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Publisher: Elsevier   (Total: 3048 journals)

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Showing 1 - 200 of 3048 Journals sorted alphabetically
A Practical Logic of Cognitive Systems     Full-text available via subscription   (Followers: 7)
AASRI Procedia     Open Access   (Followers: 15)
Academic Pediatrics     Hybrid Journal   (Followers: 25, SJR: 1.402, h-index: 51)
Academic Radiology     Hybrid Journal   (Followers: 22, SJR: 1.008, h-index: 75)
Accident Analysis & Prevention     Partially Free   (Followers: 86, SJR: 1.109, h-index: 94)
Accounting Forum     Hybrid Journal   (Followers: 25, SJR: 0.612, h-index: 27)
Accounting, Organizations and Society     Hybrid Journal   (Followers: 30, SJR: 2.515, h-index: 90)
Achievements in the Life Sciences     Open Access   (Followers: 4)
Acta Anaesthesiologica Taiwanica     Open Access   (Followers: 5, SJR: 0.338, h-index: 19)
Acta Astronautica     Hybrid Journal   (Followers: 360, SJR: 0.726, h-index: 43)
Acta Automatica Sinica     Full-text available via subscription   (Followers: 3)
Acta Biomaterialia     Hybrid Journal   (Followers: 25, SJR: 2.02, h-index: 104)
Acta Colombiana de Cuidado Intensivo     Full-text available via subscription   (Followers: 1)
Acta de Investigación Psicológica     Open Access   (Followers: 2)
Acta Ecologica Sinica     Open Access   (Followers: 8, SJR: 0.172, h-index: 29)
Acta Haematologica Polonica     Free   (SJR: 0.123, h-index: 8)
Acta Histochemica     Hybrid Journal   (Followers: 3, SJR: 0.604, h-index: 38)
Acta Materialia     Hybrid Journal   (Followers: 226, SJR: 3.683, h-index: 202)
Acta Mathematica Scientia     Full-text available via subscription   (Followers: 5, SJR: 0.615, h-index: 21)
Acta Mechanica Solida Sinica     Full-text available via subscription   (Followers: 9, SJR: 0.442, h-index: 21)
Acta Oecologica     Hybrid Journal   (Followers: 10, SJR: 0.915, h-index: 53)
Acta Otorrinolaringologica (English Edition)     Full-text available via subscription   (Followers: 1)
Acta Otorrinolaringológica Española     Full-text available via subscription   (Followers: 3, SJR: 0.311, h-index: 16)
Acta Pharmaceutica Sinica B     Open Access   (Followers: 1)
Acta Poética     Open Access   (Followers: 4)
Acta Psychologica     Hybrid Journal   (Followers: 24, SJR: 1.365, h-index: 73)
Acta Sociológica     Open Access  
Acta Tropica     Hybrid Journal   (Followers: 6, SJR: 1.059, h-index: 77)
Acta Urológica Portuguesa     Open Access  
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 4)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 4, SJR: 0.383, h-index: 19)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 2)
Actualites Pharmaceutiques     Full-text available via subscription   (Followers: 5, SJR: 0.141, h-index: 3)
Actualites Pharmaceutiques Hospitalieres     Full-text available via subscription   (Followers: 4, SJR: 0.112, h-index: 2)
Acupuncture and Related Therapies     Hybrid Journal   (Followers: 4)
Acute Pain     Full-text available via subscription   (Followers: 13)
Ad Hoc Networks     Hybrid Journal   (Followers: 11, SJR: 0.967, h-index: 57)
Addictive Behaviors     Hybrid Journal   (Followers: 15, SJR: 1.514, h-index: 92)
Addictive Behaviors Reports     Open Access   (Followers: 6)
Additive Manufacturing     Hybrid Journal   (Followers: 7, SJR: 1.039, h-index: 5)
Additives for Polymers     Full-text available via subscription   (Followers: 21)
Advanced Drug Delivery Reviews     Hybrid Journal   (Followers: 135, SJR: 5.2, h-index: 222)
Advanced Engineering Informatics     Hybrid Journal   (Followers: 11, SJR: 1.265, h-index: 53)
Advanced Powder Technology     Hybrid Journal   (Followers: 17, SJR: 0.739, h-index: 33)
Advances in Accounting     Hybrid Journal   (Followers: 9, SJR: 0.299, h-index: 15)
Advances in Agronomy     Full-text available via subscription   (Followers: 15, SJR: 2.071, h-index: 82)
Advances in Anesthesia     Full-text available via subscription   (Followers: 26, SJR: 0.169, h-index: 4)
Advances in Antiviral Drug Design     Full-text available via subscription   (Followers: 3)
Advances in Applied Mathematics     Full-text available via subscription   (Followers: 6, SJR: 1.054, h-index: 35)
Advances in Applied Mechanics     Full-text available via subscription   (Followers: 11, SJR: 0.801, h-index: 26)
Advances in Applied Microbiology     Full-text available via subscription   (Followers: 22, SJR: 1.286, h-index: 49)
Advances In Atomic, Molecular, and Optical Physics     Full-text available via subscription   (Followers: 16, SJR: 3.31, h-index: 42)
Advances in Biological Regulation     Hybrid Journal   (Followers: 4, SJR: 2.277, h-index: 43)
Advances in Botanical Research     Full-text available via subscription   (Followers: 3, SJR: 0.619, h-index: 48)
Advances in Cancer Research     Full-text available via subscription   (Followers: 25, SJR: 2.215, h-index: 78)
Advances in Carbohydrate Chemistry and Biochemistry     Full-text available via subscription   (Followers: 9, SJR: 0.9, h-index: 30)
Advances in Catalysis     Full-text available via subscription   (Followers: 5, SJR: 2.139, h-index: 42)
Advances in Cell Aging and Gerontology     Full-text available via subscription   (Followers: 4)
Advances in Cellular and Molecular Biology of Membranes and Organelles     Full-text available via subscription   (Followers: 12)
Advances in Chemical Engineering     Full-text available via subscription   (Followers: 27, SJR: 0.183, h-index: 23)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10, SJR: 0.665, h-index: 29)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 9, SJR: 1.268, h-index: 45)
Advances in Clinical Chemistry     Full-text available via subscription   (Followers: 29, SJR: 0.938, h-index: 33)
Advances in Colloid and Interface Science     Full-text available via subscription   (Followers: 18, SJR: 2.314, h-index: 130)
Advances in Computers     Full-text available via subscription   (Followers: 16, SJR: 0.223, h-index: 22)
Advances in Dermatology     Full-text available via subscription   (Followers: 12)
Advances in Developmental Biology     Full-text available via subscription   (Followers: 11)
