Abstract:
BACKGROUND:Restrictive transfusion triggers are safe for most critically ill patients, but doubts exist for patients with ischaemic heart disease (IHD). We investigated the prevalence of reported IHD at admission to the intensive care unit (ICU) and investigated how this influenced red cell transfusion triggers. We also compared observed practice with the clinicians' responses to clinical scenarios. METHODS:We studied 1023 sequential ICU admissions over 100 days to 10 Scottish ICUs. Daily haemoglobin, red cell transfusion, and haemorrhage data were available for 99.4% of 5638 ICU patient days. We recorded if IHD was recorded in clinical records at ICU admission. We grouped admissions as having a non-cardiac primary ICU diagnosis and no documentary evidence of IHD (Group 1, n=697), a non-cardiac primary ICU diagnosis with evidence of IHD (Group 2, n=213), or a cardiac primary ICU admission diagnosis (Group 3, n=113). We examined pre-transfusion haemoglobin concentration (Hb) for transfusion episodes not associated with haemorrhage. Clinical transfusion scenarios were sent to intensivists in the ICUs after data collection, which were designed to explore the clinicians' attitude to transfusion triggers in patients with IHD. RESULTS:Previous myocardial infarction was documented in 159 (16%), cardiac failure in 142 (14%), and angina in 167 (16%). Overall, 28.8% of admissions had >/=1 of these documented. The adjusted mean (se) pre-transfusion Hb concentrations varied across the groups. These were 74 (2.2) g litre(-1) in Group 1, 77 (2.3) g litre(-1) in Group 2, and 79 (3.1) g litre(-1) in Group 3 (P=0.003 across the groups). There was concordance between observed practice and responses to the scenario similar to Group 1, but discordance for patients with IHD (Groups 2 and 3). In scenario responses, intensivists stated these patients should have significantly higher transfusion triggers than were actually observed (median [IQR] response for both groups: 90 [80-100] g litre(-1)). CONCLUSIONS:About 29% of patients admitted to Scottish ICUs had documented IHD, which was associated with small adjustments to Hb transfusion triggers. In response to scenarios, clinicians believe that patients with IHD require higher transfusion triggers than are observed in practice.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Walsh TS,McClelland DB,Lee RJ,Garrioch M,Maciver CR,McArdle F,Crofts SL,Mellor I,ATICS Study Group.doi
10.1093/bja/aei073subject
Has Abstractpub_date
2005-04-01 00:00:00pages
445-52issue
4eissn
0007-0912issn
1471-6771pii
S0007-0912(17)35663-5journal_volume
94pub_type
杂志文章,多中心研究abstract:BACKGROUND:The population in the UK is growing older and the number of elderly patients cared for on intensive care units (ICU) is increasing. This study was designed to identify risk factors for mortality in critically ill patients of >80 yr of age after surgery. METHODS:We identified 275 patients, aged 80 yr or grea...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem307
更新日期:2007-12-01 00:00:00
abstract::To determine the influence of renal failure on the pharmacokinetics and neuromuscular blockade of Org NC 45 (Norcuron), a new monoquaternary homologue of pancuronium, 13 patients under halothane and nitrous oxide anesthesia were studied. Org NC 45 was administered by 2-min infusion in doses of 0.28 mg kg-1 (normal ren...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.10.1049
更新日期:1981-10-01 00:00:00
abstract::We report the anaesthetic management of a male neonate with congenital cyst adenoid malformation (CCAM) of the lung who underwent thoracotomy for resection of CCAM 24 h after birth and again at 24 days. The initial operation involved a 10-day admission to a paediatric intensive care unit (PICU) requiring ventilation, ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aei171
更新日期:2005-08-01 00:00:00
abstract::One hundred and forty male rats received a cryoinjury to a segment of the exposed sciatic nerve. A variety of temperatures and freeze patterns was used and the recovery of function was monitored. Where obvious nerve freezing occurred, the cryoinjury caused complete loss of function in the limb. The return of motor act...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/53.11.1121
更新日期:1981-11-01 00:00:00
abstract::Thirty-two patients received lumbar extradural anaesthesia for elective Caesarean section. The results obtained from this series were compared with those from a similar (control) group of parturients who received general anaesthesia. The extradural group (mothers and infants) were metabolically acidaemic relative to c...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/51.4.367
更新日期:1979-04-01 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::Studies with an emulsion formulation of ICI 35 868 (2,6- diisopropylphenol ) indicate that this new formulation has anaesthetic properties in rats and mice, and haemodynamic effects in the mini-pig which are similar to those of the previously available Cremophor formulation. Administration of the emulsion formulation ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/56.6.617
更新日期:1984-06-01 00:00:00
abstract::The Walton-Brodie strain gauge arch is an instrument that quantitatively measures CF. Like many methods, the strain gauge arch is affected by loading conditions and heart rate. Nevertheless, this methodology, when properly used, has proved very useful in describing the direct action of anaesthetic drugs. Knowledge fro...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/60.suppl_1.78s
更新日期:1988-01-01 00:00:00
abstract::Chinese hamster fibroblast cells in stirred suspension cultures were exposed to volatile anaesthetic agents for 3 hr or for 24 hr. Cell viability was measured as colony forming ability and was found to be reduced, in a dose related manner, by halothane, chloroform, methoxyflurane, trichloroetheylene and diethyl ether....
