Abstract:
BACKGROUND:Malposition of tracheostomy tubes is difficult to detect at the bedside and may contribute to eventual device misplacement. Endoscopic examination can be undertaken via tracheoscopic (T-view) or trans-laryngeal (L-view) approach, offering more precise detail regarding positioning within the airway. The aims of this study were to evaluate inter-rater agreement between bespoke T and L view scoring systems and subsequently whether T-views could predict L-views. METHODS:Adult intensive care unit patients with percutaneous or surgical tracheostomies were included and paired T and L-views of their tracheostomy tube within the airway were taken on up to four occasions. Images were later scored by five independent raters using bespoke scoring systems. The primary outcome was to determine the T and L view scoring system with the best inter-rater agreement, defined by weighted kappa and intra-class correlation coefficients. The secondary outcome was to assess agreement between T and L-view scoring systems. RESULTS:Seventy-one T-views and 43 L-views were obtained from a total of 20 patients. Images were scored by five raters, resulting in 355 T-view scores, 215 L-view scores and 215 paired T and L-view scores for comparison. There was good inter-rater agreement (highest T-view k = 0.84, L-view k = 0.72). There was poor agreement between T and L-view scores for each of the paired images (highest k = 0.25) although extreme-to-extreme misclassification rates remained acceptable. CONCLUSIONS:Whilst our data demonstrated good inter-rater agreement between scoring systems, it is not possible to reliably predict the T-view orientation and position of a tracheostomy tube within the airway from the paired L-view. CLINICAL TRIAL REGISTRATION:NCT01356719.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
McGrath BA,Lynch K,Templeton R,Webster K,Simpson W,Alexander P,Columb MOdoi
10.1093/bja/aew336subject
Has Abstractpub_date
2017-01-01 00:00:00pages
132-138issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)30124-1journal_volume
118pub_type
评论,信件abstract::Intravenous dose-response relationships for dimethyl tubocurarine showed that vagal blockade only became appreciable (50-83%) at doses 8-16 times those sufficient for full neuromuscular paralysis in anaesthetized cats (0.0625 mg/kg) and rhesus monkeys (0.125 mg/kg); heart rate was unchanged. Sympathetic function was u...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/48.9.847
更新日期:1976-09-01 00:00:00
abstract::A 38-yr-old woman with an atrial septum defect and Eisenmenger syndrome was scheduled for a lung biopsy via thoracoscopy during one-lung ventilation. Fluids were given to increase central venous pressure to 8 mm Hg, an epidural catheter was inserted at the sixth thoracic intervertebral space and ropivacaine 0.3%, 6 ml...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh104
更新日期:2004-04-01 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
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:BACKGROUND:The Bispectral Index (BIS) is a proprietary index of anaesthesia depth, which is correlated with the level of consciousness and probability of intraoperative recall. The present study investigates the use of a neural network technique to obtain a non-proprietary index of the depth of anaesthesia from the pro...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/88.5.644
更新日期:2002-05-01 00:00:00
abstract::The coherent frequency (CF) of the auditory evoked response (AER) is derived using auditory clicks presented at frequencies in the range 5-47 Hz. CF and psychological performance were measured while seven subjects breathed isoflurane in doses increasing from 0% to 0.2%, 0.4% and 0.8% end-tidal concentration and then d...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/71.5.633
更新日期:1993-11-01 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:BACKGROUND:It is believed that the severely disturbed night-time sleep architecture after surgery is associated with increased cardiovascular morbidity with rebound of rapid eye movement (REM). The daytime sleep pattern of patients after major general surgery has not been investigated before. We decided to study the ci...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aem340
更新日期:2008-01-01 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::We report an unusual case of acute upper airway obstruction. Inhalation of a foreign body caused choking in a 5-yr-old child, but subsequent investigations revealed a large anterior mediastinal tumour, externally compressing the trachea and the main bronchi. Such a presentation may be deceptive and is important, as ge...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.5.632
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:Psychological factors are thought to drive inter-patient variations in anaesthetic and analgesic requirements. This cross-sectional study investigated whether preoperative psychological factors can predict anaesthetic requirements and postoperative pain. METHODS:Before total thyroidectomy, 100 consecutive w...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer305
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Anaesthetics suppress the formation of lasting memories at concentrations that do not suppress perception, but it is unclear which elements of the complex cascade leading from a conscious experience to a lasting memory trace are disrupted. Experiments in conscious humans suggest that subhypnotic concentratio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer451
更新日期:2012-04-01 00:00:00
abstract:BACKGROUND:Capnography may provide useful non-invasive bedside information concerning heterogeneity in lung ventilation, ventilation-perfusion mismatching and metabolic status. Although the capnogram may be recorded by mainstream and sidestream techniques, the capnogram indices furnished by these approaches have not pr...
journal_title:British journal of anaesthesia
pub_type: 评论,杂志文章
doi:10.1093/bja/aew127
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:The relationship between end-tidal sevoflurane concentration, bispectral index (BIS) and the EEG bispectrum in children appears to be age dependent. The aim of this study was to quantify the BIS values at 1 MAC (minimum alveolar concentration) for desflurane and halothane, and explore the relationship with a...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/ael034
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:The safety of performing spinal anaesthesia for both patients and anaesthetists alike in the presence of active infection with the novel coronavirus disease 2019 (COVID-19) is unclear. Here, we report the clinical characteristics and outcomes for both patients with COVID-19 and the anaesthetists who provided...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.03.007
更新日期:2020-06-01 00:00:00
abstract::The case histories are reported of one patient who developed evidence of extradural infection 16 days postpartum, and another who spontaneously developed an extradural haematoma. Several points of interest and concern raised by these case histories are discussed. ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/47.3.412
更新日期:1975-03-01 00:00:00
abstract::Five hundred and seventeen women in labour receiving extradural analgesia, using bupivacaine plain solution, were randomly allocated to one of three groups. Group A received 6-8ml of 0.5% solution, group B 10-14ml of 0.25% solution, and group C 6-8 ml of 0.25% solution. Spontaneous delivery occurred in 31.7% of patien...
