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 substitute for medical autopsy in this setting. METHODS:We investigated the potential of virtual autopsy by post-mortem CT to identify complications associated with medical devices in a prospective study of patients who had died in the ICU. Clinical records were reviewed to determine the number and types of medical devices used, and findings from medical and virtual autopsies, related and unrelated to the medical devices, were compared. RESULTS:Medical and virtual autopsies could be performed in 61 patients (Group M/V), and virtual autopsy only in 101 patients (Group V). In Group M/V, 41 device-related complications and 30 device malpositions were identified, but only with a low inter-method agreement. Major findings unrelated to a device were identified in about 25% of patients with a high level of agreement between methods. In Group V, 8 device complications and 36 device malpositions were identified. CONCLUSIONS:Device-related complications are frequent in ICU patients. Virtual and medical autopsies showed clear differences in the detection of complications and device malpositions. Both methods should supplement each other rather than one alone for quality control of medical devices in the ICU. Further studies should focus on the identification of special patient populations in which virtual autopsy might be of particular benefit. CLINICAL TRIAL REGISTRATION:NCT01541982.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Wichmann D,Heinemann A,Zähler S,Vogel H,Höpker W,Püschel K,Kluge Sdoi
10.1016/j.bja.2018.02.031subject
Has Abstractpub_date
2018-06-01 00:00:00pages
1229-1236issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(18)30168-5journal_volume
120pub_type
杂志文章abstract::The use of di-isopropyl phenol (Diprivan) for induction of anaesthesia was assessed in doses ranging from 1 to 3 mg kg-1. With less than 1.75mg kg-1 not all patients were anaesthetized; 2.0 mg kg-1 appeared to be a satisfactory induction dose. Involuntary muscle movement, cough and hiccup at induction were rare with a...
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/53.11.1197
更新日期:1981-11-01 00:00:00
abstract::Healthcare litigation in the UK continues to grow at an alarming rate, with claims against anaesthetists and critical care physicians increasing each year. This has led to a huge financial burden for the taxpayer and a sharp increase in professional indemnity fees for individual doctors. Although such litigation shoul...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes188
更新日期:2012-07-01 00:00:00
abstract::Methodology for assessment of depth of anaesthesia based on analysis of the electroencephalogram (EEG) is controversial. Techniques range from display of single measures, for example median value of the frequency spectrum, to dedicated pattern recognition systems based on measures of several EEG features. We have comp...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/77.2.172
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:A multidisciplinary approach to improve postoperative outcomes in frail elderly patients is gaining interest. Multidisciplinary team care should be targeted at complex patients at high risk for adverse postoperative outcome to limit the strain on available resources and to prevent an unnecessary increase in ...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2019.12.042
更新日期:2020-02-14 00:00:00
abstract::Raised intracranial pressure (ICP) and low cerebral blood flow (CBF) are associated with ischaemia and poor outcome after brain injury. Therefore, many management protocols target these parameters. This overview summarizes the technical aspects of ICP and CBF monitoring, and their role in the clinical management of br...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/ael110
更新日期:2006-07-01 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: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::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
abstract::In theory, setting an infrared multi-gas analyser to measure a volatile anaesthetic different from that in the sampled gas mixture may cause interference with carbon dioxide and nitrous oxide readings. The theory was investigated during evaluation of the Dräger Cicero EM anaesthetic workstation for the Medical Devices...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.5.737
更新日期:1996-05-01 00:00:00
abstract::We have compared bispectral index (BIS), 95% spectral edge frequency (SEF) and approximate entropy (ApEn) in 37 patients during induction and recovery from a short general anaesthetic. Heart rate variability (HRV) was also compared during induction only. These indices were noted at the start of induction, when a syrin...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/82.5.666
更新日期:1999-05-01 00:00:00
abstract:BACKGROUND:While volatile agents have been implicated in metastasis-enhancing effects on cancer cells, the effects of xenon are unknown. We investigated xenon- and sevoflurane-mediated effects on migration and expression of angiogenesis biomarkers in human breast adenocarcinoma cells. METHODS:MDA-MB-231 and MCF-7 cell...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeu191
更新日期:2014-07-01 00:00:00
abstract::Sleep disordered breathing is a common problem affecting all age groups, particularly in association with certain other medical conditions and syndromes. The pathological consequences of the disorder may be severe, with significant implications for the perioperative management of sufferers. Research into the effects o...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/86.2.254
更新日期:2001-02-01 00:00:00
abstract:BACKGROUND:To determine the pharmacokinetics (PK) of a new i.v. formulation of paracetamol (Perfalgan) in children ≤15 yr of age. METHODS:After obtaining written informed consent, children under 16 yr of age were recruited to this study. Blood samples were obtained at 0, 15, 30 min, 1, 2, 4, 6, and 8 h after administr...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aes025
更新日期:2012-05-01 00:00:00
abstract::Fifteen patients (10 men and five women; mean age 67.3 yr) with a history of a recent (less than 1 yr) myocardial infarction underwent ambulatory ECG monitoring for 5 days after non-cardiac surgery. The duration, number and severity of ischaemic episodes were maximal within the first 12 h after surgery and again on th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/67.3.317
更新日期:1991-09-01 00:00:00
abstract::Cancer treatment is associated with significant morbidity and mortality. Surgery is a mainstay of treatment for many tumours, and anaesthetists care for cancer patients on a daily basis. Surgery itself induces a stress response and inhibits the immune system, and cancer surgery is associated with the release of tumour...