Advances in Digestive Medicine     Open Access   (Followers: 6)
Advances in DNA Sequence-Specific Agents     Full-text available via subscription   (Followers: 5)
Advances in Drug Research     Full-text available via subscription   (Followers: 22)
Advances in Ecological Research     Full-text available via subscription   (Followers: 44, SJR: 3.25, h-index: 43)
Advances in Engineering Software     Hybrid Journal   (Followers: 26, SJR: 0.486, h-index: 10)
Advances in Experimental Biology     Full-text available via subscription   (Followers: 7)
Advances in Experimental Social Psychology     Full-text available via subscription   (Followers: 42, SJR: 5.465, h-index: 64)
Advances in Exploration Geophysics     Full-text available via subscription   (Followers: 3)
Advances in Fluorine Science     Full-text available via subscription   (Followers: 8)
Advances in Food and Nutrition Research     Full-text available via subscription   (Followers: 50, SJR: 0.674, h-index: 38)
Advances in Fuel Cells     Full-text available via subscription   (Followers: 16)
Advances in Genetics     Full-text available via subscription   (Followers: 15, SJR: 2.558, h-index: 54)
Advances in Genome Biology     Full-text available via subscription   (Followers: 12)
Advances in Geophysics     Full-text available via subscription   (Followers: 6, SJR: 2.325, h-index: 20)
Advances in Heat Transfer     Full-text available via subscription   (Followers: 22, SJR: 0.906, h-index: 24)
Advances in Heterocyclic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 0.497, h-index: 31)
Advances in Human Factors/Ergonomics     Full-text available via subscription   (Followers: 26)
Advances in Imaging and Electron Physics     Full-text available via subscription   (Followers: 2, SJR: 0.396, h-index: 27)
Advances in Immunology     Full-text available via subscription   (Followers: 36, SJR: 4.152, h-index: 85)
Advances in Inorganic Chemistry     Full-text available via subscription   (Followers: 9, SJR: 1.132, h-index: 42)
Advances in Insect Physiology     Full-text available via subscription   (Followers: 3, SJR: 1.274, h-index: 27)
Advances in Integrative Medicine     Hybrid Journal   (Followers: 6)
Advances in Intl. Accounting     Full-text available via subscription   (Followers: 4)
Advances in Life Course Research     Hybrid Journal   (Followers: 8, SJR: 0.764, h-index: 15)
Advances in Lipobiology     Full-text available via subscription   (Followers: 2)
Advances in Magnetic and Optical Resonance     Full-text available via subscription   (Followers: 9)
Advances in Marine Biology     Full-text available via subscription   (Followers: 16, SJR: 1.645, h-index: 45)
Advances in Mathematics     Full-text available via subscription   (Followers: 10, SJR: 3.261, h-index: 65)
Advances in Medical Sciences     Hybrid Journal   (Followers: 6, SJR: 0.489, h-index: 25)
Advances in Medicinal Chemistry     Full-text available via subscription   (Followers: 5)
Advances in Microbial Physiology     Full-text available via subscription   (Followers: 4, SJR: 1.44, h-index: 51)
Advances in Molecular and Cell Biology     Full-text available via subscription   (Followers: 22)
Advances in Molecular and Cellular Endocrinology     Full-text available via subscription   (Followers: 10)
Advances in Molecular Toxicology     Full-text available via subscription   (Followers: 8, SJR: 0.324, h-index: 8)
Advances in Nanoporous Materials     Full-text available via subscription   (Followers: 4)
Advances in Oncobiology     Full-text available via subscription   (Followers: 3)
Advances in Organ Biology     Full-text available via subscription   (Followers: 2)
Advances in Organometallic Chemistry     Full-text available via subscription   (Followers: 15, SJR: 2.885, h-index: 45)
Advances in Parallel Computing     Full-text available via subscription   (Followers: 7, SJR: 0.148, h-index: 11)
Advances in Parasitology     Full-text available via subscription   (Followers: 7, SJR: 2.37, h-index: 73)
Advances in Pediatrics     Full-text available via subscription   (Followers: 24, SJR: 0.4, h-index: 28)
Advances in Pharmaceutical Sciences     Full-text available via subscription   (Followers: 13)
Advances in Pharmacology     Full-text available via subscription   (Followers: 15, SJR: 1.718, h-index: 58)
Advances in Physical Organic Chemistry     Full-text available via subscription   (Followers: 8, SJR: 0.384, h-index: 26)
Advances in Phytomedicine     Full-text available via subscription  
Advances in Planar Lipid Bilayers and Liposomes     Full-text available via subscription   (Followers: 3, SJR: 0.248, h-index: 11)
Advances in Plant Biochemistry and Molecular Biology     Full-text available via subscription   (Followers: 8)
Advances in Plant Pathology     Full-text available via subscription   (Followers: 5)
Advances in Porous Media     Full-text available via subscription   (Followers: 4)
Advances in Protein Chemistry     Full-text available via subscription   (Followers: 17)
Advances in Protein Chemistry and Structural Biology     Full-text available via subscription   (Followers: 20, SJR: 1.5, h-index: 62)
Advances in Psychology     Full-text available via subscription   (Followers: 62)
Advances in Quantum Chemistry     Full-text available via subscription   (Followers: 5, SJR: 0.478, h-index: 32)
Advances in Radiation Oncology     Open Access  
Advances in Small Animal Medicine and Surgery     Hybrid Journal   (Followers: 2, SJR: 0.1, h-index: 2)
Advances in Space Biology and Medicine     Full-text available via subscription   (Followers: 5)
Advances in Space Research     Full-text available via subscription   (Followers: 363, SJR: 0.606, h-index: 65)
Advances in Structural Biology     Full-text available via subscription   (Followers: 8)
Advances in Surgery     Full-text available via subscription   (Followers: 7, SJR: 0.823, h-index: 27)
Advances in the Study of Behavior     Full-text available via subscription   (Followers: 30, SJR: 1.321, h-index: 56)
Advances in Veterinary Medicine     Full-text available via subscription   (Followers: 16)
Advances in Veterinary Science and Comparative Medicine     Full-text available via subscription   (Followers: 13)
