Abstract:
BACKGROUND AND OBJECTIVE:Although the PROWESS trial demonstrated a mortality benefit, subsequent studies in different patient populations have not reproduced the effect. As a result, concerns have been expressed about the clinical effectiveness of drotrecogin alfa (activated). Therefore the aim of this audit was to review the clinical impact of drotrecogin alfa (activated) when used outside clinical trials. METHODS:A retrospective review of ICU charts and medical records of patients who had received drotrecogin alfa (activated) in the five largest users of drotrecogin alfa (activated) in England. Patients characteristics details at ICU admission and vital status at hospital discharge were recorded. The severity of illness was assessed by the APACHE II score (using first 24 h admission data) and the number of organ dysfunctions. Adverse incidents were recorded and any sequence effect explored. RESULTS:In all, 351 patients received drotrecogin alfa (activated) between December 2002 and November 2005. Of those, 201 (57.2%) were male, and 177 (50.4%) were admitted after recent surgery. The patients' average age was 61.8 yr. The mean admission APACHE II score was 23.3 and the average number of dysfunctional organs on admission was 3.3. The hospital mortality was 46.7% (164 deaths). The expected number of deaths calculated by using the APACHE II risk of death was 173 (49.3%) and by number of sepsis induced organ failures 210 (59.7%). Overall, there were 33 (9.4%) adverse incidents. CONCLUSIONS:Expected mortality derived from both the APACHE II score and organ dysfunctions suggests that drotrecogin alfa (activated) does reduce mortality. Serious adverse incidents occurred in 5.1% patients; however, the direct contributing effect of drotrecogin alfa (activated) cannot be established from this type of audit.
journal_name
Eur J Anaesthesioljournal_title
European journal of anaesthesiologyauthors
Ridley S,Lwin A,Wyncoll D,Lippett S,Watson D,Gunning K,Higgins Ddoi
10.1017/S0265021507002992subject
Has Abstractpub_date
2008-03-01 00:00:00pages
211-6issue
3eissn
0265-0215issn
1365-2346pii
S0265021507002992journal_volume
25pub_type
杂志文章abstract:BACKGROUND:Volatile anaesthetics are a potential hazard during occupational exposure, pregnancy or in individuals with existing disposition to malignant hyperthermia. Anaesthetic waste gas concentration in postanaesthesia care units (PACU) has rarely been investigated. OBJECTIVE(S):The current study aims to assess con...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000785
更新日期:2018-07-01 00:00:00
abstract::Patients about to undergo a suspension laryngoscopy were randomly assigned to one of two groups (n = 10). They were given either etomidate 1 mg kg-1 followed by 1 mg kg-1 h-1, or propofol 2.5 mg kg-1 followed by 9 mg kg-1 h-1. Alfentanil 10 micrograms kg-1 was given to provide analgesia with a further half dose if nec...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1991-03-01 00:00:00
abstract::The post-operative period is particularly dangerous for obese patients. The aim of this study was to compare the immediate post-operative course after either laparoscopic or open gastroplasty. We studied retrospectively 20 and 14 consecutive patients who underwent laparoscopic or open adjustable silicone gastric bandi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1999.00510.x
更新日期:1999-06-01 00:00:00
abstract::The suitability of tramadol suppositories for inclusion in our hospital formulary for the treatment of mild to moderate post-operative pain was evaluated. In an open randomized trial, rectal tramadol was compared with our standard treatment acetaminophen/codeine suppositories. We expected tramadol to be equally effect...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2346.1999.00520.x
更新日期:1999-07-01 00:00:00
abstract::: Institutional protocols need to address the indications for pharmacological and mechanical thromboprophylaxis. The use of graduated compression stockings (GCS) and intermittent pneumatic compression (IPC) strongly differs between institutions. As a consequence, no strong recommendations can be made based on the cont...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,实务指引
doi:10.1097/EJA.0000000000000726
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Patients in cardiac surgery and critically ill patients often demonstrate either hypothermia or fever. In addition, owing to heart failure, they frequently require inotropic support. The relative effectiveness of modern inotropic agents at various temperatures has not yet been evaluated. Theref...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0b013e328330e9a0
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:Postoperative cognitive decline (pCD) occurs frequently (6 to 30%) after carotid endarterectomy (CEA), although there are no exact estimates and risk factors are still unclear. OBJECTIVE:The objective of this study was to determine pCD incidence and risk factors in CEA patients. DESIGN:We performed a syste...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000001130
