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Добірка наукової літератури з теми "Anaesthesia and intensive care"

Автор: Grafiati

Опубліковано: 14 вересня 2024

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Статті в журналах з теми "Anaesthesia and intensive care"

Stoddart, J. C. "Anaesthesia and intensive care." Anaesthesia 44, no. 3 (March 1989): 193. http://dx.doi.org/10.1111/j.1365-2044.1989.tb11219.x.

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Vanstrum, Glenn. "Anaesthesia and Intensive Care." Critical Care Medicine 18, no. 10 (October 1990): 1194. http://dx.doi.org/10.1097/00003246-199010000-00045.

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Cooper, Michael G., Jeanette Thirlwell, Richard J. Bailey, Stephanie Brown, and Caitlin Murphy. "Anaesthesia and Intensive Care." Anaesthesia and Intensive Care 43, no. 1_suppl (July 2015): 1. http://dx.doi.org/10.1177/0310057x150430s101.

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Downey, G. B., and A. J. O'Connell. "Audit of Unbooked Paediatric Post-Anaesthesia Admissions to Intensive Care." Anaesthesia and Intensive Care 24, no. 4 (August 1996): 464–71. http://dx.doi.org/10.1177/0310057x9602400409.

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We performed an audit of booked and unbooked admissions to a paediatric intensive care unit (PICU) after anaesthesia over a 19 month period in order to determine whether unbooked admissions were predictable, or whether there were any preventable anaesthetic factors responsible for PICU admission, and to evaluate the necessity of PICU admission in all study patients. Data was collected from the PICU database and from the medical records, especially the anaesthesia records, of unbooked admissions. There were 640 admissions to the PICU from the operating theatres, with 35 (5%) unbooked. Of the unbooked admissions, 71% were considered predictable and 20% had preventable features. There was an appropriate use of intensive care resources by these unbooked patients, with 77% having PICU-specific therapies (compared with 88% of booked cases). This quality assurance tool was relatively easy to perform, however it has numerous limitations hampering future routine use.

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MEAKIN, GEORGE H. "Pharmacology for Anaesthesia and Intensive Care." Current Anaesthesia & Critical Care 12, no. 3 (June 2001): 186–87. http://dx.doi.org/10.1054/cacc.2001.0302.

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Shaefi, Shahzad, and James P. Rathmell. "Pharmacology for Anaesthesia and Intensive Care." Journal of Trauma: Injury, Infection, and Critical Care 65, no. 6 (December 2008): 1569. http://dx.doi.org/10.1097/ta.0b013e31818b20b4.

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Sneyd, R. "Evidence-Based Anaesthesia and Intensive Care." British Journal of Anaesthesia 98, no. 2 (February 2007): 278–79. http://dx.doi.org/10.1093/bja/ael348.

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McLeod, G. A. "Pharmacology for Anaesthesia and Intensive Care." British Journal of Anaesthesia 100, no. 5 (May 2008): 731. http://dx.doi.org/10.1093/bja/aen056.

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Farling, P. A. "Radiology for Anaesthesia and Intensive Care." British Journal of Anaesthesia 104, no. 3 (March 2010): 391. http://dx.doi.org/10.1093/bja/aeq008.

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Gribomont, Bernard Francois. "Monitoring in Anaesthesia and Intensive Care." Anesthesia & Analgesia 80, no. 2 (February 1995): 435–36. http://dx.doi.org/10.1097/00000539-199502000-00059.

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Більше джерел

Дисертації з теми "Anaesthesia and intensive care"

Hawthorne, Christopher. "Physiological and pharmacological modelling in neurological intensive care and anaesthesia." Thesis, University of Glasgow, 2017. http://theses.gla.ac.uk/8721/.

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Mathematical models of physiological processes can be used in critical care and anaesthesia to improve the understanding of disease processes and to guide treatment. This thesis provides a detailed description of two studies that are related through their shared aim of modelling different aspects of brain physiology. The Relationship Between Transcranial Bioimpedance and Invasive Intracranial Pressure Measurement in Traumatic Brain Injury Patients (BioTBI) Study describes an attempt to model intracranial pressure (ICP) in patients admitted with severe traumatic brain injury (TBI). It is introduced with a detailed discussion of the monitoring and modelling of ICP in patients with TBI alongside the rationale for considering transcranial bioimpedance (TCB) as a non-invasive approach to estimating ICP. The BioTBI Study confirmed a significant relationship between TCB and invasively measured ICP in ten patients admitted to the neurological intensive care unit (NICU) with severe TBI. Even when using an adjusted linear modelling technique to account for patient covariates, the magnitude of the relationship was small (r-squared = 0.32) and on the basis of the study, TCB is not seen as a realistic technique to monitor ICP in TBI. Target controlled infusion (TCI) of anaesthetic drugs exploit known pharmacokinetic pharmacodynamic (PKPD) models to achieve set concentrations in the plasma or an effect site. Following a discussion of PKPD model development for the anaesthetic drug propofol, the Validation Study of the Covariates Model (VaSCoM) describes a joint PKPD study of the Covariates Model. Pharmacokinetic validation of plasma concentrations predicted by the model in forty patients undergoing general anaesthesia confirmed a favourable overall bias (3%) and inaccuracy (25%) compared to established PKPD models. The first description of the pharmacodynamic behaviour of the Covariates Model is provided with an estimated rate constant for elimination from the effect site compartment (ke0) of 0.21 to 0.27 min-1.

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Kong, Kin Leong. "The use of isoflurane for sedation of ventilated patients in the intensive therapy unit : a comparative study with midazolam." Thesis, University of Bristol, 1991. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364341.

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Samuelsson, Peter. "Awareness and Dreaming during Anaesthesia : Incidence and Importance." Doctoral thesis, Linköpings universitet, Institutionen för medicin och hälsa, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-15408.