Advances in Virus Research     Full-text available via subscription   (Followers: 5, SJR: 1.878, h-index: 68)
Advances in Water Resources     Hybrid Journal   (Followers: 44, SJR: 2.408, h-index: 94)
Aeolian Research     Hybrid Journal   (Followers: 5, SJR: 0.973, h-index: 22)
Aerospace Science and Technology     Hybrid Journal   (Followers: 327, SJR: 0.816, h-index: 49)
AEU - Intl. J. of Electronics and Communications     Hybrid Journal   (Followers: 8, SJR: 0.318, h-index: 36)
African J. of Emergency Medicine     Open Access   (Followers: 5, SJR: 0.344, h-index: 6)
Ageing Research Reviews     Hybrid Journal   (Followers: 8, SJR: 3.289, h-index: 78)
Aggression and Violent Behavior     Hybrid Journal   (Followers: 415, SJR: 1.385, h-index: 72)
Agri Gene     Hybrid Journal  
Agricultural and Forest Meteorology     Hybrid Journal   (Followers: 16, SJR: 2.18, h-index: 116)
Agricultural Systems     Hybrid Journal   (Followers: 30, SJR: 1.275, h-index: 74)
Agricultural Water Management     Hybrid Journal   (Followers: 40, SJR: 1.546, h-index: 79)
Agriculture and Agricultural Science Procedia     Open Access  
Agriculture and Natural Resources     Open Access   (Followers: 1)
Agriculture, Ecosystems & Environment     Hybrid Journal   (Followers: 55, SJR: 1.879, h-index: 120)
Ain Shams Engineering J.     Open Access   (Followers: 5, SJR: 0.434, h-index: 14)
Air Medical J.     Hybrid Journal   (Followers: 5, SJR: 0.234, h-index: 18)
AKCE Intl. J. of Graphs and Combinatorics     Open Access   (SJR: 0.285, h-index: 3)
Alcohol     Hybrid Journal   (Followers: 11, SJR: 0.922, h-index: 66)
Alcoholism and Drug Addiction     Open Access   (Followers: 8)
Alergologia Polska : Polish J. of Allergology     Full-text available via subscription   (Followers: 1)
Alexandria Engineering J.     Open Access   (Followers: 1, SJR: 0.436, h-index: 12)
Alexandria J. of Medicine     Open Access   (Followers: 1)
Algal Research     Partially Free   (Followers: 8, SJR: 2.05, h-index: 20)
Alkaloids: Chemical and Biological Perspectives     Full-text available via subscription   (Followers: 3)
Allergologia et Immunopathologia     Full-text available via subscription   (Followers: 1, SJR: 0.46, h-index: 29)
Allergology Intl.     Open Access   (Followers: 4, SJR: 0.776, h-index: 35)
Alpha Omegan     Full-text available via subscription   (SJR: 0.121, h-index: 9)
ALTER - European J. of Disability Research / Revue Européenne de Recherche sur le Handicap     Full-text available via subscription   (Followers: 9, SJR: 0.158, h-index: 9)
Alzheimer's & Dementia     Hybrid Journal   (Followers: 46, SJR: 4.289, h-index: 64)
Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring     Open Access   (Followers: 4)
Alzheimer's & Dementia: Translational Research & Clinical Interventions     Open Access   (Followers: 4)
Ambulatory Pediatrics     Hybrid Journal   (Followers: 5)
American Heart J.     Hybrid Journal   (Followers: 48, SJR: 3.157, h-index: 153)
American J. of Cardiology     Hybrid Journal   (Followers: 47, SJR: 2.063, h-index: 186)
American J. of Emergency Medicine     Hybrid Journal   (Followers: 40, SJR: 0.574, h-index: 65)
American J. of Geriatric Pharmacotherapy     Full-text available via subscription   (Followers: 9, SJR: 1.091, h-index: 45)
American J. of Geriatric Psychiatry     Hybrid Journal   (Followers: 14, SJR: 1.653, h-index: 93)
American J. of Human Genetics     Hybrid Journal   (Followers: 32, SJR: 8.769, h-index: 256)
American J. of Infection Control     Hybrid Journal   (Followers: 26, SJR: 1.259, h-index: 81)
American J. of Kidney Diseases     Hybrid Journal   (Followers: 32, SJR: 2.313, h-index: 172)
American J. of Medicine     Hybrid Journal   (Followers: 46, SJR: 2.023, h-index: 189)
American J. of Medicine Supplements     Full-text available via subscription   (Followers: 3)
American J. of Obstetrics and Gynecology     Hybrid Journal   (Followers: 200, SJR: 2.255, h-index: 171)
American J. of Ophthalmology     Hybrid Journal   (Followers: 59, SJR: 2.803, h-index: 148)
American J. of Ophthalmology Case Reports     Open Access   (Followers: 6)
American J. of Orthodontics and Dentofacial Orthopedics     Full-text available via subscription   (Followers: 6, SJR: 1.249, h-index: 88)
American J. of Otolaryngology     Hybrid Journal   (Followers: 25, SJR: 0.59, h-index: 45)
American J. of Pathology     Hybrid Journal   (Followers: 26, SJR: 2.653, h-index: 228)
American J. of Preventive Medicine     Hybrid Journal   (Followers: 24, SJR: 2.764, h-index: 154)
American J. of Surgery     Hybrid Journal   (Followers: 35, SJR: 1.286, h-index: 125)
American J. of the Medical Sciences     Hybrid Journal   (Followers: 12, SJR: 0.653, h-index: 70)
Ampersand : An Intl. J. of General and Applied Linguistics     Open Access   (Followers: 5)
Anaerobe     Hybrid Journal   (Followers: 4, SJR: 1.066, h-index: 51)
Anaesthesia & Intensive Care Medicine     Full-text available via subscription   (Followers: 58, SJR: 0.124, h-index: 9)
Anaesthesia Critical Care & Pain Medicine     Full-text available via subscription   (Followers: 12)
Anales de Cirugia Vascular     Full-text available via subscription  
Anales de Pediatría     Full-text available via subscription   (Followers: 2, SJR: 0.209, h-index: 27)
Anales de Pediatría (English Edition)     Full-text available via subscription  
Anales de Pediatría Continuada     Full-text available via subscription   (SJR: 0.104, h-index: 3)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 4, SJR: 2.577, h-index: 7)
Analytica Chimica Acta     Hybrid Journal   (Followers: 37, SJR: 1.548, h-index: 152)
Analytical Biochemistry     Hybrid Journal   (Followers: 167, SJR: 0.725, h-index: 154)
Analytical Chemistry Research     Open Access   (Followers: 8, SJR: 0.18, h-index: 2)
Analytical Spectroscopy Library     Full-text available via subscription   (Followers: 12)
Anesthésie & Réanimation     Full-text available via subscription   (Followers: 1)
Anesthesiology Clinics     Full-text available via subscription   (Followers: 23, SJR: 0.421, h-index: 40)
Angiología     Full-text available via subscription   (SJR: 0.124, h-index: 9)
Angiologia e Cirurgia Vascular     Open Access  
Animal Behaviour     Hybrid Journal   (Followers: 170, SJR: 1.907, h-index: 126)