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.8.831
更新日期:1975-08-01 00:00:00
abstract::The analgesic effects of an identical inguinal field block, performed before or immediately after inguinal herniorrhaphy, were evaluated in 32 healthy patients in a double-blind, randomized study. During surgery, all patients received a light general anaesthesia with thiopentone, alfentanil and nitrous oxide in oxygen...
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/68.4.344
更新日期:1992-04-01 00:00:00
abstract::We have assessed neuromuscular block electromyographically at the gastrocnemius muscle and compared it with that at the abductor digiti minimi muscle in 60 adult patients undergoing cervical spine surgery under general anaesthesia. All patients were in the prone position. After vecuronium 0.2 mg kg-1, times to onset o...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,收录出版
doi:10.1093/bja/82.3.329
更新日期:1999-03-01 00:00:00
abstract::Arterial PO2 (PaO2) has been related to inspired oxygen concentration (FIO2 range 0.21-0.60) in 20 patients, breathing spontaneously, while recovering from a range of conditions treated in an intensive therapy unit. There was a highly significant linear trend (P < 0.001) for the mean venous admixture ("virtual shunt")...
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/72.5.515
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND:Assessments of labour pain focus on pain intensity, not on duration. We aimed to assess the importance labouring women apply to pain intensity and duration before labour and post-delivery. METHODS:Forty healthy women scheduled for labour induction were enrolled in this institutional review board-approved, p...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu149
更新日期:2014-09-01 00:00:00
abstract::Although most local anaesthetic drugs are generally regarded as vasodilators at their site of injection, they produce systemic effects characterized by increases in peripheral resistance, cardiac output, arterial pressure heart rate. The direct depressive effects of the drugs are counterbalanced by increased sympathet...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:
更新日期:1975-02-01 00:00:00
abstract::The neuromuscular blocking effect of repeated bolus administration of suxamethonium 1 mg/kg was observed in 10 healthy surgical patients under enflurane-nitrous oxide-oxygen anaesthesia. Tachyphylaxis and slow recovery of the thumb twitch occurred in close dose-relationships with transition of Phase I block to Phase I...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.2.91
更新日期:1976-02-01 00:00:00
abstract:BACKGROUND:Anaesthetics blunt neuronal responses to noxious stimulation, including effects on electroencephalographic (EEG) responses. It is unclear how anaesthetics differ in their ability to modulate noxious stimulation-evoked EEG activation. We investigated the actions of propofol and halothane on EEG responses to n...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aei208
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:The 'cannot intubate cannot oxygenate' (CICO) emergency requires urgent front of neck airway (FONA) access to prevent death. In cases reported to the 4th National Audit Project, the most successful FONA was a surgical technique, almost all of which were performed by surgeons. Subsequently, UK guidelines adop...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.07.011
更新日期:2019-11-01 00:00:00
abstract::A simple method of adapting a pressure-cycled ventilator of the flow generator type to ventilate patients on a circle-absorber anaesthetic system is described. Standard lengths of corrugated black rubber tubing are placed between the ventilator and the circle-absorber is deadspace, replacing the reservoir bag. The per...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/49.3.273
更新日期:1977-03-01 00:00:00
abstract::Some recipients of isolated, orthotopic lung transplants have now survived to leave hospital with greatly improved quality of life. Inevitably, the successful demonstration of the feasibility of these operations means that transplant centres throughout the world may wish to participate in a lung transplant programme. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/61.4.468