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The definition of awareness used consistently in this thesis is: Explicit recall of intraoperative events during general anaesthesia. Since there is no objective method to detect awareness, the patients must be interviewed after anaesthesia. The form and timing of the interview is crucial. To rely on spontaneous disclosure of awareness episodes is not sufficient. The total number of awareness-victims is considerable although the incidence may seem modest. A number of these patients look upon the awareness experience as the worst experience in their life. Suffering can include pain, mental distress and delayed psychological symptoms. However, the experience of awareness is not uniform and not all patients suffer. A comprehensible definition for dreaming during anaesthesia is: Any recalled experience, excluding awareness, which occurred between induction of anaesthesia and the first moment of consciousness upon emergence. Some findings point in the direction that dreaming during anaesthesia may be related to light or insufficient anaesthesia, but other findings do not. Some patients find dreaming during anaesthesia distressing, but generally the overall impression is that consequences of dreaming during anaesthesia seem to be small and of minor importance to the majority of patients. In this thesis I have found the following:The incidence of awareness is approximately 0.2% when neuromuscular blocking drugs are used and awareness also exists without these drugs, albeit to a lesser extent. These findings represent standard practice in an adult population at normal risk. 50% of awareness cases may have delayed recall of awareness. Using a consecutive inclusion design we found initial awareness suffering comparable to previous studies, but a lower incidence and less pronounced severity of late psychological symptoms. The incidences found among the awareness-victims in our study were; experience of pain 46%, immediate mental distress 65%, any late psychological symptom 33%, and PTSD below 10%. A memory of an intraoperative dream after general anaesthesia is not an early interpretation of delayed awareness, indicating that no routine follow up of dreaming-only patients is indicated. Dreams reported after anesthesia are generally not related to insufficient anesthesia defined as high BIS, and should not be regarded as near awareness.

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Micski, Erik. "CO2 Flow Estimation using Sidestream Capnography and Patient Flow in Anaesthesia Delivery Systems." Thesis, KTH, Skolan för kemi, bioteknologi och hälsa (CBH), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-261664.

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Volumetric CO2 data from patients in anaesthesia delivery systems are sought after by physicians. The CO2 data obtained with the commonly used sidestream sampling technique are not considered adequate for volumetric CO2 estimation due to distortion and desynchrony with patient flow. The purpose of this thesis was to explore the possibility of using signal enhancing methods to the sidestream data to accurately estimate CO2 flow using a Flow-i anaesthesia delivery system. To evaluate sidestream performance, experimental data was acquired using a mainstream and a sidestream capnograph connected in series to a FRC test lung with known CO2 content, ventilated by a Flow-i anaesthesia machine. The data was then enhanced and analysed using signal processing methods including sigmoid modelling and neural networks. A Feed Forward Neural Network achieved results closest resembling the mainstream capnogram of the evaluated signal processing methods. The mainstream capnogram, considered the benchmark, produced large internal scattering and approximately 25 % offset from actual CO2 flow while using the inherent patient flow data produced by the Flow-i anaesthesia system. When using patient flow data from a Servo-i ventilator, the resulting CO2 flow estimates were drastically improved, producing estimates within 10 % error. This thesis concludes that there are several potential processing methods of the sidestream data to approximate the mainstream signal, however the patient flow of the Flow-i system are a suspected source of error in the CO2 flow estimation.

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Halvorsen, Alexander. "Preoperativ oro hos barn : Anestesisjuksköterskors erfarenhet att bemöta och lindra oro hos barn : intervjustudie." Thesis, Högskolan i Gävle, Medicin- och vårdvetenskap, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-24090.

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Introduktion: Anestesi på barn ställer anestesisjuksköterskan inför en komplex situation. Barn är oroliga inför det okända som ska hända. För att minska oron behöver anestesisjuksköterskan reducera deras nivå av oro. Föräldrarna tryggar barnen och tillsammans med dem ska anestesisjuksköterskan delge barnen trygghet. Syfte: Beskriva anestesisjuksköterskors erfarenheter i att bemöta och lindra oro hos barn som ska genomgå anestesi. Metod: En kvalitativ intervjustudie, innehåll analyserades utifrån kvalitativ innehållsanalys. Sammanlagt intervjuades 8 anestesisjuksköterskor med varierande ålder och yrkeserfarenhet. Resultat: Anestesisjuksköterskornas erfarenheter visade att skapa trygghet, ha ett avledande tillvägagångsätt och att utgå ifrån den egna professionen var viktigt för att bemöta och lindra oro. Att samarbeta med föräldrarna, skapa en relation till barnet och ha bra preoperativa förberedelser tycktes skapa trygghet hos både barnet och föräldern. De använde sig av avledande strategier för att flytta den negativa oron till något positivt. Den erfarenhet som anestesisjuksköterskorna hade gav dem en trygg grund i de situationer som inte var fullt så optimala. Då det inte fanns några färdiga mallar i hur de ska bemöta och lindra oro hos barn ansåg de flesta att ”fingertoppskänslan” har stor betydelse. Det viktiga var att hela tiden anpassa sig till barnet och ta den tid som behövdes. Slutsats: Studien belyste anestesisjuksköterskans erfarenhet av att bemöta och lindra oro hos barn. I resultatet framkom att anestesisjuksköterskan upplevde svårighet att bemöta oroliga barn samt att det var en svår situation de ställdes inför. Emellanåt kunde samarbetet med oroliga föräldrar vara svårt, dock kunde samarbetet förbättras om anestesisjuksköterskan och föräldern hade samma målbild. Det ställdes höga krav på kompetens och ödmjukhet samtidigt som anestesisjuksköterskan hade en viktig roll i att skapa trygghet hos barnen.
Introduction To prepare a child for anesthesia put the nurses in a complex situation. The child is worried about the unknow that is going to happen and therefore the nurse needs to reduce the child’s level of anxiety and worry. The parents are supposed to comfort the child and together with the nurse they should help the child to manage the difficult situation. Aim: Describe the anesthesia nurses experience in addressing and reducing anxiety in children who are about to undergo anesthesia. Method:A qualitative interview study of 8 nurses with different age and work experience where included and interviewed. Result: Based on the experience of the nurses it showed that the most important thing where to create comfort, use distractions and the ability to use their previous professional experience. To be able to cooperate with the parents, create a relationship with the child as well as excellent preoperative preparation seemed to create comfort in both the child and the parents. The nurses used distracting strategies to transfer the negative anxiety to something more positive. Since there are no written guidelines of how to comfort children about to undergo anesthesia the nurses had to use and incorporate their previous experience as an anesthesia nurse. The nurses mentioned that it is crucial to be able to sense and evaluate the situation and then act based on the conclusion. The most important thing was to adapt and conform to the need of the child and not rush the process. Conclusion: The study highlighted the experience of the nurse’s preoperative care. The result showed that the nurses experienced difficulty to care for worried children as well as the complex situation they were presented with. Sometimes worried parents made the situation more complex for the anesthesia nurse since they were not able to cooperate and work together. However, the corporation could be improved if the anesthesia nurse and the parent had the same goal and a joint way of handling the situation. The anesthesia nurse were required to have high professional competence, advanced humility as well the ability to make sure that the child is comfortable and relaxed.