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Journal Cover Anaesthesia & Intensive Care Medicine
  [SJR: 0.124]   [H-I: 9]   [58 followers]  Follow
    
   Full-text available via subscription Subscription journal
   ISSN (Print) 1472-0299
   Published by Elsevier Homepage  [3048 journals]
  • Self-assessment
    • Authors: Vijayanand Nadella
      First page: 161
      Abstract: Publication date: Available online 27 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Vijayanand Nadella


      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.01.001
      Issue No: Vol. 18, No. 3 (2017)
       
  • Respiratory system: applied pharmacology
    • Authors: Jonathan Brand; Joseph E. Arrowsmith
      Abstract: Publication date: Available online 15 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Jonathan Brand, Joseph E. Arrowsmith
      Knowledge and application of respiratory pharmacology is essential for both anaesthetists and intensive care physicians. Patients often present with co-existing respiratory disease for which they may be taking prescription medications. Respiratory function is often altered by anaesthetic drugs and interventions, therefore an in-depth understanding of respiratory pathophysiology and pharmacology is required in order to safely treat these patients. This article describes the basics of the bronchial tone, the ability of the lung to handle and metabolize drugs in addition to discussion of the drugs that can be used to alter bronchial tone and pulmonary vascular resistance.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.001
       
  • Basic principles of lasers
    • Authors: Daniel Haley; Oliver Pratt
      Abstract: Publication date: Available online 15 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Daniel Haley, Oliver Pratt
      The theoretical basis for laser was first described by Einstein, 100 years ago. Lasers are now in widespread use and have an extensive range of applications, including many within the field of medicine. This article explores the properties of laser; its physical principles; and the main components required to produce a laser beam. The specific properties of laser render it an extremely useful clinical tool in a variety of circumstances. The application of laser also brings potential hazards, which are discussed, along with the safety measures utilised to minimize the associated risk.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.10.001
       
  • Measurement of gas concentrations
    • Authors: Alastair Duncan; Oliver W. Pratt
      Abstract: Publication date: Available online 14 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Alastair Duncan, Oliver W. Pratt
      Gas analysis is one of the minimum standards of monitoring for any patient undergoing anaesthetic intervention. Side stream analysers are commonly employed to allow for measurement of gas concentrations. The systems used to measure oxygen (O2) concentration include the paramagnetic analyser, the Clark electrode and the fuel cell. Infrared absorption spectroscopy is used to measure carbon dioxide (CO2), nitrous oxide (N2O), and volatile anaesthetic agents in gaseous form. Refractometry, piezoelectric absorption, Raman scattering, and mass spectrometry may also be used. The Severinghaus electrode is used to measure CO2 concentration in solution. This article will provide an overview of the techniques used for gas analysis and their associated potential sources of error.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.011
       
  • Common errors in clinical measurement
    • Authors: Ming Wilson
      Abstract: Publication date: Available online 14 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Ming Wilson
      In modern anaesthetic practice, the use of progressively sophisticated measuring devices increases the possibility of erroneous measurements. This can potentially result in misguided decision-making and patient harm. Anaesthetists must be aware of the limitations of these devices and their sources of error. This article will discuss the errors associated with equipment used in daily anaesthetic practice including capnography, electrocardiography, invasive and non-invasive blood pressure, and pulse oximetry.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.008
       
  • Tests of pulmonary function before thoracic surgery
    • Authors: Neil G. Britton; Matthew Stagg
      Abstract: Publication date: Available online 14 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Neil G. Britton, Matthew Stagg
      Respiratory function declines following surgery due to atelectasis. After thoracic surgery, there is an even greater decline due to resection and lung handling. Patients undergoing thoracic surgery often have concomitant respiratory disease and testing pulmonary function pre-operatively allows: diagnosis and optimization of lung disease; counselling of patients accurately to obtain truly informed consent and guide the multidisciplinary team to the best operation. Tests of pulmonary function can be divided into tests of mechanical function, tests of parenchymal function, tests of cardiorespiratory reserve and function, and anatomical tests. When these tests are combined with knowledge of the lobes resected they allow predicted postoperative values to be calculated. Evidence-based guidelines show which investigations should be performed preoperatively and risk-stratify patients for postoperative dyspnoea, morbidity and mortality.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.003
       
  • Measurement of pulse oximetry, capnography and pH
    • Authors: Andrew J. Deacon; Oliver W. Pratt
      Abstract: Publication date: Available online 11 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Andrew J. Deacon, Oliver W. Pratt
      The measurement of arterial oxygen saturations, end-tidal carbon dioxide and pH are all key to modern anaesthetic practice. They can all be measured in a variety of ways but with the most common being discussed in the article. The understanding of the underlying physical principles and how the anaesthetist monitors function to measure these variables is discussed in this article, including limitations and inaccuracies of each technique.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.004
       
  • Respiration: ventilation
    • Authors: James Cameron; Upma Misra
      Abstract: Publication date: Available online 11 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): James Cameron, Upma Misra
      Ventilation is the process by which air moves into and out of the lungs and is made available for gas exchange. Weibel's description divided the lungs into a conductive zone and a respiratory zone of 23 generations of dichotomously branching airways. Gas flow within the proximal airways is in the form of bulk movement and via diffusion in the distal airways. Resistance to gas flow in the airways is determined by a number of factors. Airway radius is the most important factor influencing resistance and gas flow changes from being turbulent proximally to laminar distally. Inspiration is an active process. The diaphragm is the main muscle of inspiration. Expiration is normally a passive process during quiet breathing but requires energy expenditure during certain actions (e.g. coughing). Ventilation is not evenly distributed throughout the lungs and distribution is related to the compliance of alveoli in different areas. Under normal circumstances, in the standing position, basal alveoli are the most compliant and are therefore preferentially ventilated. Ventilation occurs automatically in a continuous rhythmic pattern without conscious effort. It is controlled by neural and chemical inputs and is concerned with the homeostasis of oxygen and carbon dioxide and acid–base balance.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.012
       
  • Fibreoptic bronchoscopic positioning of double-lumen tubes
    • Authors: Karen A. Foley; Peter Slinger
      Abstract: Publication date: Available online 11 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Karen A. Foley, Peter Slinger
      Double-lumen tubes (DLTs) should be placed using a fibreoptic bronchoscope. This allows correct positioning of the bronchial lumen in the chosen mainstem bronchus. It also ensures that the blue bronchial cuff does not obstruct the side to be ventilated when it is inflated under direct vision. Fibreoptic bronchoscopy facilitates correct positioning of the ventilatory side slot of a right DLT over the right upper lobe bronchus. The anaesthetist must know the fibreoptic tracheo-bronchial anatomy to properly position left- and right-sided DLTs and should always reconfirm the position of a DLT with fibreoptic bronchoscopy after repositioning the patient. Maintaining orientation (anterior-posterior) during fibreoptic bronchoscopy is crucial to positioning a DLT, particularly after the patient has been turned to the lateral position. A fibreoptic bronchoscope can also be used as a guide to direct a DLT under direct vision into its correct position.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.005
       
  • Fluid balance
    • Authors: Emrys Kirkman; Peter Tryphonopoulos; Christopher Harle
      Abstract: Publication date: Available online 11 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Emrys Kirkman, Peter Tryphonopoulos, Christopher Harle
      The primary function of the lung is gas exchange between alveolar gas and the blood flowing through the nearby capillaries. This stage of gas exchange takes place by diffusion. Because gases such as oxygen diffuse relatively slowly through liquids it is essential that the fluid barrier is kept as short as possible. Furthermore, it is vital that interstitial fluid does not escape into the alveoli because this would abolish gas exchange in the flooded alveoli and lead to shunt. The net movement of these fluids is largely determined by the Starling forces. A number of physiological mechanisms normally ensure that fluid that does leave the pulmonary microvasculature is quickly removed and hence gas transfer is not impaired. The lungs, in addition, perform a number of other important non-respiratory functions, including modification of circulating levels of a range of biologically active materials, filtration of blood and serving as a reservoir of blood for rapid adjustment of input to the left atrium when needed.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.013
       
  • Airway apparatus for thoracic surgery
    • Authors: K. George Lee
      Abstract: Publication date: Available online 11 November 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): K. George Lee
      One-lung anaesthesia is becoming mandatory for thoracic operations; knowledge of the required apparatus is essential for anaesthetists. Developed in the 1950s from non-anaesthetic apparatus, the double-lumen endobronchial tube (DLT) remains the most widely used piece of equipment in this field. The early rubber tubes are giving way to modern plastic, but the principle and function of the DLT remains unchanged. The introduction of robust fine flexible bronchoscopes (FB) has improved the positioning of tubes, and also stimulated the reintroduction of bronchus blockers. Miniature video cameras have recently been incorporated into both tracheal tubes and flexible bronchoscopes, improving visualization of the lower airway during anaesthesia. This article outlines the development and use of the currently available DLTs and bronchus-blockers. It concludes with comparison of the two methods of lung isolation.