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Patient blood management (PBM) can prevent preoperative anaemia, but little is known about practice in Europe. OBJECTIVE:To assess the pre and postoperative prevalence and perioperative management of anaemia in patients undergoing elective orthopaedic surgery in Europe. DESIGN:An observational study; data ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,多中心研究
doi:10.1097/EJA.0000000000000202
更新日期:2015-03-01 00:00:00
abstract:CONTEXT:Strabismus surgery is one of the most common ophthalmic surgical procedures in children and is associated with significant postoperative nausea and vomiting (PONV). OBJECTIVE:We evaluated the effect of intravenous paracetamol on PONV in children after strabismus surgery. DESIGN:Prospective, placebo-controlled...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0b013e32834c580b
更新日期:2011-12-01 00:00:00
abstract::The effects of 5% and 8% glucose in 0.5% tetracaine or bupivacaine on the anaesthetic spread were investigated in 80 urological patients requiring spinal anaesthesia for trans-urethral resection of the prostate. The local anaesthetic solutions were randomly administered, the patients being divided into four groups of ...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1989-05-01 00:00:00
abstract::We investigated the effects of controlled hypotension with haemodilution under isoflurane anaesthesia on splanchnic perfusion in elderly patients. We determined the intramucosal pH using gastric tonometry in 28 patients scheduled for hip surgery. Patients without cardiac disease were assigned to two groups according t...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章
doi:10.1046/j.1365-2346.1999.00531.x
更新日期:1999-08-01 00:00:00
abstract::Ninety-eight patients scheduled for elbow, forearm, wrist or hand surgery were allocated randomly to one of two different techniques of brachial plexus block, both using the axillary approach. The blocks were all performed at the level of the insertion of the lateral margin of the pectoralis major muscle on the humeru...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1995-07-01 00:00:00
abstract::The time profile of the neuromuscular block produced by a single bolus administration of vecuronium was simulated by a new model for the access of the relaxant to the receptors on the motor end plates. The receptors were assumed to be kinetically a part of the interstitial space of the muscle. The time course of the n...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:We assessed the analgesic efficacy of postoperative epidural infusions of ropivacaine 0.1 and 0.2% combined with sufentanil 1 microg mL(-1) in a prospective, randomized, double-blinded study. METHODS:Twenty-two ASA I-III patients undergoing elective total-knee replacement were included. Lumbar...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021502001096
更新日期:2002-09-01 00:00:00
abstract::The analgesic efficacy of tenoxicam, a newer injectable non-steroidal anti-inflammatory drug, for post-operative analgesia after abdominal or orthopaedic surgery in ASA Grade I/II patients is reported. Two hundred and fifty-six patients received a single dose of tenoxicam 40 mg intravenous (i.v.) at the end of surgery...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2346.1997.00061.x
更新日期:1997-05-01 00:00:00
abstract::Data on 13 043 operations were abstracted from 108 878 anaesthetic records in the Cardiff Anaesthetic Record System. Nine groups of surgical operations with high mortality in hospital were identified. These records were analysed using a logistic regression model to determine the probability of death in hospital. Varia...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
abstract::This paper focuses on the potential role of second messenger systems as general anaesthetic targets. Intracellular free calcium, cyclic nucleotides (cAMP, cGMP), inositol polyphosphates, the protein kinase-activating second messenger diacylglycerol, and the transducing G proteins involved in receptor-coupled second me...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The importance of monitoring the breathing pattern during sedation of children undergoing magnetic resonance scans is indicated in guidelines, but no appropriate magnetic resonance-compatible devices are available. We report preliminary findings from a technique referred to as remote pressure s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021507000312
更新日期:2007-09-01 00:00:00
abstract::Ringer's solution expands blood volume by between 20% and 25% in awake volunteers, but little is known about its volume effect during general anaesthesia. In 35 men with a mean age of 70 years, the power of various intra-operative factors to change blood volume as estimated by the haemoglobin dilution method were anal...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00313.x