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Kongara, Kavitha. "Studies on renal safety and preventive analgesic efficacy of tramadol and parecoxib in dogs : thesis in fulfilment of the degree of Doctor of Philosophy in Veterinary Clinical Science, Institute of Veterinary Animal and Biomedical Sciences, College of Sciences, Massey University, Palmerston North, New Zealand." Massey University, 2008. http://hdl.handle.net/10179/864.

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Ovariohysterectomy and castration are common surgical procedures in small animal practice that can result in clinically significant postoperative pain. One way of controlling postoperative pain is administration of a single analgesic or a combination of different classes of analgesics prior to the onset of noxious stimuli. A constraint to the perioperative use of traditional opioids and non-steroidal anti-inflammatory drugs (NSAIDs) is their undesirable side effects. In this series of experiments, the preventive (pre-emptive) analgesic efficacy of two popular human analgesics, tramadol (an ?atypical? opioid) and parecoxib (a NSAID with selective COX-2 inhibition) was evaluated in dogs. Initially, the efficacy and renal safety of parecoxib, tramadol and a combination of parecoxib, tramadol and pindolol (a -adrenoceptor blocker and 5-HT1A/1B antagonist) were screened in anaesthetised healthy dogs. These analgesics increased the dogs? nociceptive threshold to mechanical stimuli, without causing significant alterations in the dogs? glomerular filtration rate (GFR) estimated by plasma iohexol clearance. Subsequently, the efficacy of tramadol was compared with morphine, in dogs undergoing ovariohysterectomy or castration. The Glasgow composite measure pain scale-short form score (CMPS-SF) and changes in intraoperative electroencephalogram (EEG) responses were used to assess the efficacy of analgesics. Of the three treatment groups (preoperative morphine, 0.5 mg kg-1; preoperative tramadol, 3 mg kg-1; a ?combination? of preoperative low-dose morphine, 0.1 mg kg-1, and postoperative tramadol 3 mg kg-1), dogs given the ?combination? had significantly lower pain scores after ovariohysterectomy. In castrated dogs, preoperative tramadol (3 mg kg-1) and morphine (0.5 mg kg-1) were tested and no significant difference in the CMPS-SF score were observed between them. Changes in EEG variables were not specific between the treatment groups in ovariohysterectomised dogs. Finally, the efficacy of test drugs was evaluated against acute noxious electrical stimulation in anaesthetised dogs, using EEG. Median frequency of the EEG, a reliable indicator of nociception, increased significantly in tramadol and parecoxib groups, compared to morphine, after electrical stimulation. These studies demonstrated that tramadol and parecoxib can produce analgesia in dogs with insignificant side effects. The efficacy of tramadol appears to vary with the type of noxious stimulus. A complete prevention of noxious input by administration of analgesics pre- and post-operatively could have important clinical applications.

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Cowley, Nicholas John. "Point of care intravenous anaesthetic measurement in anaesthesia and critical care." Thesis, University of Birmingham, 2014. http://etheses.bham.ac.uk//id/eprint/5127/.

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Maintenance of anaesthesia using the intravenous agent propofol has increased following development of pharmacokinetic models. An analyser capable of determining propofol concentrations at the point of care may lead to an improved accuracy of drug delivery. Validation work on a novel analyser measuring propofol concentration in near real time demonstrate a high level of precision for samples in the clinical range. Further work in the clinical setting was carried out using the novel propofol analyser to further research its potential use in a diverse patient cohort. Studies were performed in intensive care correlating blood propofol concentrations with depth of sedation, demonstrating a correlation with organ failure. The Marsh model of Target Controlled Anaesthesia was poorer at predicting propofol concentration in patients with significant organ dysfunction than in those without organ failure (correlation coefficient 0.36 vs. 0.73 respectively). Studies in the operating room were performed in which measured propofol concentrations were compared with those predicted using the Marsh model. Results demonstrated significant inaccuracies of the model (bias 32%, precision -8.7 to 72.6%). A method of Marsh model bias correction using a single blood propofol measurement was tested. Results demonstrated insufficient predictability to allow a single point calibration.

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Hammond, Janet Margaret Justine. "Nosocomial infections in intensive care." Master's thesis, University of Cape Town, 1993. http://hdl.handle.net/11427/26477.