      PubDate: 2017-11-18T11:35:05Z
      DOI: 10.1016/j.mpaic.2017.09.007
       
  • Transporting critically ill children
    • Authors: Peter-Marc Fortune; Kate Parkins; Stephen Playfor
      Abstract: Publication date: Available online 10 October 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Peter-Marc Fortune, Kate Parkins, Stephen Playfor
      Increasing centralization of paediatric intensive care services and a reduction in the numbers of children cared for in adult intensive care units over the last 15–20 years has led to an increase in the numbers of critically ill children being transferred between clinical centres throughout the UK. Seventy-seven per cent of these retrievals are conducted by a specialist paediatric intensive care unit (PICU) team, the remainder by various other teams (with and without specialist intensive care experience). Various pressures made it increasingly difficult for PICUs to facilitate the timely retrieval of critically ill children whilst maintaining the provision of quality care to children already under their supervision. This situation has led to the development of regional, stand-alone transport teams throughout the UK. A typical example of such a team is the North West & North Wales Paediatric Transport Service (NWTS). This team uses the structured approach ‘ACCEPT’, advocated by the Advanced Life Support Group, Neonatal, Adult and Paediatric Safe Transfer and Retrieval (NAPSTaR) course. This acronym summarizes the key components of transfer: Assessment, Control, Communication, Evaluation, Preparation/Packaging, Transportation and places the evaluation, planning and execution of these elements in context by considering the defining features of transport medicine summarized as ‘SCRUMP’: Shared assessment, Clinical isolation, Resource limitations, Unfamiliar equipment, Movement and Safety and Physiology. Regional transport teams have improved patient outcomes and experiences when compared to previous models of service delivery. The approach used by these services may be adopted by all teams providing intra- and inter-hospital transfer of the sick or injured child.

      PubDate: 2017-10-13T18:08:52Z
      DOI: 10.1016/j.mpaic.2017.08.002
       
  • Transfusion guidelines in children: I
    • Authors: Helen Jones; Katherine Reeve
      Abstract: Publication date: Available online 4 October 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Katherine Reeve, Helen Jones
      The transfusion of a blood product to a child is associated with a greater risk of harm when compared to an adult. Transfusion is necessary in certain situations and so the benefits have to be balanced against potential adverse events. This article will present information concerning blood transfusion thresholds in children, calculations for maximal tolerated blood loss and the concept of massive transfusion protocols.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.004
       
  • Special considerations in paediatric intensive care
    • Authors: Cheryl E. Peters; Alexander F. Pitfield; Norbert R. Froese
      Abstract: Publication date: Available online 29 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Cheryl E. Peters, Alexander F. Pitfield, Norbert R. Froese
      The modern-day paediatric intensive care unit (PICU) is staffed and equipped to provide care to the most critically ill children. It is by definition a low-volume, high-cost service. High staff-to-patient ratios are required both because of the potentially rapid evolution of critical illness in children and because of the complexity of the supportive therapy offered. Children are admitted to the PICU with a wide variety of medical illnesses and following diverse surgical procedures. Treatment strategies are complex. Although definitive evidence for specific paediatric therapies is often limited, international collaborative efforts have produced consensus treatment guidelines that serve to promote the use of best practice therapies. This article reviews critical therapies and techniques that define care in the PICU, and outlines the management of acute lung injury, traumatic brain injury and septic shock. Neonatal and cardiac intensive care medicine topics are outside the scope of this article.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.007
       
  • Trauma and burns in children
    • Authors: Mairi Crawford; Jon G. McCormack
      Abstract: Publication date: Available online 28 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Mairi Crawford, Jon G. McCormack
      Trauma is the leading cause of death and disability in children, most often resulting from blunt trauma. An immediate co-ordinated and pathology-focussed resuscitation will contribute to improved morbidity and mortality outcomes. This article discusses the principles of the primary and secondary survey in injured children and outlines the management of children suffering from burns. A multi-professional approach to the treatment of critically injured children should be adopted; where the primary survey aims to identify and manage catastrophic haemorrhage followed by management of life-threatening injuries to airway, breathing and circulation. The secondary survey includes a detailed examination to identify and manage other subtle or less severe injuries. Attention to fluid therapy, analgesia, thermoregulation, blood coagulation and glucose homeostasis form important aspects of this secondary survey. Children injured in fires may have suffered from smoke inhalation or sustained burns to the upper airway, with rapid swelling of mucosal tissue, which can make immediate control of the airway very challenging. Both flame burns and scalds can cause significant fluid losses and are associated with a significant risk of mortality.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.006
       
  • Aetiology and outcome of paediatric cardiopulmonary arrest
    • Authors: Helen Jones; Sally L. Wilmshurst; Cameron Graydon
      Abstract: Publication date: Available online 28 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Helen Jones, Sally L. Wilmshurst, Cameron Graydon
      Paediatric cardiopulmonary arrest is an uncommon event in the general population but is not infrequent in the paediatric hospital setting. This article looks at the causes of arrests in children, the likely outcomes, and the ways in which this can be improved.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.003
       
  • Principles of pressure transducer function and sources of error in
           clinical use
    • Authors: Thomas E.F. Walton; Ming Wilson
      Abstract: Publication date: Available online 28 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Thomas E.F. Walton, Ming Wilson
      The invasive measurement of physiological pressures is a common requirement in anaesthesia and intensive care medicine. From arterial blood pressure to intracranial pressure, these calculated variables give a swift graphical and numerical representation of a patient's current physiological status. This allows us to respond rapidly to conditions outside our preferred parameters and to carefully titrate treatments to target effects. These systems are, however, not infallible. An understanding of the principles of their function will promote appropriate use and an ability to recognize and react to sources of error. This article aims to furnish the reader with this level of understanding in order to inform their academic and clinical practice.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.010
       
  • Transfusion guidelines in children: II
    • Authors: Helen Jones; Katherine Reeve
      Abstract: Publication date: Available online 28 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Helen Jones, Katherine Reeve
      The appropriate avoidance of the use of blood products can reduce the incidence of adverse events. This article presents ways of achieving this goal and introduces the process of the safe administration of blood products where indicated.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.004
       