更新日期:1988-10-01 00:00:00
abstract::The effect of the i.v. administration of methylene blue dye on haemoglobin oxygen saturation, measured by a pulse oximeter was investigated. The absorption spectra of various concentrations of haemoglobin, oxyhaemoglobin and methylene blue were compared. The amount of 660-nm light absorbed by methylene blue was suffic...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/60.4.439
更新日期:1988-03-01 00:00:00
abstract::In 40 patients anaesthetized with thiopentone, 66% nitrous oxide and 1% halothane, the effects of a single i.v. dose of nalbuphine 4.5, 8, 15, 25 or 50 mg/70 kg or morphine 3, 5, 10 or 17.5 mg/70 kg on total ventilation and end-tidal carbon dioxide concentration have been measured. Depression of respiration occurred w...
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/58.6.625
更新日期:1986-06-01 00:00:00
abstract::We describe a six-compartment physiological model of the kinetics and dynamics of induction of anaesthesia with propofol in sheep. It includes a faithful description of initial bolus kinetics caused by accurate representations of the inter-relationships between initial vascular mixing, lung kinetics and cardiac output...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/79.4.497
更新日期:1997-10-01 00:00:00
abstract::We describe the management of three patients undergoing awake carotid surgery who developed signs of cerebral ischaemia after carotid cross-clamping. Drug treatment to increase arterial blood pressure above baseline reversed the neurological deficit and an internal carotid artery shunt was not needed. Shunt insertion ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.4.641
更新日期:2001-10-01 00:00:00
abstract::We investigated the effect of incision and sternotomy on the auditory evoked potential (AEP) and EEG, to try to predict a haemodynamic response to incision or sternotomy using the AEP and EEG in 41 patients undergoing cardiac surgery during propofol and alfentanil anaesthesia. The AEP and EEG were recorded before inci...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.5.685
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:Normalization of plasma fibrinogen levels may be associated with satisfactory haemostasis and reduced bleeding. The aim of this retrospective study was to assess fibrinogen recovery parameters after administration of fibrinogen concentrate (Haemocomplettan P) to patients with diffuse bleeding in cardiovascul...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq058
更新日期:2010-05-01 00:00:00
abstract::Experiments were performed on rats using two analgesimetric tests (tail-flick; hot-plate) before and after injection i.v. of graded doses of aprotinin (12.5, 25.0 and 50 KIU g-1). A dose-related analgesic effect was noted with both tests. Prior administration of naloxone 0.001 mg g-1 i.p. inhibited the analgesic actio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.11.1107
更新日期:1980-11-01 00:00:00
abstract::Tetanic contractions of the adductor pollicis muscle in man were evaluated continuously after the administration of tubocurarine 0.2 mg/kg and during reversal by edrophonium 0.1 mg/kg. Single twitch contractions of the adductor pollicis were measured simultaneously. The response of tetanic and single twitch contractio...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/47.10.1087
更新日期:1975-10-01 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:Forty-eight ASA I-II patients undergoing total abdominal hysterectomy (TAH) were studied in a double blind, randomized placebo controlled trial of parecoxib for postoperative analgesia. METHODS:All patients were given propofol 2-4 mg kg(-1) i.v., a non-depolarizing muscle relaxant, morphine 10 mg i.v. and p...
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/aeg139
更新日期:2003-06-01 00:00:00
abstract:BACKGROUND:There has been increasing use of invasive techniques, such as extracorporeal organ support, in intensive care units (ICU), and declining autopsy rates. Thus, new measures are needed to maintain high-quality standards. We investigated the potential of computed tomography (CT)-based virtual autopsy to substitu...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2018.02.031
更新日期:2018-06-01 00:00:00