexmedetomidine sedation for non-painful radiological imaging studies. Secondarily, we quantified changes in memory in relation to ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aew421
更新日期:2017-02-01 00:00:00
abstract::Robotic surgery pushes the frontiers of innovation in healthcare technology towards improved clinical outcomes. We discuss the evolution to five generations of robotic surgical platforms including stereotactic, endoscopic, bioinspired, microbots on the millimetre scale, and the future development of autonomous systems...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aex383
更新日期:2017-12-01 00:00:00
abstract::Protein kinase C (PKC) is a key regulatory enzyme that has been implicated as a molecular target for the action of general anaesthetics. We have determined the effects of halothane on the translocation and down-regulation of conventional PKC (cPKC) by analysing the subcellular distribution of PKC activity, [3H]phorbol...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/78.2.189
更新日期:1997-02-01 00:00:00
abstract::Blood transfusion saves many lives but carries significant risk of injury. Currently, red blood cell (RBC) concentrates can be stored up to 42 days. Concerns have recently been raised about the safety and efficacy of transfusing stored RBCs. Refrigerated storage results in a 'storage lesion' that is reflected by metab...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aet405
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:The solubility of desflurane compared with sevoflurane suggests more rapid recovery from desflurane anaesthesia. This could be important after prolonged anaesthesia and fast recovery may be advantageous in the elderly where slow recovery of mental function is a concern. We compared emergence from desflurane ...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/aeg221
更新日期:2003-10-01 00:00:00
abstract::We have compared deep body temperature (DBT) measured at the forehead with the core temperatures of the nasopharynx, oesophagus and rectum during the warming phase of cardiopulmonary bypass (CPB) (moderate hypothermia of 26.7-29.6 degrees C) in 12 patients. DBT was measured transcutaneously by an insulated thermistor ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.4.583
更新日期:1993-10-01 00:00:00
abstract::We have used the technique of double-blind sequential allocation to quantify the minimum local analgesic concentration (MLAC) of extradural bupivacaine for women in early (median cervical dilatation 2 cm) and late (median cervical dilatation 5 cm) labour. The first bolus was 20 ml of the bupivacaine test solution. The...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/80.1.11
更新日期:1998-01-01 00:00:00
abstract::We have compared bupivacaine 5 mg ml-1, either isobaric in saline 0.9% or hyperbaric in 8% glucose, for spinal anaesthesia in 100 children, aged 2-115 months, in a double-blind, randomized, parallel group, prospective study. Children were premedicated with diazepam 0.5 mg kg-1 orally. Seventy-two children were sedated...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/81.4.502
更新日期:1998-10-01 00:00:00
abstract::Bupivacaine 2.5 mg kg-1 (0.5 ml kg-1 of 0.5% solution), with or without adrenaline 5 micrograms ml-1, was administered by interpleural injection to 12 patients after elective cholecystectomy. Noncompartmental analysis indicated that the addition of adrenaline had no effect on total body clearance, apparent volume of d...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/64.6.662
更新日期:1990-06-01 00:00:00
abstract:BACKGROUND:High-dose glucocorticoid may reduce postsurgical pain and improve recovery. We hypothesized that 125 mg methylprednisolone (MP) would reduce time to meet functional discharge criteria after total hip arthroplasty (THA). METHODS:Forty-eight patients undergoing unilateral THA under spinal anaesthesia were con...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aes345
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Some anaesthetic agents exhibit an age-dependent analgesic effect, for example nitrous oxide, which is ineffective in newborn rats. We investigated whether a similar time dependency existed for the responses to the volatile anaesthetic isoflurane. METHODS:The analgesic and hypnotic properties of isoflurane ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei182
更新日期:2005-09-01 00:00:00
abstract::Use of inhaled nitric oxide for treatment of pulmonary hypertension in adult critical illness is limited by its mode of delivery and high costs, prompting evaluation of alternative therapies. We report the use of oral sildenafil in a patient with severe secondary pulmonary hypertension and right ventricular dysfunctio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei114