  • Intraosseous cannulation in children
    • Authors: Victoria J. Bewick
      Abstract: Publication date: Available online 25 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Victoria J. Bewick
      In an emergency situation when intravenous (IV) access cannot be rapidly achieved, the intraosseous (IO) route is recommended in order to infuse medications and fluids. Specifically designed needles make this technique quick, easy and reliable. This article describes the anatomy and physiology relevant to IO cannula insertion as well as indications and contraindications for IO use. The variety of devices and the techniques for their use in the paediatric population are discussed.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.002
       
  • Ethics in clinical trials
    • Authors: Kirsteen A. Jones; Michael Semple
      Abstract: Publication date: Available online 25 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Kirsteen A. Jones, Michael Semple
      Although one of the first pieces of legislation to address ethical issues in clinical trials was drawn up following the findings from the Nuremberg Trials, only in the most recent clinical research have the principles of beneficence, non-maleficence, autonomy and justice been considered and informed consent plays a major role. In the UK, the National Research Ethics Service and the Medicines and Healthcare Products Regulatory Agency require compliance with Good Clinical Practice. Patients are unlikely to participate in, or clinicians consent their patients to, trials where they do not feel safe or protected – data and safety monitoring assess for loss of clinical equipoise thus ensuring the most efficacious treatment is always available. Honesty and trust are crucial and place an obligation on investigators to disseminate even less favourable trial results, with the ultimate aim being partnerships between patients, their families, and those delivering the research which are mutually beneficial and respectful.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.005
       
  • Fluid and electrolyte balance in children
    • Authors: Mark Terris; Peter Crean
      Abstract: Publication date: Available online 25 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Mark Terris, Peter Crean
      Safe intravenous fluid prescription in children requires an understanding of certain basic principles to avoid adverse events. Careful consideration needs to be given to both the appropriate rate and composition of the fluids to be administered with frequent re-assessment. In this review we examine the indications for parenteral fluid management; specifically maintenance fluid requirements, correction of any fluid deficit and replacement of ongoing losses. The role of non-osmotic secretion of anti-diuretic hormone (ADH) is discussed and children at particular risk are identified. We review complications associated with intravenous fluid therapy, in particular hyponatraemic encephalopathy and discuss the management of this medical emergency. Other electrolyte abnormalities that may arise are highlighted. Fluid management in children with diabetic ketoacidosis is also reviewed.

      PubDate: 2017-10-08T17:18:53Z
      DOI: 10.1016/j.mpaic.2017.07.009
       
  • Self-assessment
    • Authors: Viyayanand Nadella
      Abstract: Publication date: Available online 9 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Viyayanand Nadella


      PubDate: 2017-09-11T13:44:17Z
      DOI: 10.1016/j.mpaic.2017.08.001
       
  • Pharmacological control of blood sugar
    • Authors: Sudesna Chatterjee; Melanie J. Davies; Giridhar Tarigopula
      Abstract: Publication date: Available online 6 September 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Sudesna Chatterjee, Melanie J. Davies, Giridhar Tarigopula
      Diabetes is a chronic and progressive metabolic disorder characterized by hyperglycaemia. The two main types of diabetes are type 1 diabetes (T1DM) where there is complete lack of insulin and type 2 diabetes (T2DM) which may be due to a combination of insulin resistance and relative insulin deficiency due to impaired β-cell function. Good control of blood glucose near physiological limits is vital to reduce long-term microvascular and macrovascular complications of diabetes. Insulin replacement is a life-saving measure in individuals with T1DM whereas the mainstay of therapy in T2DM includes oral agents, non-insulin injectables (incretin mimetics) and insulin. In T2DM, the incretin mimetics and sodium glucose co-transporter 2 inhibitors have revolutionized recent treatment options by reducing blood glucose, promoting weight loss and improving β-cell function with improved cardiovascular outcomes associated with some of these agents. Despite the availability of several drugs to treat this chronic debilitating condition, the management of hyperglycaemia remains challenging. The role of diet, lifestyle changes and patient education is of paramount importance and should be pursued aggressively. This review will look at drugs currently used to optimize blood glucose control and briefly discuss the role of newer therapeutic agents.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.017
       
  • Starvation, exercise and the stress response
    • Authors: Christopher Naisbitt; Susie Davies
      Abstract: Publication date: Available online 18 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Christopher Naisbitt, Susie Davies
      Starvation, exercise and the stress response have a physiological impact on the body. Many patients are malnourished, have impaired exercise tolerance or undergo the stress response. We describe how the body adapts to decreased nutrient supply, increased energy demands and to stress.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.020
       
  • Thyroid disease and thyroid surgery
    • Authors: Zoe Parry; Ross Macnab
      Abstract: Publication date: Available online 18 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Zoe Parry, Ross Macnab
      Thyroid disease remains very common. Knowledge of the implications of these diseases is essential for all anaesthetists as these patients are frequently encountered and may be at risk of complications at any stage, preoperatively, intraoperatively or postoperatively. This article focuses on disorders of thyroid function and their management, thyroid malignancy, surgery of the thyroid gland and the perioperative anaesthetic management of patients undergoing thyroidectomy.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.015
       
  • Thyroid, parathyroid hormones and calcium homeostasis
    • Authors: Rebecca Summers; Ross Macnab
      Abstract: Publication date: Available online 18 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Rebecca Summers, Ross Macnab
      The thyroid gland secretes thyroxine (T4) and triiodothyronine (T3) in response to thyroid-stimulating hormone release from the anterior pituitary gland. Iodine is essential for the synthesis of thyroid hormones. T4 and T3 increase the basal metabolic rate, heat production, and help to maintain normal growth and development. Serum calcium levels are under very tight control. The majority of calcium is found in bones. Calcium and phosphate levels are maintained by four hormones – parathyroid hormone (PTH), calcitonin, vitamin D and fibroblast growth factor 23. PTH is produced by the parathyroid glands and its secretion is determined by serum calcium levels.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.023
       
  • Recognition and management of phaeochromocytoma and paraganglioma
    • Authors: Henry Wang; Chandran Jepegnanam
      Abstract: Publication date: Available online 17 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Henry Wang, Chandran Jepegnanam
      Phaeochromocytomas and paragangliomas (PPGL) are catecholamine-secreting neuroendocrine tumours arising from the chromaffin cells in the adrenal medulla. These tumours may be identified incidentally, as part of a work-up for multiple endocrine neoplasia or following haemodynamic surges during unrelated procedures. Advances in perioperative management and improved management of intraoperative haemodynamic instability have significantly reduced surgical mortality from around 40% to less than 3%. Surgery is the definitive treatment in most cases and laparoscopic resection where possible is associated with improved outcomes. Anaesthetic management of PPGL cases represents a unique haemodynamic challenge both before and after tumour resection. In this article we describe the physiology of these tumours, their diagnosis, preoperative optimization methods, intraoperative anaesthetic management and management of postoperative complications.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.022
       