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The objectives of this thesis are : 1) To provide a review of the literature on the significance, pathogenesis, diagnosis and management of secondary infections in the Intensive Care Unit. 2) To present the findings of a study of the technique of selective parenteral and enteral antisepsis regimen (SPEAR) in the patient population of the Respiratory ICU at Groote Schuur Hospital, aimed at reducing the incidence of secondary infection and, further to evaluate the study in terms of the effect of SPEAR on the incidence of secondary infection and its influence on the mortality due to secondary infection. 3) To present the findings of the effect of SPEAR on patient bacterial colonisation in the ICU, and to evaluate its longterm influence on the microbial flora of the ICU.

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Whitfield, Karen M. "Sedation in paediatric intensive care." Thesis, Aston University, 2002. http://publications.aston.ac.uk/11055/.

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This study consisted of two stages. Stage 1 investigated the reproducibility and practicality of two observational sedation assessment scales for use in critically ill children. The two scales were different in design, the first being simple in design requiring a single assessment of the patient. The second was more complex in design requiring assessment of five patient parameters to obtain an overall sedation score. It was established that nursing staff preferred the second, more complex sedation scale mainly because it was perceived to give a more accurate assessment of level of sedation and anxiety rather than merely level of sedation. Stage 2 investigated the pharmacokinetics and pharmacodynamics of midazolam in critically ill children. 52 children, aged between 0 and 18 years were recruited to the study and 303 blood samples taken to analyse midazolam and its metabolites, 1-hydroxymidazolam (1-OH) and 4-hydroxymidazolam (4-OH). A significant correlation was found between midazolam plasma concentration and sedative effect (r=0.598, p=0.01). It was found that a midazolam plasma concentration of 223ng/ml (±31.9) achieved a satisfactory level of sedation. Only a poor correlation was found between dose of midazolam and plasma concentration of midazolam. Similarly only a poor correlation was found between sedative effect and dose of midazolam. Clearance of midazolam was found to be 6.3ml/kg/min (±0.36), which is lower than that reported in healthy children (9.11-13.3ml/kg/min). neonates produced the lowest clearance values (1.63ml/kg/min), compared to children aged 1 to 12 months (8.52ml/kg/min) who achieved the highest clearance values. Clearance was found to decrease after the age of 12 months to values of 5.34ml/kg/min in children aged 7 yeas and above. Patients with renal (n=5) and liver impairment (n=4) were found to have reduced midazolam clearance (1.37 and 0.74ml/kg/min respectively). Disease state was found to affect production of 1-OH. Patients with renal impairment (n=5) produced the lowest 1-OH midazolam plasma ratio (0.059) compared to patients with head injury (0.858).

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Vetcho, Siriporn. "Family-Centred Care Within Thai Neonatal Intensive Care." Thesis, Griffith University, 2022. http://hdl.handle.net/10072/417298.

