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Biomedical subjects

A T Dewhurst

Publications and source records attributed to A T Dewhurst.

3 recordsLinked to original sources
PubMed2002

Pharmacological agents as cerebral protectants during deep hypothermic circulatory arrest in adult thoracic aortic surgery. A survey of current practice.

A postal survey was sent to members of the Association of Cardiothoracic Anaesthetists to ascertain current practice in the use of pharmacological agents as cerebral protectants during deep hypothermic circulatory arrest. The response rate was 60%. Eighty-three per cent of respondents used some form of pharmacological agent specifically for cerebral protection. Fifty-nine per cent of respondents used thiopental, 29% used propofol and 48% used a variety of other agents, the most common of these being a steroid. There were variations in the dose and timing of administration of drugs. Few respondents believed that there was a body of evidence to support this use of pharmacological agents. Only 35% of respondents believed there to be sufficient evidence to support the use of thiopental. Similarly, only 11% of respondents believe that there is evidence supporting the use of propofol, and 16% the use of steroids. The above findings demonstrate that it would not be possible to create a "best practice" set of guidelines at present. A national database of all cases of adult thoracic surgery involving deep hypothermic cardiac arrest, with methodology and outcome, could probably establish such guidelines, evidence based.

Adult↗
PubMed2001

Medical repatriation via fixed-wing air ambulance: a review of patient characteristics and adverse events.

Anaesthetists are often employed as medical escorts for patients undergoing international transfer by air ambulance. There is little published data on the types of patients being transferred and on the incidence of adverse events. We performed a retrospective review of the documentation of all air ambulance transfers performed by a single company over a 2-year period followed by a prospective assessment of all high-risk patients transferred over a 1-year period. Of 483 transfers identified, 47% were defined as high-risk and 20% were of patients receiving mechanical ventilation. In the prospective group, 28% of patients required pretransfer optimisation, 7% required a major therapeutic intervention during transfer and there was a major adverse event in 12% of transfers. There were two deaths during transport. These data support the recommendation that escorting personnel should be from an appropriate speciality, have reasonable seniority and be adequately trained and supervised.

Adolescent↗