  • Anaesthetic management of diabetes
    • Authors: Michael McGinlay; Swamy Mruthunjaya
      Abstract: Publication date: Available online 16 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Michael McGinlay, Swamy Mruthunjaya
      Diabetes is a complex, chronic metabolic disorder affecting approximately 8.5% of the adult population with the number of people living with diabetes worldwide having almost quadrupled since 1980. This increase has largely been attributed to global urbanization and lifestyle changes. Diabetes affects 10–15% of the surgical population. These patients are now frequently elderly, have complex medical co-morbidities and present for both high-risk elective and emergency surgery. This multisystem disease poses a significant challenge to both anaesthesia and surgery with diabetic patients demonstrating higher morbidity and mortality rates compared to their non-diabetic counterparts. As the management of diabetes becomes more complex, it is vital that the anaesthetist, as a member of the multidisciplinary team, remains up-to-date and plays a key role in patient optimization and perioperative glycaemic control. It is crucial that good glycaemic control is maintained throughout the perioperative period as this has been shown to correlate with positive patient outcomes. Patients themselves are well experienced in managing their own diabetes and should be involved in doing so whenever possible.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.016
       
  • Clinical aspects of endocrinology: parathyroid and adrenal gland disorders
    • Authors: Ahmad Moetamin; Kailash Bhatia
      Abstract: Publication date: Available online 16 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Ahmad Moetamin, Kailash Bhatia
      The parathyroid glands are responsible for calcium homoeostasis, which is necessary for appropriate functioning of the musculoskeletal and nervous systems. Parathyroid adenoma remains the most common indication for surgery. Anaesthetic considerations for parathyroid surgery include good hydration, appropriate positioning, monitoring renal function along with serum electrolytes. The adrenal cortex is mainly responsible for secretion of mineralocorticoids, glucocorticoids, and androgens whereas the medulla consists of pre-ganglionic sympathetic ganglion, which secretes epinephrine, nor-epinephrine and dopamine. Adrenocortical disease results in disturbance of water balance, electrolytes, cardiovascular instability and metabolic disturbances. Correction of water, electrolyte imbalance, blood pressure control with invasive monitoring, appropriate positioning, analgesia with appropriate hormone replacement therapy form the key principles of the anaesthetic management.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.011
       
  • Homeostasis in dynamic self-regulatory physiological systems
    • Authors: Niroshini Nirmalan; Mahesh Nirmalan
      Abstract: Publication date: Available online 16 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Niroshini Nirmalan, Mahesh Nirmalan
      Understanding the general principles of homeostasis and its regulation in health and disease is key to managing patients in intensive care units and operating theatres. In these environments, it is crucial to realize that physiological control is a dynamic process aimed at achieving a balance between two opposing sets of factors. Whereas one set of factors (e.g. the sympathetic nervous system) attempt to increase a physiological variable of interest at any given time, opposing forces acting almost concurrently, (e.g. the parasympathetic nervous system) will result in the reduction in the value of this variable. The human body is a self-adapting system and as a result of its ability to adapt, new physiological ‘steady states’ will be reached and maintained even in diseases. This review will explore some of the concepts and pathways involved in the regulation of homeostasis in the immediate, intermediate and delayed time scales following an initial perturbation, emphasizing the dynamic nature of this regulation.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.018
       
  • Adrenocortical hormones
    • Authors: Ahmed Osman; Rhys Clayton
      Abstract: Publication date: Available online 16 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Ahmed Osman, Rhys Clayton
      Adrenal glands are vital endocrine glands located above the kidneys bilaterally. They play a major rule in sodium and potassium balance. They regulate blood pressure and consequently tissue perfusion both directly, through vasopressor effect of renin–aldosterone–angiotensin system, and indirectly, through the effect on sodium balance. Glucocorticoids play a major rule in regulation of metabolism which affects almost all body tissues. Glucocorticoid release is regulated via the hypothalamic–pituitary–adrenal axis.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.014
       
  • The pancreas
    • Authors: Jennifer Cade; James Hanison
      Abstract: Publication date: Available online 16 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Jennifer E. Cade, James Hanison
      The pancreas plays a vital role in coordinating and regulating digestion and nutrient metabolism, and does so via endocrine and exocrine processes. Insulin and glucagon are produced within the endocrine pancreas to not only achieve glucose homeostasis, but regulate protein and fat metabolism. Enzymes and zymogens are secreted in alkaline pancreatic fluid to aid digestive function. This article looks at how the pancreas achieves such precise synthetic and secretory functions, and reviews the physiology of the secreted hormones and enzymes.

      PubDate: 2017-09-06T13:05:19Z
       
  • Hormonal control of metabolism: regulation of plasma glucose
    • Authors: Niroshini Nirmalan; Mahesh Nirmalan
      Abstract: Publication date: Available online 15 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Niroshini Nirmalan, Mahesh Nirmalan
      Blood glucose concentrations are required to be maintained within a narrow therapeutic range in order to ensure the normal functioning of the body. This is accomplished through a complex, interactive, finely coordinated neuro-endocrine regulatory process. Hormonal control through the opposing actions of insulin and glucagon secreted by the islet cells of the pancreas serve as the primary response mechanism to avert post-prandial hyperglycaemia and fasting hypoglycaemia. In addition to this basic response, a range of endocrine mediators concurrently intervene, to enable the fine modulation of the process through a range of insulin-dependent and insulin-independent processes, which ultimately achieve glycaemic control by influencing tissue glucose uptake, glycolysis, glycogenesis, glycogenolysis and gluconeogenesis. More recent evidence supports a central, predominantly hypothalamic role initiated through nutrient (glucose, fatty acid) and hormonal (insulin, leptin, glucagon-like peptide-1) stimuli that influences glucose regulation by direct or indirect effects on skeletal muscle glucose uptake, islet cell insulin/glucagon secretion and hepatic glucose production.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.019
       
  • Anaesthesia for obesity surgery
    • Authors: Rhys Clayton; Mahmoud Alkholany
      Abstract: Publication date: Available online 14 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Rhys Clayton, Mahmoud Alkholany
      The aim of this article is highlight the anaesthetic management of patients undergoing bariatric (weight loss) surgery. There are different types of commonly performed procedures each of which requires careful perioperative and postoperative management. Those principles can successfully be extrapolated to obese patients undergoing non-obesity surgery.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.013
       
  • Anaesthesia in the obese patient
    • Authors: Graham Nelson; Rhys Clayton
      Abstract: Publication date: Available online 14 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Graham Nelson, Rhys Clayton
      Obesity is an increasing problem and its burden on healthcare resources is well documented. This article gives an overview of the physiological and pharmacological considerations when anaesthetizing the obese patient. It will look at key aspects of assessing obese patients, and planning and delivering a safe anaesthetic to them. Special areas of focus include correct drug dosing, as well as equipment, monitoring and environmental aspects involved in delivering the anaesthetic.