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Background: Neonates who require specialized care and life-saving therapies in neonatal intensive care units (NICUs) and neonatal special care units (NSCUs) can be exposed to separation from their parents and families. Consequently, establishing a parental-neonate bond can be difficult. However, addressing this problem of separation through involving parents and families in neonatal care to improve parent-professional collaboration can result in positive outcomes for neonates and their families. Family-centred care (FCC) has developed over decades and is broadly recommended as an ideal model of care in daily clinical practice in NICUs. However, FCC implementation is challenging at individual, organizational, cultural, and healthcare system levels. In particular, developing countries are challenged by the lack of material resources, infrastructure, and staff shortages. In Thailand, the practical incorporation of FCC into daily clinical practice in neonatal care units is difficult, and it has not been sustainably achieved. Furthermore, there has been minimal research reporting on the development, implementation, and evaluation of FCC in the neonatal critical care context within Thailand. Aim and Objectives: The aim of this PhD study has been to develop, implement and evaluate innovation to facilitate FCC by improving respect, collaboration, and support in a Thai NICU. It had three objectives, each representing a distinct phase in the study: (1) to identify perceptions, current practices and FCC strategies; (2) to develop and implement an innovation to facilitate FCC by improving respect, collaboration, and support in a Thai NICU; and (3) to evaluate the FCC innovation developed in Phase 2. Methods and Results Design: The multistage, mixed-methods study design applied the Participatory Intervention Model (PIM) to guide the innovation’s development, implementation, and evaluation to facilitate FCC by improving respect, collaboration, and support in a Thai NICU. Setting and context: This study was conducted in a tertiary care hospital in southern Thailand (February 2020-January 2021). Ethics approval was obtained from the Research Ethics Committee of Hatyai Hospital and Griffith University. Phase 1: Identification of perceptions, current practices, and FCC strategies Phase 1 was planned to include data collection over 3 months. Due to the COVID-19 pandemic, it was reduced to 2 months during the very early stages of the pandemic (February to March 2020). This phase consisted of two parts, including surveys and interviews with parents and the interdisciplinary professionals. Participants: Participants consisted of two groups: parents of neonates (all gestational ages with no life-threatening or life-limiting diagnosis) who had an expected NICU stay of at least 72 hours and visited the study NICU at least once, and interdisciplinary professionals with a permanent position for at least 1 year in the study unit. Part A: Survey of parents and interdisciplinary professionals Surveys of parents and interdisciplinary professionals were conducted using the validated Perceptions of Family Centred Care – Parent (PFCC-P) and Perceptions of Family Centred Care – Staff (PFCC-S) instruments which were translated into Thai. Sample size: Sample size was based on availability of parents and interdisciplinary professionals over the planned 3-month Phase 1 period. Recruiting parent participants in Phase 1 was prior/during the very early stages of the COVID-19 pandemic and needed to be stopped prior to pre-determined sample size of 100 parents due to visitor restriction (n = 85). Eighty-five parents and 20 interdisciplinary professionals completed the surveys. Data analysis: Demographic characteristics of parents, interdisciplinary professionals, and neonates are reported using descriptive statistics. The subscale scores for parents and interdisciplinary professionals were not normally distributed, so medians were calculated for each of the three sub-scales (respect, collaboration, and support). Parents’ and interdisciplinary professionals’ perceptions of FCC (PFCC-P & PFCC-S) were compared using the Mann-Whitney U test to examine differences in medians in the preimplementation phase because they were unpaired groups. Part B: Semi-structured interviews with parents and interdisciplinary professionals Face-to-face, semi-structured, individual interviews were planned to gain information from extended family members and parents and interdisciplinary professionals; however, given the visitation restrictions, only parents and interdisciplinary professionals were recruited to participate (during the first half of February 2020). Sample size: The sample size was determined when data saturation was identified. Eight interdisciplinary professionals and nine parents participated in face-to-face interviews. Data analysis: Thematic analysis was used to analyse the transcribed Thai language interviews. Results: The survey results across the median of three subscales demonstrated that parents and interdisciplinary professionals’ perceptions on the FCC strategies in current practice were 2-3/4 (Interquartile range [IQR] 1.7-3.8) and 3-4/4 (2.85-3.55), respectively. Considering the median subscale scores, the interdisciplinary professionals had significantly higher subscale scores for respect (median 3.00 (95% CI, 2.91-3.24) vs 2.50 (2.37-2.81)), collaboration (median 3.22 (3.10-3.37) vs 2.33 (1.9-2.62)), and support (median 3.20 (3.03-3.39) vs 2.60 (2.03-2.61)) (all p ≤ 0.001). The interview findings highlighted that the interdisciplinary professionals in this study accepted that the three critical elements of FCC (respect, collaboration, and support) were necessary to be implemented into clinical practice. However, they believed that in reality it was not easy in the Thai NICUs context. This finding identified that the challenge to promote parent-healthcare professional partnerships was associated with the structure and processes of the healthcare delivery system. In addition, the individuality of families' readiness and healthcare providers' perceptions of parents’ involvement as obstacles to providing care were found to be challenges to current practices of FCC. Phase 2: Development and implementation of innovation to facilitate FCC This phase was achieved by two different methods: strategy development working group and implementation of the FCC innovation. Strategy development working group: The development of FCC innovations by the strategy development working group (June to August 2020) was based on Phase 1 findings and the reported integrative literature review. In addition, the FCC innovations were considered within the policies and practices of the NICU in the context of COVID- 19 in Thailand. The development working group members were key and high-level stakeholders in the NICU. Educational activities for the healthcare professional team to incorporate the FCC innovations into their clinical practice in NICU were provided. Implementation of the FCC innovation: The FCC innovations were then implemented over 2 months (September to October 2020), during a period of restrictions on parents and staff arising from COVID-19. Results: The working group identified the gaps in the three key elements (respect, collaboration, and support) to providing FCC in a Thai NICU through the analysis of Phase 1’s results in consort with the findings from the integrative review. A preliminary protocol for the FCC innovations and implementation plan were developed consistent with the challenges associated with COVID-19 in Thailand. FCC practice innovations associated with improving communication were established, including changes and updates to the material within the parent booklet with specific material related to COVID- 19, neonatal updates at bedside or conducted via telephone calls, interdisciplinary family meeting for complex care situations, structured communication checklists, and documentation templates. In addition, although visiting restrictions were limiting, parents were provided with more flexibility as to when they could visit based on individual circumstances. The majority of the healthcare providers in this setting (80%) attended the educational activities to incorporate the FCC innovations into their clinical practice in the NICU. The FCC innovations were incorporated into daily NICU practice by nurses in cooperation with other healthcare providers and ancillary support staff during the pandemic. Phase 3: Evaluation of the FCC innovation Phase 3 (post-implementation) was conducted over 3 months (November 2020-January 2021), and it focused on evaluating the FCC innovations. This phase repeated the collection of data from the validated PFCC-P and PFCC-S surveys of parents and interdisciplinary professionals' perceptions, as per Phase 1, to assess respect, collaboration, and support changes after implementing the FCC innovations in the Thai NICU during the pandemic. Sample size: One hundred parents and 20 interdisciplinary professionals completed the surveys. Data analysis: As per Phase 1 for demographic characteristics. The Mann-Whitney U test was used to analyse parents' perceptions of the items of the PFCC-P pre- and postimplementation given they were two independent groups. Wilcoxon signed-rank test was used to compare the perceptions of the interdisciplinary professionals pre- and postimplementation using the PFCC-S given they were matched samples. Results: The participants consisted of 83 pairs of parents (i.e., mother and/or father of neonate participated) (35 pre; 48 post), which represented 102 neonates (50 pre; 52 post). There were 185 parents; 85 pre-implementation and 100 post-implementation. For the NICU health care team, 20 participated. The median scores of parents' perceptions post-implementation significantly improved for respect (2.50 to 3.50; 95%CI, 3.02-3.53), collaboration (2.33 to 3.33; 2.90- 3.40), support (2.60 to 3.60; 2.84-3.62), and the overall score (2.50 to 3.43) (p < 0.001, 95%CI 2.93-3.51). There was an absolute difference of at least 0.3 in the pre- and postimplementation scores for three subscales and overall score, where 0.3 corresponds to 10% of the rating scale. Comparatively, interdisciplinary professionals' perception of FCC did not significantly change pre- and post-implementation for respect ([median] 3.00 to 2.92; 95%CI, 2.87-3.16), collaboration (3.22 to 3.33; 3.16-3.47), support (3.20 to 3.20; 2.96-3.28) and overall (3.15 to 3.20; 95%CI, 3.10-3.25). Conclusions:Results from this study indicate that incorporating FCC innovations in the NICU appeared to be successful, despite the challenges of COVID-19. The key finding was that the innovations incorporated in the NICU were primarily based on communication strategies, a simple means to support, collaborate with, and respect parents that required low investment within the complex situation arising from COVID-19. These innovations were essential to engage collaborative working between parents and healthcare providers to promote parents as partners in a neonatal critical care team. To successfully implement FCC innovations in different settings, further innovations associated with communication methods need to target the specifics of individuals involved, healthcare settings, and available resources.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Nursing & Midwifery
Griffith Health
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Книги з теми "Anaesthesia and intensive care"

Morris, Turner John, and Beasley Jennifer, eds. Neurosurgical anaesthesia and intensive care. 2nd ed. London: Butterworths, 1986.