更新日期:2005-06-01 00:00:00
abstract::In order to clarify the relative contribution of hepatic metabolism to the short term disposition of methohexitone, we have measured hepatic blood flow during induction of anaesthesia with a 1.5-mg kg-1 i.v. bolus dose of methohexitone. Median hepatic clearance was 1.01 litre min-1 and hepatic extraction 87%. As a con...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.5.478
更新日期:1992-11-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine (DEX) is increasingly used intraoperatively in infants undergoing cardiac surgery. This phase 1 multicentre study sought to: (i) determine the safety of DEX for cardiac surgery with cardiopulmonary bypass; (ii) determine the pharmacokinetics (PK) of DEX; (iii) create a PK model and dosing for...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.bja.2019.06.026
更新日期:2019-12-01 00:00:00
abstract::A randomized, double-blind study of 38 patients undergoing total knee replacement was undertaken to compare the efficacy and respiratory effects of low-dose spinal morphine and patient-controlled i.v. morphine against patient-controlled i.v. morphine alone. Patients received either morphine 0.3 mg or saline 0.3 ml wit...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/85.2.233
更新日期:2000-08-01 00:00:00
abstract::Sepsis is a constellation of clinical signs and symptoms resulting from excessive systemic host inflammatory response to infection. This inflammatory response is largely mediated by cytokines, which are released into the systemic circulation. Plasma concentrations of specific cytokines, TNF alpha, IL-1 beta, IL-6 and ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/77.1.110
更新日期:1996-07-01 00:00:00
abstract:INTRODUCTION:Compared with term neonates, preterm babies are more likely to die from sepsis. However, the combined effects of sepsis and prematurity on neonatal postoperative mortality are largely unknown. Our objective was to quantify the proportion of neonatal postoperative mortality that is attributable to the syner...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,多中心研究
doi:10.1016/j.bja.2020.07.026
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Mechanosensory thalamocortical relay neurones (TCNs) receive glutamatergic excitatory input and are subjected to gamma-aminobutyric acid (GABA)Aergic inhibitory input. This study assessed the effects of an increase in concentration of isoflurane on thalamic excitatory and inhibitory mechanisms. METHODS:TCNs...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aef170
更新日期:2002-08-01 00:00:00
abstract:BACKGROUND:Individual patient information from clinical trials is infrequently available, but can provide insights for clinical trials and practice. METHODS:We analysed individual patient information from five randomized trials (913 patients) of i.v. patient-controlled analgesia (IVPCA) plus epidural placebo, morphine...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,meta分析
doi:10.1093/bja/aep300
更新日期:2009-12-01 00:00:00
abstract::We have studied the complications associated with three techniques used to maintain extradural analgesia in labour: midwife top-up doses of 0.25% bupivacaine 10 ml, continuous infusion of 0.125% bupivacaine 10 ml h-1 and patient-controlled extradural analgesia (PCEA) with self-administered 3-ml bolus doses of 0.25% bu...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/73.5.619
更新日期:1994-11-01 00:00:00
abstract::BW 403C65, an isoquinolinium bisquaternary compound, was investigated for its neuromuscular blocking properties. In vitro in from preparations, low concentrations induced an increase in miniature endplate potentials (m.e.p.p.) frequency without altering their amplitude. With increasing concentrations m.e.p.p. frequenc...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.9.929
更新日期:1975-09-01 00:00:00
abstract::Patients with renal failure and undergoing a cadaver renal transplant were found to have plasma concentrations of laudanosine, following the administration of a single bolus dose of atracurium 0.5 mg kg-1, higher than those found in patients without renal failure. Since laudanosine is a known central nervous system st...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/57.11.1049
更新日期:1985-11-01 00:00:00
abstract::We studied the effects of minor surgery and endotracheal intubation on postoperative breathing patterns. We measured breathing patterns and laryngeal resistance during the periods immediately before intubation (preoperative) and immediately after extubation following minor surgery (postoperative) in eight patients ana...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/bja/87.5.706
更新日期:2001-11-01 00:00:00