      PubDate: 2017-09-06T13:05:19Z
      DOI: 10.1016/j.mpaic.2017.06.012
       
  • General anaesthesia for dentistry
    • Authors: Susan Hutchinson
      Abstract: Publication date: Available online 2 August 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Susan Hutchinson
      Dental anaesthesia developed down a different pathway from the rest of anaesthesia. Techniques such as nasal mask anaesthesia in the sitting position were specific to dental surgery, which took place largely outside hospital in dental clinics. Now dental anaesthesia is confined to locations within the aegis of a hospital and anaesthetic techniques are similar to those in other surgical specialities. Dental surgery consists of extractions and conservation. Short procedures for the extraction of teeth may still be carried out in children using a nasal mask, but more difficult extractions in adults and children, or conservation procedures are best done with a laryngeal mask or endotracheal tube. Close liaison with the dental surgeon is imperative in the planning of the anaesthetic technique. The downward pressure applied to the mandible during the extraction of teeth may cause reduction in airway patency unless intubated, and the anaesthetist may need to support the jaw and head in order to provide counter-pressure, also preventing excessive movement of the neck. Patients needing general anaesthesia include children, those with allergy to local anaesthetics, and adults with special needs, as well as those adults who are likely to need surgical extractions with removal of alveolar bone. During the recovery phase, the airway has to be watched carefully as the potential for obstruction is increased due to stimulation and soiling of the larynx with bleeding. Paracetamol and non-steroidal analgesics are the mainstay of analgesia in combination with local anaesthetic infiltration and specific dental blocks. In addition, stronger analgesics such as tramadol may be required in adults who are having multiple extractions. It should be an aim to provide all dental surgery in a day case setting, and careful choice of the technique should make this possible for all but those with unstable cardiorespiratory disease.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.007
       
  • Anaesthesia for maxillofacial surgery
    • Authors: Luay Kersan; Urmila Ratnasabapathy
      Abstract: Publication date: Available online 29 July 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Luay Kersan, Urmila Ratnasabapathy
      Airway management is central to anaesthesia for maxillofacial surgery. Not only is there a shared airway to contend with, difficult airways are frequently encountered. The main pathologies that present for surgery include trauma, infection, cancer and craniofacial deformities. All of these may present an airway challenge in either elective or emergency settings but a similar approach to the airway can be used in all these scenarios. Other surgical procedures include dental extractions, temporomandibular joint (TMJ) arthrocentesis, salivary gland surgery and facial aesthetic surgery. It is vital that clear airway management plans including rescue plans are made at the outset. These must be communicated to the surgical and anaesthetic team in advance. Trauma is excluded as it will be covered in a separate review article.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.010
       
  • Flexible fibreoptic intubation
    • Authors: Vera Sokolova; Dmitrijs Sokolovs
      Abstract: Publication date: Available online 27 July 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Vera Sokolova, Dmitrijs Sokolovs
      Flexible fibreoptic intubation offers options of airway control in awake and asleep patients, in cases with limited or absent mouth opening and complex anatomy. It may be used as a first choice or a rescue technique. Despite its limitations, for example in situations with significant airway blood or secretions, and airway obstruction, it is a valuable core skill for every anaesthetist.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.009
       
  • Sedation for dental and other procedures
    • Authors: Ruth L. Mawhinney; Alan Hope
      Abstract: Publication date: Available online 27 July 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Ruth L. Mawhinney, Alan Hope
      Conscious sedation is an anaesthetic technique which helps patients tolerate dental and other procedures. Safe sedation requires attention to patient selection, the clinical environment, appropriate intraoperative and recovery monitoring, sedation technique, and postoperative management. Various drugs can be used either singly or in combination. Low doses of short-acting anaesthetic agents allow fine control of sedation and a greater chance of success. Where anaesthetic agents are used, inadvertent overdosage is a risk, and these drugs must be administered by an anaesthetist. Entonox and oral and intravenous benzodiazepines can be safely administered by appropriately trained practitioners. Key definitions include ‘sedation’ and ‘conscious sedation’.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.008
       
  • Dental damage in anaesthesia
    • Authors: Aravind Basavaraju; Kate Slade
      Abstract: Publication date: Available online 26 July 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Aravind Basavaraju, Kate Slade
      Dental trauma is a frequently reported complication related to the administration of general anaesthesia and is the most common source of litigation against anaesthetists. General anaesthesia involving direct laryngoscopy, a difficult airway, pre-existing poor dentition and prosthetic dental restoration are major risk factors for dental trauma. Central maxillary incisors are the most frequently damaged teeth. It is good practice to perform a preoperative oral examination, document the findings and communicate the risk of dental trauma to the patient. In the event of dental damage appropriate timely management will minimize dental morbidity.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.002
       
  • Identification of the difficult airway
    • Authors: Sumit Gajree; Kevin J. O'Hare
      Abstract: Publication date: Available online 26 July 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Sumit Gajree, Kevin J. O'Hare
      Failure to identify a difficult airway can have serious consequences. It is essential that a thorough assessment of a patient's airway is made, including history and a focussed examination. It is known that the reliability of preoperative assessment is disappointing but positive findings will allow for an appropriate airway management plan to be devised in order to minimize airway-related complications. Despite this, situations will still occur where an unexpected difficult airway is encountered.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.004
       
  • Anaesthesia for facial trauma
    • Authors: Cristina Niciu; Val Cunningham; Kevin Fitzpatrick
      Abstract: Publication date: Available online 26 July 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Cristina Niciu, Val Cunningham, Kevin Fitzpatrick
      Facial trauma is common and can produce both physical and psychological problems for patients. Managing patients in both the emergency setting and elective theatre environment can be extremely challenging, so airway interventions should be carefully planned so the safest and most effective technique can be chosen. This may mean that direct laryngoscopy may not be the safest or most straightforward option and awake fibreoptic intubation, videolaryngoscopy, submental intubation or awake tracheostomy may be a better choice in a given set of circumstances. An understanding of common mechanisms of injury and pathologies and the likely difficulties that will be present are essential. Senior anaesthetic input and effective teamwork are required to provide excellent levels of care for these patients.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.003
       
  • Pharmacokinetic analysis
    • Authors: William J.D. Whiteley; Jonathan G. Hardman
      Abstract: Publication date: Available online 25 July 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): William J.D. Whiteley, Jonathan G. Hardman
      Pharmacokinetic analysis is an experimentally determined theory of how a drug behaves when in vivo. Volume of distribution, clearance and terminal half-life are defined. Compartmental modelling is introduced and some relevant graphs are described in this article. Applications of this theory in anaesthesia are considered.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.006
       
  • Modes of drug elimination and bioactive metabolites
    • Authors: Shruti Chillistone; Jonathan G. Hardman
      Abstract: Publication date: Available online 25 July 2017
      Source:Anaesthesia & Intensive Care Medicine
      Author(s): Shruti Chillistone, Jonathan G. Hardman
      Drug elimination is the removal of active drug from the body. Metabolism takes place largely in the liver and produces water-soluble metabolites which can be excreted in the bile or urine. Metabolism may also produce active or toxic metabolites or a pharmacologically active drug from an inactive prodrug. Most volatile anaesthetics are excreted unchanged via the lungs. Drug elimination can be affected by factors such as first-pass metabolism, genetic variants and various disease processes. Knowledge of these processes will allow better prediction of pharmacokinetics in practice.

      PubDate: 2017-08-08T21:39:16Z
      DOI: 10.1016/j.mpaic.2017.06.005
       
 
 
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