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P, Adams Anthony, and Cashman Jeremy N, eds. Anaesthesia, analgesia and intensive care. London: Edward Arnold, 1991.

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Hopkins, Richard, Carol Peden, and Sanjay Gandhi, eds. Radiology for Anaesthesia and Intensive Care. Cambridge: Cambridge University Press, 2009. http://dx.doi.org/10.1017/cbo9780511642166.

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Moller, Ann, and Tom Pedersen, eds. Evidence-Based Anaesthesia and Intensive Care. Cambridge: Cambridge University Press, 2006. http://dx.doi.org/10.1017/cbo9780511544613.

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Hopkins, Richard. Radiology for anaesthesia and intensive care. Cambridge: Cambridge University Press, 2010.

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P, Smith S., ed. Drugs in anaesthesia and intensive care. Tunbridge Wells: Castle House, 1990.

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Ann, Møller, and Pedersen Tom, eds. Evidence-based anaesthesia and intensive care. Cambridge, UK: Cambridge University Press, 2006.

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Peck, T. E. Pharmacology for anaesthesia and intensive care. 3rd ed. Cambridge: Cambridge University Press, 2008.

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Hopkins, Richard. Radiology for anaesthesia and intensive care. 2nd ed. Cambridge, UK: Cambridge University Press, 2010.

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Sasada, M. P. Drugs in anaesthesia and intensive care. Tunbridge Wells: Castle House, 1990.

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Частини книг з теми "Anaesthesia and intensive care"

Kaliamoorthy, Ilankumaran. "Anaesthesia in Paediatric Liver Transplantation." In Pediatric Liver Intensive Care, 91–93. Singapore: Springer Singapore, 2018. http://dx.doi.org/10.1007/978-981-13-1304-2_15.

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Racenberg, E. "The First Interdisciplinary Centre for Intensive Care Therapy in Prague." In Anaesthesia, 262–64. Berlin, Heidelberg: Springer Berlin Heidelberg, 1985. http://dx.doi.org/10.1007/978-3-642-69636-7_56.

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Persona, Paolo, and Carlo Ori. "Simulation in Anaesthesia and Intensive Care." In Anaesthesia, Pharmacology, Intensive Care and Emergency A.P.I.C.E., 39–46. Milano: Springer Milan, 2013. http://dx.doi.org/10.1007/978-88-470-5516-2_4.

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Aitkenhead, A. R. "Training in Anaesthesia and Intensive Care." In Anaesthesia, Pain, Intensive Care and Emergency Medicine - A.P.I.C.E., 627–34. Milano: Springer Milan, 1998. http://dx.doi.org/10.1007/978-88-470-2278-2_68.

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Jacques, T. "Education in Intensive Care." In Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E., 913–20. Milano: Springer Milan, 2001. http://dx.doi.org/10.1007/978-88-470-2903-3_87.

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Sikdar, Sunandan, and Swarup Paul. "Nutrition in Cardiac Intensive Care." In Handbook of Cardiac Critical Care and Anaesthesia, 282. Boca Raton: CRC Press, 2023. http://dx.doi.org/10.1201/9781003027584-40.

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Barvais, L., B. Ickx, and P. Pandin. "Total Intravenous Anaesthesia." In Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E., 227–36. Milano: Springer Milan, 1999. http://dx.doi.org/10.1007/978-88-470-2145-7_20.

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Busoni, P. "Perioperative paediatric anaesthesia." In Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E., 835–40. Milano: Springer Milan, 2004. http://dx.doi.org/10.1007/978-88-470-2189-1_14.

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Gasparetto, A., and R. Orsi. "Pharmacoeconomics in Anaesthesia." In Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E., 1031–40. Milano: Springer Milan, 1996. http://dx.doi.org/10.1007/978-88-470-2203-4_99.

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Merli, M., M. Migliarese, and F. Milazzo. "Fast Track Anaesthesia." In Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E., 653–63. Milano: Springer Milan, 1997. http://dx.doi.org/10.1007/978-88-470-2296-6_60.

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Тези доповідей конференцій з теми "Anaesthesia and intensive care"

Suciaghi, Mariana. "The role and involvement of the family in the care of patients hospitalized at anaesthesia and intensive care units." In Scientific-Practical Сonference ‘FAMILY RESILIENCE PERSPECTIVES IN THE CONTEXT OF MULTIPLE CRISES’. X Edition. Stratum plus I.P., High Anthropological School University, 2023. http://dx.doi.org/10.55086/prfcmcx153162.

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This paper aims to study the role and involvement of the family in the care of patients hospitalized in the ICU, which is a traumatic experience for both patients and their families. First and foremost, the family can provide emotional support to patients who may feel anxious, stressed and frightened during their hospitalisation in the ICU. Secondly, the family can play an important role in communicating with medical staff, ensuring that patients receive the necessary information about their health status and treatment plan. Thirdly, patients who feel supported by their family may be more confident in their own abilities and more willing to be actively involved in the recovery process. In conclusion, family involvement in the care of critically ill patients in the ICU can lead to reduced levels of anxiety and stress in patients and help to achieve a favourable outcome.