journal_title:British journal of anaesthesia
pub_type: 杂志文章,评审
doi:10.1093/bja/aev375
更新日期:2015-12-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aeq001
更新日期:2010-03-01 00:00:00
abstract::We have investigated the effect of interpleural morphine on postoperative pain and pulmonary function after thoracotomy. At the end of surgery, an interpleural catheter was inserted in 17 patients and, in a double-blind and randomized manner, either a bolus of morphine 2.5 mg interpleurally (i.p.) and normal saline i....
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/69.6.637
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:ROTEM(®)/TEG(®) (rotational thromboelastometry) assays appear to be useful for the treatment of bleeding trauma patients. However, data on the prevalence and impact of abnormal ROTEM(®) assays are scarce. METHODS:This is a prospective cohort study of blunt trauma patients (Injury Severity Score ≥15 or Glasg...
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pub_type: 杂志文章
doi:10.1093/bja/aer158
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/87.6.935
更新日期:2001-12-01 00:00:00
abstract::In order to investigate the analgesic effect of timing of administration of ketorolac 10 mg i.v., we recorded patient-controlled use of diamorphine at 2, 4 and 12 h after abdominal hysterectomy. In a randomized, double-blind trial, 30 patients received ketorolac before skin incision and 28 after skin closure. A contro...
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/75.1.15
更新日期:1995-07-01 00:00:00
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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/47.11.1213
更新日期:1975-11-01 00:00:00
abstract::We have evaluated the accuracy and reliability of the Paratrend 7 continuous blood-gas analyser in infants and small children under conditions of severe hypoxaemia admitted to the paediatric intensive care unit in the perioperative period with cyanotic congenital heart disease. PO2, PCO2 and pH (hydrogen ion concentra...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/79.5.665
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:The 15-item Quality of Recovery (QoR-15) scale is a validated patient-reported outcome questionnaire that measures the quality of postoperative recovery. This study aimed to validate a translated Korean version of QoR-15 (QoR-15K) in a broad range of surgical patients. METHODS:After Korean translation of th...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1016/j.bja.2020.06.040
更新日期:2020-10-01 00:00:00
abstract::Abnormal oxygen use and organ failure in the critically ill may result from 'poisoning' of mitochondrial function. Measurement of arterial ketone body ratio (AKBR) has been proposed to reflect mitochondrial redox state and may provide a useful marker to monitor mitochondrial function in the critically ill. We measured...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/83.2.325
更新日期:1999-08-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/aer298
更新日期:2011-12-01 00:00:00
abstract::The effects of doxacurium chloride, a new long-acting non-depolarizing neuromuscular blocking drug, on cardiac performance were studied in 45 patients undergoing high-dose fentanyl-diazepam-oxygen anaesthesia for cardiac surgery. Data were collected at baseline (10 min after tracheal intubation), and at 2, 5 and 10 mi...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/63.6.675
更新日期:1989-12-01 00:00:00
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journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/76.1.99
更新日期:1996-01-01 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::A specific technique for detection of pulmonary aspiration during the perioperative period is lacking. In this study, we developed a scintigraphic method for its diagnosis. Technetium 99m sulphur colloid was given orally 2 h before an i.v. infusion of propofol in patients undergoing elective colonoscopy. During the pr...
journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章
doi:10.1093/bja/87.2.204
更新日期:2001-08-01 00:00:00
abstract::Visceromotor responses and vasopressin release before and after colonic visceral distension were compared between male (n=5 (n=4 for vasopressin)) and female rats and between females during the oestrous cycle (proestrus n=6, oestrus n=5, metestrus n=5, diestrus n=6) at a controlled depth of anaesthesia. Pre-stimulatio...
journal_title:British journal of anaesthesia
pub_type: 杂志文章
doi:10.1093/bja/85.6.907
更新日期:2000-12-01 00:00:00