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/53.9.933
更新日期:1981-09-01 00:00:00
abstract:BACKGROUND:There are no published data to predict tracheostomy tube size as growth proceeds in children requiring long-term ventilation. METHODS:A retrospective audit was undertaken of children having long-term ventilation, managed from the Southport spinal injuries unit. The dates of step-up in size of tracheostomy t...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh296
更新日期:2005-01-01 00:00:00
abstract:BACKGROUND:Arterial cannulation is a common anaesthetic procedure that can be challenging and time-consuming in small children. By visualizing the position of the radial artery, near-infrared vascular imaging systems (NIRVISs) might be of assistance in arterial cannulation. The present study evaluates the effectiveness...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes193
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Data on bupivacaine concentrations in the cerebral spinal fluid (CSF) during spinal anaesthesia are scarce. The purpose of this study was to determine the concentration of bupivacaine in the lumbar CSF of patients with an adequate level of spinal anaesthesia after injection of plain bupivacaine 0.5%. METHOD...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep049
更新日期:2009-06-01 00:00:00
abstract::The effects of different premedication (i.m. and i.v.) on the usefulness of midazolam or thiopentone as induction agents for minor surgery was studied in 194 women undergoing either dilatation and curettage or explorative fractionate curettage. Midazolam appeared to produce light sedation which required powerful preme...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/54.5.507
更新日期:1982-05-01 00:00:00
abstract::We conducted a randomized, double-blind comparison of 8% sevoflurane and propofol as induction agents for day-case cystoscopy in 102 patients. All patients received an i.v. cannula and breathed oxygen 5 litre min-1. Anaesthesia was induced with propofol i.v. or inhalation of 8% sevoflurane and 10% Intralipid (as a pla...
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/78.4.356
更新日期:1997-04-01 00:00:00
abstract:BACKGROUND:The minimum alveolar concentration (MAC) is a traditional index of the hypnotic potency of an inhalational anaesthetic. To investigate the anaesthetic as well as the unwanted effects of xenon (Xe) in a swine model, it is useful to know MAC(Xe). METHODS:The study was performed using ten swine (weight 27.8-35...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeh077
更新日期:2004-03-01 00:00:00
abstract::We have studied the immediate and long term (up to 28 days) effects of short and long bevelled needle impalement of the rat sciatic nerve. Three techniques were used to assess neural trauma and its consequences: stained longitudinal nerve sections were assessed by light microscopy and scored for injury; the extravasat...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/69.5.433
更新日期:1992-11-01 00:00:00
abstract::Dose-response relationships for the antagonism of intermediate-acting neuromuscular blocking agents have not been evaluated previously in children. We have examined the dose-response relationships for neostigmine antagonism of 90% rocuronium-induced neuromuscular block in children and adults, during nitrous oxide-1 MA...
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/77.6.710
更新日期:1996-12-01 00:00:00
abstract:BACKGROUND:The objective of the present study was to investigate sublingual microvascular blood flow and microcirculatory haemoglobin oxygen saturation (Smc(O(2))) during cardiopulmonary bypass (CPB) using constant systemic blood flow but different perfusion pressures achieved by phenylephrine administration. METHODS:...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aep018
更新日期:2009-04-01 00:00:00
abstract::A study of core temperature monitoring during general anesthesia indicates that this can be introduced as a routine procedure in order to reduce mortality from malignant hyperpyrexia. The temperature profiles of 2410 patients are presented. Both mean rectal and mean oesophageal temperatures decreased during general an...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/52.12.1223
更新日期:1980-12-01 00:00:00
abstract:BACKGROUND:The second gas effect (SGE) is considered to be significant only during periods of large volume N(2)O uptake (VN(2)O); however, the SGE of small VN(2)O has not been studied. We hypothesized that the SGE of N(2)O on sevoflurane would become less pronounced when sevoflurane administration is started 60 min aft...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/ael008
更新日期:2006-03-01 00:00:00
abstract::An oxygen consuming lung model was used for evaluation and validation of a technique for metabolic gas exchange measurements during controlled ventilation. The technique comprised a Servo 900 C ventilator (Siemens) and separate oxygen and carbon dioxide analysers (Beckman). Measurements of oxygen consumption and carbo...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/64.3.311
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:The surgical pleth index (SPI) is a measurement of intraoperative nociception. Evidence of its usability in children is limited. Given that the autonomic nervous system is still developing during the first years of life, the performance of the SPI on small children cannot be concluded from studies carried ou...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,随机对照试验
doi:10.1093/bja/aew215
更新日期:2016-09-01 00:00:00