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Beck, A., K. Smith, and A. McCallum. "ESRA19-0064 Survey of current attitudes towards the use of regional anaesthesia in intensive care units." In Abstracts of the European Society of Regional Anesthesia, September 11–14, 2019. BMJ Publishing Group Ltd, 2019. http://dx.doi.org/10.1136/rapm-2019-esraabs2019.282.

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Supraptomo, Rth. "A Case Report on Regional Anaesthesia in Pregnant Women with Severe Pre-Eclampsia, Partial Hellp Syndrome, Fetal Distress, and Type II Diabetes Mellitus." In The 7th International Conference on Public Health 2020. Masters Program in Public Health, Universitas Sebelas Maret, 2020. http://dx.doi.org/10.26911/the7thicph.05.29.

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ABSTRACT Background: Maternal mortality in Indonesia is caused by multifactors that are both direct and indirect factors. Complications during pregnancy and after delivery, including preeclampsia is the direct cause of 90% of maternal deaths. This case report aimed to describe the anaesthesia management on the incidence of severe preeclampsia to prevent the complications. Subjects and Method: We reported a 33-year-old G3P2A0 woman with 33 weeks of gestational age, diagnosed with severe pre-eclampsia partial HELLP syndrome, fetal dis-tress, type II diabetes mellitus pro SCTP emergency with physical status ASA II. Regional anaesthesia with sub-arachnoid block was performed by using Lidodex 75 mg and fentanyl 25 mcg intrathecally. Results: From the operation process, a baby boy with birth weight 2.900 gram and APGAR Score 7-8-9 was born. Two-hour post operation examination on patient showed compos mentis (consciousness), blood pressure 121/ 80 mmHg, heart rate 64 bpm, respiration rate 20 breath per minute, blood oxygen saturation levels (SpO2) 99% with 3 L/min nasal cannula. Patient was administered to HCU post operation to be monitored vital sign and signs of impending eclampsia. Post-operative refeeding was performed after bowel sound was positive. Conclusion: Selection of appropriate anaesthetic management in severe preeclampsia cases can prevent complications. Keywords: severe preeclampsia, sectio caesaria, regional anesthesia, subarachnoid block Correspondence: R. Th. Supraptomo. Department of Anaesthesiology and Intensive Therapy Dr. Moewardi Hospital. Jl Kolonel Sutarto 132 Jebres, Surakarta, Central Java, 57126. Email: ekasatrio-@gmail.com. Mobile: +6281329025599. DOI: https://doi.org/10.26911/the7thicph.05.29

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Backhouse, C. M., D. AJ Galvin, R. A. Harper, A. C. Meek, and C. N. McCollum. "PARTICULATE CONTAMINATION OF DRUGS: THEIR EFFECT ON PLATELET KINETICS AND THE PULMONARY CIRCULATION." In XIth International Congress on Thrombosis and Haemostasis. Schattauer GmbH, 1987. http://dx.doi.org/10.1055/s-0038-1644867.

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More than 107 particulate contaminants >2um and many more <2um are infused daily in parenteral medications to intensive care patients. They may form emboli with aggregated platelets and damage pulmonary vasculature [1], perhaps contributing to alveolar fibrosis in very premature babies. We studied this possibility in neonatal pigs.Nineteen newborn pigs were randomised to either daily 0.2um filtered salineas controls, or infusions of particles similar to drug contaminants at 10x greater than the patient equivalent dose/kg given via subcutaneous injection portals with tunnelled central venous catheters. Four weeks later, autologous platelets were labelled with llllndium and arterial and Swann Ganz catheters inserted under general anaesthesia. Before particle or filtered saline infusion and at 5 and 20 minutes later platelet count, lung platelet uptake, mean arterial pressure (BP), pulmonary vascular resistance, pulmonary shunt and alveolar-arterial P02 difference were measured.Initially, there were no significant differences between the groups indicating no measureable effect from chronic particle dosing over 4 weeks. Within 30 sec of bolus particle injection BP fell from a mean ( ± sem) of 68.9+2.1mmHg to 61.0±2.1 (p<0.01, paired t-test) but returned to normal within 5 minutes. This was not seen with controls or particle injections given over 5 minutes. Platelet counts fell in the particle group from 660±43 (x109/L) to 584±46 at 20 minutes (p<0.01) but lung platelet accumulation was insignificant.Transient fall in blood pressure due to contaminating particles can be avoided by slow injection or 0.2um in-line filters. Particles stimulate a loss of circulating platelets but with insignificant pulmonary accumulation and no impairment of pulmonary function after 4 weeks of daily particle injection at considerably higher doses than patients receive.1. Chia C, Cattell V. The role of platelets in mesangial localisation: carbon uptake in thrombocytopaenic rats. BrJ Exp Path 1985; 66: 465-474.

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Stylianides, Nikolas, Marios D. Dikaiakos, George Panayi, and Theodoros Kyprianou. "Intensive Care Window: Real time monitoring and analysis in the intensive care environment." In 2009 9th International Conference on Information Technology and Applications in Biomedicine (ITAB 2009). IEEE, 2009. http://dx.doi.org/10.1109/itab.2009.5394437.

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Kothare, Pratima. "Endoscopic skull base surgery-anaesthesia considerations." In 17th Annual Conference of Indian Society of Neuroanaesthesiology and Critical Care. Thieme Medical and Scientific Publishers Private Ltd., 2016. http://dx.doi.org/10.1055/s-0038-1667599.

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V, Ramya. "Embedded Intensive Patient Care Unit." In First International Conference on Artificial Intelligence, Soft Computing and Applications. Academy & Industry Research Collaboration Center (AIRCC), 2011. http://dx.doi.org/10.5121/csit.2011.1315.