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Adding various opioids to the local anaesthetic solution administrated intrathecally improves the analgesic potency of spinal analgesia. The purpose of this study was to evaluate the efficacy and safety of intrathecal fentanyl 10 microg added to 15 mg hyperbaric ropivacaine in patients undergoi...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021505000785
更新日期:2005-06-01 00:00:00
abstract::A 36-year-old female presented with seizures and transient dysphasia in her 31 week of pregnancy. Neuroradiological investigations revealed a large falx meningioma. A decision was taken to deliver the infant and excise the tumor before term because of the risk of an increase in the size of the tumour and the risk of s...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.1365-2346.1998.00225.x
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:The current opioid epidemic highlights the urgent need for effective adjuvant therapies to complement postoperative opioid analgesia. Intra-operative ketamine infusion has been shown to reduce postoperative opioid consumption and improve pain control in opioid-tolerant patients after spinal fusion surgery. I...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000000877
更新日期:2019-01-01 00:00:00
abstract::The occurrence of myocardial ischaemia will result in either reversible or irreversible myocardial dysfunction. Even when revascularization is successful, some reperfusion injury may occur that transiently impairs myocardial function. Therefore, treatment should not only be directed towards prompt restoration of myoca...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,评审
doi:10.1097/EJA.0b013e32832fad8b
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Hypotension, the commonest side-effect of spinal anaesthesia, results from sympathetic denervation. This study compared patient positioning (supine vs. decubitus) on haemodynamic variables during spinal anaesthesia. METHODS:After intravenous crystalloid preloading with 5 mL kg(-1), hyperbaric ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1017/s0265021505001183
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:Comparisons of peri-operative complications associated with paediatric (≤16 years) and adult anaesthesia are poorly available, especially in which cardiac surgery, organ transplantation and neurosurgery are involved. OBJECTIVE:The aim of this study was to evaluate the nature and incidence of peri-operative ...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000769
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Measurement of inflammatory mediators in bronchoalveolar lavage (BAL) during lung resection surgery with periods of one-lung ventilation (OLV) has revealed an intense local pulmonary response. The role of each lung in the inflammation that occurs during this procedure has never been investigated. OBJECTIVE(...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1097/EJA.0000000000000233
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:ProSeal Laryngeal Mask Airway (PLMA) and Laryngeal Tube Suction (LTS), supraglottic airway devices allowing gastric drainage, were compared in this prospective, randomized study for airway management under conditions with elevated intra-abdominal pressure induced by capnoperitoneum. METHODS:Fi...
journal_title:European journal of anaesthesiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1017/s0265021505000220
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The gamma-aminobutyric acidA receptor (GABAAR) is a target for anaesthetic agents. We investigated the interactions of sevoflurane with a recombinant GABAAR. Emphasis was on the mechanism of block, as relevant open-channel block by a volatile anaesthetic would possibly explain prolonged GABAerg...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1046/j.0265-0215.2001.00848.x
更新日期:2001-06-01 00:00:00
abstract:BACKGROUND:Magnesium sulphate is an important adjuvant drug in multimodal anaesthesia. In combination with rocuronium it can enhance neuromuscular blockade (NMB). Limited data exist concerning the effect of magnesium sulphate on the duration of deep or intense NMB and the period of no response. OBJECTIVE(S):To determi...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章,随机对照试验
doi:10.1097/EJA.0000000000001003
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:It has been reported that the left molar approach of laryngoscopy can make difficult intubation easier. The aim of this study was to investigate whether left molar approach to laryngoscopy provided a better laryngeal view in cases of unexpected difficult intubation. METHODS:Following the appro...
journal_title:European journal of anaesthesiology
pub_type: 杂志文章
doi:10.1017/S0265021508004110
更新日期:2008-08-01 00:00:00