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Gjermundrod, Harald, Marios Papa, Demetrios Zeinalipour-Yazti, Marios D. Dikaiakos, George Panayi, and Theodoros Kyprianou. "Intensive Care Window: A Multi-Modal Monitoring Tool for Intensive Care Research and Practice." In Twentieth IEEE International Symposium on Computer-Based Medical Systems. IEEE, 2007. http://dx.doi.org/10.1109/cbms.2007.64.

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Evans, Ruth, Victoria Barber, Padmanabhan Ramnarayan, and Jo Wray. "97 Paediatric intensive care retrieval – families’ experience of their child’s journey to intensive care." In GOSH Conference 2020 – Our People, Our Patients, Our Hospital. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2020. http://dx.doi.org/10.1136/archdischild-2020-gosh.97.

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Beer, David de, Jonathan Smith, and Bill Walsh. "22 Simulation-based training in paediatric anaesthesia: the experience of running a managing emergencies in paediatric anaesthesia (MEPA) programme at one institution." In GOSH Conference 2019, Care of the Complex Child. BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health, 2019. http://dx.doi.org/10.1136/archdischild-2019-gosh.22.

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Звіти організацій з теми "Anaesthesia and intensive care"

Denny, Dr N. M., Dr K. Fox, Dr C. Gillbe, Dr A. W. Harrop-Griffiths, Dr M. Jones, Dr N. Love, Dr P. MacNaughton, et al. Ultrasound in anaesthesia and intensive care: a guide to training. The Association of Anaesthetists of Great Britain and Ireland, July 2011. http://dx.doi.org/10.21466/g.uiaaic-.2011.

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He, Miao, Zhaoqiong Zhu, Min Jiang, Xingxing Liu, Rui Wu, and Junjie Zhou. Risk factors for postanesthetic emergence delirium in adults: A systematic review and meta-analysis. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, January 2022. http://dx.doi.org/10.37766/inplasy2022.1.0021.

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Review question / Objective: Patientor population: patients with emergence delirium; Exposure: anaesthesia and surgery; Control: patients with no emergence delirium; Outcome: risk factors; Study design: meta-analysis. Eligibility criteria: To ensure the quality of this meta-analysis, inclusion criteria was decided before we carried out the search. These criteria were: (a) Original researches that carried out in observational studies. (b)Adult patients who were extubated and recovered at PACU, operation room, or intensive care unit (ICU) after surgeries and anesthesia (including general and neuraxial anesthesia, peripheral nerve blocks and sedation). (c) Risk factors for delirium must be assessed with odds ratio (OR) with 95% confidence interval (CI). Researches must present the results of multivariate regression to be considered eligible for inclusion, since multivariate analysis results shall be used to identify variables eligible for meta-analysis. (d) Full-text available literatures.

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Boaden, Dr Bill. Syringe labelling in anaesthesia and critical care areas: review 2022. Association of Anaesthetists of Great Britain and Ireland, September 2022. http://dx.doi.org/10.21466/g.sliaacc.2022.

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This document replaces the Association of Anaesthetists’ previous guidance1 on this topic, following the publication of BS ISO 26825:2020. BS ISO 26825:2020 is the second edition of the standard for user-applied labels for syringes containing drugs used in anaesthesia. It technically revises, cancels and replaces the 2008 first edition. It gives requirements for labels attached to syringes so that the contents can be identified during anaesthesia and covers the colour, size, design and general properties of the label and the typographical characteristics of the wording for the drug name. Its purpose is solely for use in anaesthesia and as such covers a range of core drug groups. It is acknowledged that these labels may find a use in other critical care areas. The main technical reason for the revision of BS ISO 26825 was to improve the colour, size and design of the labels. Several labels were revised to take account of comments made regarding their clarity and possibility of confusion in use.

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Zhang, Wei, Yun Tang, Huan Liu, and Li ping Yuan. Risk prediction models for intensive care unit-acquired weakness in intensive care unit patients: A systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, April 2021. http://dx.doi.org/10.37766/inplasy2021.4.0010.

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Baker, Laurence, and Ciaran Phibbs. Managed Care, Technology Adoption, and Health Care: The Adoption of Neonatal Intensive Care. Cambridge, MA: National Bureau of Economic Research, September 2000. http://dx.doi.org/10.3386/w7883.

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Gao, Tingting, Yang Wang, and Hong Jiang. A Meta analysis of Hospice care in Chinese intensive care unit. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, December 2020. http://dx.doi.org/10.37766/inplasy2020.12.0007.

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Cutler, David, Mary Beth Landrum, and Kate Stewart. Intensive Medical Care and Cardiovascular Disease Disability Reductions. Cambridge, MA: National Bureau of Economic Research, May 2006. http://dx.doi.org/10.3386/w12184.

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Song, Xiu, Nan Wang, and Juan Wu. Risk factors for post intensive care syndrome: A systematic review. INPLASY - International Platform of Registered Systematic Review and Meta-analysis Protocols, May 2021. http://dx.doi.org/10.37766/inplasy2021.5.0077.

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NAPICU. National minimum standards for psychiatric intensive care in general adult services. NAPICU, 2014. http://dx.doi.org/10.20299/napicu.2017.001.

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Kuzmin, Vyacheslav, and Alexander Kulikov. Electronic training course "Anesthesia and intensive care in a multidisciplinary hospital". SIB-Expertise, December 2022. http://dx.doi.org/10.12731/er0654.15122022.

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Актуальность дополнительной профессиональной образовательной программы повышения квалификации врачей по теме" Анестезия и интенсивная терапия в многопрофильной больнице" обусловлена необходимостью совершенствования профессиональный компетенций анестезиологов-реаниматологов актульным вопросам анестезиологии и реаниматологии

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